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Flashcards in Knee 1 Deck (32)
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1

knee pain lifetime prevelence

45%

2

Red flags for lower extremity injuries

-Ottawa ankle rules
-Ottawa knee rules
-dislocation of tibiofemoral jt
-legg calves perth, slipped capital, congenital dysplasia

3

Ottawa knee rules

1. >55
2. knee flex <90
3. Tenderness patella/fib head
4. inability to walk 4 steps

4

What forces does the med and lat meniscus withstand

med- compressive
lat- torsional forces

5

What part of the menisci are typically pain generators an what lig can be a pain generator

post parts of menisci more vulnerable to injury
coronary lig (attach menisci to post tin plates) is innervated and can be pain generator

6

2 biomechanics knee movements

rocking- first 15-18
gliding- 15-135

7

What is the screwhome mechanism of the knee when non weight bearing and weight bearing

non- upon ext of knee, tibia rotates ext relative to femur

weight- upon ext of knee, femur rots int relative to tib

8

How do the menisci move during flexion

move post during flexion of knee

9

Ratio of med to lat menisci injuries

5:1

10

What injuries are the lat meniscus more associated with

Discoid meniscus
meniscal cyst

11

MOI for meniscal injury (3)

compression
torsional
combo of compression/torsional force

12

What type of meniscus tear causes inability to fully extend especially during walking

Bucket handle tear

13

Symptoms of meniscal injury

-hx of trauma (knee twisting)
-severe pain acutely
-pain localized to jt line (mc)

14

Signs of meniscal injury

-effusion (capsular)
-Decreased ROM (flex/ext- ext lag)
-may not be able to fully weight bear

15

What combo of tests should be used for meniscus injury

Mcmurrays, JLT and apleys

16

what is the gold standard imaging for meniscal lesions

mri

17

what is the prognosis of partial and total meniscectomy

partial- good prognosis

total- increased incedence of oa

18

mc and 2nd mc moi for acl injury in contact sports

1. clipping- valgus loaf and ext rot of tibia

2. Hyperextension

19

3 common moi for acl injury in non contact sport

1. skiing injury (digging tip)- ext rot + valgus

2. deceleration injury- ant force on prox tibia due to quad contraction

3. hyperextension

20

symptoms of ACL tear and what does 75% of cases show

-loud snap/pop
-immediate onset of pain (or no pain?)
-75% of cases w hemarthrosis

21

signs of ACL tear

-unable to weight bear
-large knee effusion
-decreased ROM
-ACL tests +

22

what is the 3 degrees of ACL tear

grade I- ant translation of tibia up to 5mm
grade II- ant translation of tibia up to 5-1cm
grade III- ant translation >1cm

23

conservative tx of grade 1/2 acl tears

-rest/ice
-pain modalities
-ultrasound
-mobs
-bracing
3-6 weeks active rehab

24

prognoisis of acl rehab (time line as well)

-good to fair
-5-8 months if they require surgery

25

What gender is more susceptible to acl injuries and what are the intrinsic reasons for it

intrinsic- Smaller intercondylar notches, loose jointedness, effect of horomones on ligamentous tissue (no apparent relation between q angle and ACL injury)

26

Cyclops lesion and sign for it

complication of acl reconstruction
-rounded fibrous mass sitting in the ant intercondylar notch

sign- may have extension lag

27

What is a segond fx and what is it associated w

avulsion fx of the knee which involves the lat aspect of tibial plateau

(associated w ant cruciate lig disruption)

28

MOi, hx, signsof PCL tear

moi- post force on prox tibia

vague symptoms but often present with patellofemoral symptoms

MILD swelling, nearly full rom

29

Non operative vs operative PCL

non- treatment success 85% for grade 1/2

opperative- early PCL reconstruction surgeries yield best results

30

What do you need to rule out in mcl/lcl lesions

xray to rule out fx and pellegrini sited lesion

31

All 3 grades of mcl injury require what type of treatment

non operative**
(rice, knee brace, electrotherapy, rom ex, strengthening, closed chain ex)

32

treatment of LCL injuries

grade 1/2- non operative (rice, knee brace, ex etc)

Grade 3- Operative