Knee Interventions

Question 1

General rehab goals

Answer 1

Restore function
ROM
Minimize swelling
Return to WB
Strength
Break up adhesions

Question 2

From CPG: best evidence supports…

Answer 2

Neuromuscular re-education & E-stim: improve muscle integrity.

Question 3

Exercise should initially be focused on

Answer 3

isometrics

Question 4

ACL graft weakest at ___ weeks post-op

Answer 4

6

Question 5

What is the purpose of bracing post-op ACL

Answer 5

Quads aren’t kicking it right away, buckling, risk of re-injury.

Question 6

ACL: How do we determine when a pt is ready to remove brace?

Answer 6

SLR without extension lag (usually 4 wks)

Question 7

ACL: Why is achieving full extension important?

Answer 7

Maximizes ability for quad recruitment.
Need it for gait!

Question 8

ACL: avoid what movements early on?

Answer 8

Squats >60 - bc ACL most taut.
Terminal ext - bc tibia slides anterior, ACL taut.

Question 9

ACL: if BPTB graft, ___ more easily recruited than ___

Answer 9

Hams easier than quads

Question 10

T/F: if hamstring ACL graft, longer period of limited hamstring use compared to quad limitations with BPTB

Answer 10

TRUE

Question 11

PCL: avoid what movements early on?

Answer 11

Squats >60
Open chain hamstring exercise

Question 12

ACL: ROM goal (include time)

Answer 12

90-110 flex and full ext by 4-6 weeks

Question 13

ACL: common problems that may occur post-op

Answer 13

Patellar tendonitis
Meniscal tears
Opposite knee ACL injury

Question 14

Rehab brace

Answer 14

Allows us to set motion to whatever the limits of the protocol are

Question 15

Functional brace

Answer 15

Provide stability
Control unwanted motion

Question 16

Prophylactic brace

Answer 16

Used in sports
Prevent injury, decrease severity if injury occurs, allows motion requirements for sport but limits unwanted motion

Question 17

Unloader brace

Answer 17

For OA
Unloads one compartment

Question 18

Meniscectomy: rehab goals

Answer 18

Control swelling
ROM
Strength
Function

Question 19

Meniscus repair: rehab goals & precautions

Answer 19

Protect the repair!
Initially: brace locked at 0 ext, slowly progress flex.
WB precautions: usually first 4wks.

Question 20

Osgood-Schlatter: rehab goals

Answer 20

Stretch
Hold off on quad strengthening while everything is still tight

Question 21

Patellar Tendinopathy: rehab treatments

Answer 21

Address MOI if known
Patellar tdn strap
Rest
Stretch
Friction massage
Platelet-rich plasma (re-inject platelets)

Question 22

Fat Pad Syndrome: treatment options

Answer 22

Address inflammation
Corticosteroids
Surgical removal

Question 23

Plica: rehab treatments

Answer 23

Modalities (ice)
Friction massage

Question 24

ITB Friction Syndrome: rehab goals

Answer 24

ITB itself doesn’t have much flexibility.
Address biomechanics.

Question 25

PFPS: treatment options

Answer 25

Exercise - specific parameters depend on cause/MOI.
Closed-chain good - eccentrically load quads.
Taping, bracing, foot orthoses

Question 26

PFPS: taping can be used as treatment or…

Answer 26

to diagnose

Question 27

Research suggests _____ may be beneficial for PFPS

Answer 27

Lumbar manipulations