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MSK > Knee > Flashcards

Knee Flashcards

1
Q

common way to tear ACL

A

sudden twist or wrench of tibfib joint

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2
Q

this injury stretches the ligament which causes micro tears in the ligament. no significant affect

A

grade 1 (mild) ACL

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3
Q

Grade 2 ACL?

A

partially torn and there is some mild-to-moderate instability (or periodic giving out) (moderate)

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4
Q

grade 3 ACL tear

A

severe
the ligament is torn completely or separated at its end from the bone and the knee is more unstable

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5
Q

T or F: most ACL injuries occur without contact and after a jump

A

true

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6
Q

What are intrinsic factors that are related to ACL tears

A
  • Joint laxity
  • larger Q angles
  • a narrow intercondyler notch
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7
Q

what is an extrinsic factor for an ACL tear

A

muscle strength
- the hamstring (agonist)
- quads (antagonist)w

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8
Q

what is the most common age group for ACL tear

A
  • 14-29 and high degree of athletic activity
    (females are 2-9x more likely)
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9
Q

what is the function of the ACL

A

restraint to anterior translation of the tibia on the femur

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10
Q

what population has a 100-fold increase in ACL incidence than the general population

A

college football players

(females are however more susceptible)

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11
Q

aggravating activities for ACL tear

A
  • walking
  • up/down stairs
  • return to sport
  • direction change, cutting, pivot, jumpe
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12
Q

easing activities for ACL tear

A
  • elevation
  • anti-inflam
  • ice
    -rest
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13
Q

what are 3 surgical options for ACL tears

A
  • reconstruction (bone autographs/hamstring tendon grafts/allografts)
  • surgical reconstruction (autograft/patellar tendon/quad tendon/ hammy tendon/ medial head of gastroc)
  • allograft (Achilles/ patellar/quad/hamstring)
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14
Q

what are surgical indicators for ACL tear?

A
  • desire to return to sport
  • abnormal laxity
  • associated injuries
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15
Q

what factors do you need to consider for ACL rehab when the patient undergoes surgery

A
  • graft maturation and ligamentation
  • autographs are strong at implantation and undergo implantation
    -collagen forms 1-2 years after surgery
  • never the same as the old
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16
Q

what are the stages of ligamentation

A

1- necrosis 1-3 wks
2- revascularization 6-8 wks
3- cellular prolif 8+ wks
- collagen formation and remodeling and maturation 8+ wks

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17
Q

what are the goals of rehab in the acute inflammatory phase and how long does this last?

A

0-14 days

maintain ROM and decrease inflammation

Interventions: meds, modalities, flexibility, HEP (ROM and stretch and RICE)

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18
Q

describe phase 2 of ACL rehab

A

15-21 days

goals: restore ROM and achieve full extension ROM. also min swelling

interventions: meds, modalities, myofascial release, LE flexibility, HEP (walk and gainz)

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19
Q

when should you progress to phase 3 of ACL rehab

A

22-60 days post injury and when there is pain free ROM and no functional lims.

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20
Q

what are the goals of phase 3 ACL tear rehab

A

-increase agility
- progress to return to sports
- address contributing factors

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21
Q

describe when to progress to phase 4 rehab and when should your progress?

A

60-360 days post injury
progress when there are no functional limitations

goals: correction of contributing factors and retaining muscle injuries

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22
Q

grade 1 MCL tear

A

micro tears, stretched, no significant affect

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23
Q

grade 2 MCL tear

A

moderate; partially torn, mild-mod instability (period of giving out)

24
Q

grade 3 MCL tear

A

severe; ligament is torn completely or separated at its end from the bone and knee is more unstable

25
Q

what is the most common of all ligament injuries

A

MCL sprain

26
Q

what other structures is the MCL commonly injured with

A
  • ACL
  • medial meniscus

most commonly torn at the femoral attachment

27
Q

contributing factors to MCL tear

A
  • RA, lupus, joint laxity
  • long term corticosteroids
  • sports team
28
Q

what does the MCL do

A

resists valgus stress and ER of the tibia

29
Q

MOI for a MCL tear

A
  • direct valgus blow
  • noncontact or indirect injury observed with deceleration cutting and pivoting
  • overuse (swim)
30
Q

The MCL is __________________ and so commonly they will brace for ________ to prevent ___________ stresses to the knee for __________ weeks.

A

well vascularized
72 hours
excess valgus stress
6 weeks

31
Q

what is the typical heal time for a grade 1 or 2 MCL injury? grade 3?

A

11- 20 days
6 mo to a yr

32
Q

patients are fitted with braces near full ______ for the first 3-4 weeks and at 5-6 weeks it will be replaced with a __________ and it kept until 6 weeks post op.

A

extension
hinge brace

33
Q

Phase I of MCL rehab (0-14 days post injury )

A

maintain ROM
protect the joint and lig
decrease inflam

34
Q

phase 2 of MCL rehab (day 15-21)

A

restore ROM
protect full extension ROM
minimize swellingp

35
Q

phase 3 MCL rehab 22-60 days

A

progress when there is pain-free ROM and no functional limitations

increase agility
progress to return to sport
address contributing factors

36
Q

phase 4 of MCL rehab day 60-360

A

progress when there are no functional lim

correction the contributing factors
retain muscle activity

37
Q

a sudden or violent twist of tibiofemoral or tibiofibular joint can result in the

A

LCL tearing

38
Q

grade 1 lcl strain

A

stretches the lig
micro tears

39
Q

grade 2 lcl strain

A

partially torn
mild-moderate instability and periodic giving out

40
Q

grade 3 lcl strain

A

severe
torn completely
knee unstable

41
Q

what stress causes a lcl strain

A

varus

42
Q

what is the least common of all knee ligament injuries

A

LCL sprain

43
Q

what are related injuries to the LCL sprain

A

peroneal nerve
posterolateral capsule damage
PCL damage

44
Q

why are LCL strains less common

A

because knee adduction, flexion, and ER of the femur on the tibia is not common

45
Q

after a LCL repair there is minimal to no WB for ___ weeks and could be restricted for up to ___ weeks.

A

6
12

46
Q

what is a tear or degeneration of the semilunar, fibrous piece of cartilage located in the knee joint that is diagnosed arthroscopically or by MRI

A

meniscus tear

47
Q

who is commonly getting a degenerative meniscus tear

A

65 + (60% of them)

48
Q

who is getting an acute, traumatic, meniscal tear?

A

young active or athletic individuals

49
Q

what is a vertical tear with displacement of the inner margin, most often associated with an ACL tear and common to the medial side of knee

A

bucket-handle tear

50
Q

what is most often found in the medial aspect of the lateral meniscus and may be associated with an ACL tear and results from trauma in young active individuals

A

radial tear

51
Q

what are degenerative and often found in older patients with OA in the knee

A

horizontal tears

52
Q

what usually involves the posterior portion of the meniscus, the most common type of tear, and is typically associated with an ACL tear

A

longitudinal meniscus tear

53
Q

what is a displaced flap that is a secondary result from a radial, bucket-handle, or horizontal tear

A

flap tear

54
Q

what is a full thickness tear that runs obliquely from the inner edge of the meniscus out into the body of the meniscus

A

oblique tear

55
Q

T or F: meniscus tear have a referral pattern

A

F

56
Q

what is an easing activity of a meniscus tear

A

NWB

57
Q
A

MSK (19 decks)

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