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MSK 2 (F22) > Knee Pathology - Muscle, Cartilage, Bone, Other > Flashcards

Knee Pathology - Muscle, Cartilage, Bone, Other Flashcards

1
Q

Grade 1 Muscle Strain

A

Pain: none or mild
ROM deficit: mild

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2
Q

Grade 2 Muscle Strain

A

Pain: moderate
ROM deficit: moderate

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3
Q

Grade 3 Muscle Strain

A

Pain: none or severe
ROM deficit: severe
Maybe palpable defect

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4
Q

T/F: Quad strains are less common, and typically Grade 1-2

A

True

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5
Q

Hamstring strain MOIs (2)

A
  1. High speed running, eccentric contraction in swing phase (often Biceps Femoris).
  2. Hip flex + knee ext (often SemiMembranosus).
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6
Q

Hamstring strain (running MOI) presentation

A

SLR deficit
Knee flex strength deficit

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7
Q

Hamstring strain (hip flex/knee ext MOI) presentation

A

Painful area closer to ischial tuberosity

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8
Q

Hamstring strain - factors associated with longer recovery time

A

Proximal injury, closer to ischial tub.
Increased length/area of injury.

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9
Q

T/F: a second hamstring injury usually is not as bad as the first

A

FALSE!
2nd usually worse

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10
Q

What type of exercise is good for preventing recurrent hamstring strains?

A

Eccentric

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11
Q

Meniscus injury usually occurs along with what other injury?

A

ACL

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12
Q

Meniscus injury: acute/traumatic MOI

A

Weight-loaded + rotation (pivoting & cutting)

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13
Q

Menscus injury: degenerative MOI

A

long-term loading

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14
Q

Medial Menscus injury: MOI

A

Valgus, tibial ER

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15
Q

Lateral Menscus injury: MOI

A

Varus, tibial IR

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16
Q

Most common type of tear with acute/traumatic menscus injury

A

Vertical

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17
Q

Most common types of tears with degenerative menscus injury (3)

A

Horizontal
Complex
Maceration

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18
Q

Meniscus injury: what are the 3 types of surgeries? Considerations for each type?

A
  1. Meniscectomy: ideally want to avoid, increases risk of OA.
  2. Repair: preferred approach, preserves meniscus.
  3. Transplant: typically for younger/athletes with extensive damage & want to avoid meniscectomy.
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19
Q

What part of the meniscus has the greatest blood supply?

A

Outer 3rd

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20
Q

Articular Cartilage Defect (ACD): risk factors (3)

A
  1. Hx of knee injury/surgery
  2. High BMI
  3. Sports - jumping, pivoting, cutting
21
Q

Articular Cartilage Defect (ACD): insidious MOI

A

prior hx of knee injury/surgery

22
Q

Articular Cartilage Defect (ACD): traumatic MOI

A

Fall on knee
Severe ACL or MCL injury

23
Q

Articular Cartilage Defect (ACD): clinical presentation

A

Hemarthrosis if acute/traumatic.
Agg = repetitive impact.

24
Q

Articular Cartilage Defect (ACD): palliative surgical options

A

Debridement/Chondroplasty - not trying to fix anything, just remove the bad junk. Either to manage pain or prepare for ACI procedure.

25
Q

Articular Cartilage Defect (ACD): repair surgery - what is it & why is it not the best option?

A

Microfracture - make the bone bleed, it clots, stem cells develop into cartilage.
Not durable - develops into fibrocartilage instead of articular. Fibrocartilage is weaker and will break down over time.

26
Q

Articular Cartilage Defect (ACD): restorative surgery options (3)

A

Implantation (ACI)
Autograft (OATS)
Allograft (OCA)

27
Q

Implantation (ACI) procedure for ACD

A

implant pt’s own chondrocytes, develops into hyaline cartilage.
Good for filling large defects, BUT hyaline weak.

28
Q

Autograft (OATS) procedure for ACD

A

implant pt’s own cartilage, a bunch of tiny plugs.
BUT graft never fully fills in, holes remain.

29
Q

Allograft (OCA) procedure for ACD

A

fills hole with 1 big plug, BUT body may reject (just like any transplant surgery)

30
Q

Post-op ACD procedure: WB restrictions for patellofemoral

A

NWB in extension

31
Q

Post-op ACD procedure: WB restrictions for tibiofemoral

A

Avoid WB in 30-70 (example: we could do knee extensions to 20)

32
Q

Osgood-Schlatter: what is it?

A

apophysitis of tibial tuberosity

33
Q

Osgood-Schlatter: MOI

A

repetitive loading

34
Q

Osgood-Schlatter: clinical presentation

A

Tenderness at tibial tubercle.
Pain with quad resistance.
Agg = squatting.
Tightness in quads, hams, gastroc.

35
Q

T/F: after Osgood-Schlatter, it is best to hold off on return to sport until it resolves completely

A

FALSE - pain can continue for years, regardless of activity

36
Q

Osteochondritis Dessicans: what is it?

A

bone-cartilage unit detaches (often lateral aspect of medial condyle)

37
Q

Osteochondritis Dessicans: MOI

A

repetitive microtrauma

38
Q

Osteochondritis Dessicans: when is fixation indicated as a treatment option?

A

if only 1 piece detached

39
Q

Patellofemoral Instability: what is it?

A

recurrent sublux or dislocation of patella out of trochlear groove

40
Q

Patellofemoral Instability: risk factors (5)

A
  1. Dysplastic trochlea
  2. Patella alta
  3. Tight lateral retinaculum
  4. Insufficient medial stabilizers (medial PF ligament, VMO)
  5. Abnormal Q-angle
41
Q

Patellofemoral Instability: MOI

A

forceful quad contraction

42
Q

Patellofemoral Instability: rehab treatment

A

Taping
Strength
Movement patterns

43
Q

Patellofemoral Instability: surgical options & indications (4)

A
  1. Medial PF Ligament Reconstruction - if torn.
  2. Lateral Retinacular Release - if due to tight retinaculum.
  3. Trochleoplasty - to fix shape of groove if dysplastic trochlea.
  4. Medialization of Tibial Tuberosity - changes the line of pull of quad on patella.
44
Q

Fat Pad Syndrome: what is it?

A

Inflamed infra-patellar fat pad

45
Q

Fat Pad Syndrome: MOIs

A

Direct trauma
OA
Effusion

46
Q

Fat Pad Syndrome: presentation

A

Tenderness of patellar tendon in extension.
Pain with quad activation.
Hypertrophy of fat pad (maybe).

47
Q

Plica Syndrome: presentation

A

Gradual onset.
Intermittent pain (often medial condyle)
Catching.
Clicking/popping with flex/ext.
Reflex inhib.
Agg = flexion.

48
Q

ITB Friction Syndrome: presentation

A

Gradual onset (hip or knee pain).
May be d/t training errors (example increasing running mileage suddenly).

49
Q

T/F: stretching the ITB helps to lengthen it

A

FALSE - focus on strengthening & stretching the surrounding muscles instead.

MSK 2 (F22) (17 decks)

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