2a-c] Knee Part 1 + ACL Flashcards
Laxity is a
Sign
Instability is a
Symptom
Ligament strength
MCL > PCL > ACL > LCL
MOI for ACL
Non-contact Deceleration with twist Valgus collapse IR or IR+hyperextension Cutting maneuver- unhappy triad
Signs and Sx for ACL
Acute hemarthrosis
“Pop” with effusion
Can’t continue playing
Special tests for ACL
Lachman
Anterior drawer
Macintosh lateral pivot shift
Which lig is twice as strong as ACL?
PCL
MOI for PCL
Flex knee with PF
Hyperextension (ACL goes first)
Posterior rotation force
Valgus/varus rotation (collateral goes first)
Physical exam for PCL
Swollen knee, tender calf, loss of tibial plateau prominence
Special tests for PCL
Posterior drawer
Godfrey “sag” sign
MOI for MCL injury
Valgus force (0-90)
Signs and symptoms for MCL
Local swelling
Tender
Pain with valgus stress
What sign does MCL injury NOT have
It doesnt have hemiarthrosis
Why is there no hemiarthrosis in MCL?
MCL is extraarticular
Special tests for MCL
Valgus stress tests
Signs and symptoms for MCL injury
Usually walk with flexed knee
Tender at tibial insertion
Tender at adductor tubercle
Swelling
MOI for LCL
Varus force; usually associated with ACL or PCL
Signs and Sx of LCL injury
Local swelling
Tender
Pain with varus stress
NO hemiarthrosis (extraarticular)
Special tests for LCL
Varus stress test
ACL rehab: NM training, aggressive quad strengthening
Pre-operative
ACL rehab: BPTB or hamstring autograft or soft tissue allograft
Surgical intervention
ACL rehab: ACLR rehab guidelines
Post operative
Days 1-7 for ACL rehab
Control swelling
Full active knee extension (patellar mobility)
Quad strength
Gait training
Exercises according to article
NMES with knees in 60 flex. Wall squat with more bend and weight on impaired knee. Prone hang Single leg balance Single leg cone pick up