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MSK 2 (F22) > Knee Pathology - Tendons & Ligaments > Flashcards

Knee Pathology - Tendons & Ligaments Flashcards

1
Q

Tendinopathy

A

general term, pain + loss of function.
no specifc structures required for Dx.

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2
Q

Tendinosis

A

microtears
visible on imaging

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3
Q

Tendinitis

A

inflammation

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4
Q

Jumper’s Knee definition & MOI

A

Patellar Tendinopathy (most common) or Quad Tendinopathy
MOI = Overuse

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5
Q

Patellar Tendon Rupture is common in what population?

A

Younger, usually sports-related MOI

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6
Q

Quad Tendon Rupture is common in what population?

A

Age 45+

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7
Q

Tendon Ruptures MOI

A

High tensile force on weak tendon.
Sudden quad contraction on flexed knee.

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8
Q

Patellar Tendinopathy clinical presentation

A

Pain at inferior patella
Gradual onset
Load dependent (agg = higher load/activity)

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9
Q

Quad Tendinopathy clinical presentation

A

Pain at superior patella
Gradual onset
Load dependent (agg = higher load/activity)

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10
Q

Tendon Ruptures clinical presentation

A

Unable to extend
Palpable gap
Acute onset

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11
Q

Grade 1 Ligament Sprain

A

A few fibers torn
Integrity maintained
Pain with stretch

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12
Q

Grade 2 Ligament Sprain

A

50% fibers torn
Partial integrity lost
Pain with stretch

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13
Q

Grade 3 Ligament Sprain

A

Complete rupture
No pain to ligament (may have pain if surrounding structures affected).
Excessive joint play

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14
Q

The ligament that most commonly gets fully ruptured is the ___

A

ACL

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15
Q

ACL Rupture MOI (non-contact)

A

Quad contract w/o ham co-contract in near-full extension.
Dynamic Valgus position.

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16
Q

ACL Rupture MOI (contact)

A

Lateral contact = valgus torque

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17
Q

Dynamic Valgus position

A

Hip ADD & IR
Knee ABD

18
Q

Common presentation if ACL detaches near insertion

A

Hemarthrosis (bleeding in the joint)

19
Q

ACL Injury: indications for rehab (no surgery) as first tx approach

A

Dynamic stability (potential Coper)

20
Q

Coper Classification tests

A

6-min hop
Knee Outcome Survey
Global Rating Score
Number of give-way episodes

21
Q

A potential Coper meets threshold on ___ criteria

A

All 4

22
Q

A non-Coper fails ____ criteria

A

1 or more

23
Q

ACL Injury: indications for surgery

A

Persistant instability (non-Coper)

24
Q

ACL Injury: types of reconstruction surgeries

A

Autograft (bone-patellar tendon-bone or quad tendon graft).
Allograft (from donor).

25
Q

ACL Injury: repair surgery

A

BEAR implant: Bridge-Enhanced ACL Repair.
Creates bridge btwn ligament ends, promotes natural healing.
Maintains mechanoreceptors.

26
Q

ACL Injury: criteria for return to sport

A

9 months to reduce risk of re-injury.
Criteria:
1. No pain or effusion
2. Quad strength 90% symmetry btwn injured and non-injured.
3. SL hop test 90% symmetry
4. Good movement patterns and symmetric loading

27
Q

ACL Injury: open-chain knee extensions post-op is a controversial topic. What is the argument for doing this exercise with NO restrictions?

A

Quad strength is critical! Open-chain trains quads for functional movement. Closed-chain often leads to compensations. OKC Ext more accurate than MMT for monitoring progress.

28
Q

ACL Injury: open-chain knee extensions post-op is a controversial topic. What is the argument for RESTRICTING this exercise early? Rebuttals?

A

Concern for loosening graft due to strain on ACL - BUT walking & closed-chain also strain ACL!
Concern for patellar tendinopathy (if BPTB graft) - BUT this is how we treat pat tdnopathy anyway!

29
Q

PCL Injury: common MOIs (3)

A
  1. Posterior-directed force on proximal tibia (common in car accidents, knee hits dash).
  2. Falling on flexed knee.
  3. Sudden, violent hyperextension.
30
Q

PCL Injury: indication for conservative management

A

PCL isolated, no other structures affected

31
Q

PCL Injury: indication for reconstruction

A

Grade 3
Lots of instability

32
Q

MCL Injury: MOI

A

Valgus stress on planted leg (lat to med force), contact injury

33
Q

MCL Injury: non-operative tx

A

Grade 1: treat pain and swelling, brace for pain.
Grade 2/3: treat instability, medial immobilization.
Early WB to work quads!

34
Q

Why does the MCL have the best prognosis for recovery without surgery?

A

Blood supply!

35
Q

LCL Injury: MOI

A

Varus stress on planted leg (med to lat force), contact injury

36
Q

What commonly occurs with an LCL injury?

A

Avulsion at femur or fib head

37
Q

Posterolateral Corner (PLC) Injury: what structures involved (3)?

A

LCL
Popliteus Tendon
Poplito-fibular Ligament

38
Q

Posterolateral Corner (PLC) Injury: isolated MOI

A

Post/Lat force to tibia (hyperext + varus), contact injury

39
Q

Posterolateral Corner (PLC) Injury: combined MOI (3)

A
  1. Hyperext, ER, varus
  2. Knee dislocation
  3. Posteror force on flexed knee & ER tibia.
40
Q

Posterolateral Corner (PLC) Injury: often occurs in combination with what other injuries?

A

ACL or PCL

41
Q

3 most common concomitant injuries

A
  1. ACL + MCL
  2. ACL + MCL + Med Meniscus (Unhappy Triad)
  3. PLC + ACL or PCL

MSK 2 (F22) (17 decks)

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