Knee

Question 1

Special Tests: MCL Injury

Answer 1

Valgus stress test

Question 2

Special Tests: LCL injury

Answer 2

Varus stress test

Question 3

Special Tests: ACL injury

Answer 3

• Lachman: MOST SENSITIVE
• Anterior Drawer
• Pivot Shift Test: Valgus + IROT + Extend → Hold forces while flexing knee

Question 4

Special Tests: PCL

Answer 4

• Posterior Drawer
• Thumb Sign: Tibia rest posterior and area to place thumbs on tibial plateau decreases
  
  • Normal tibial plateau is 1 cm anterior to femoral condyles
• Posterior Sag Sign

Question 5

Special Tests: Meniscus Injury

Answer 5

• McMurray:
  
  • Foot EROT: Medial meniscus
  • Foot IROT: Lateral meniscus
• Apley compression/grind test: Apley distraction tests rotational instability w/ ACL injury
• Bounce home test
• Thessaly
  
  • Single leg stand @ 5 degrees
  • Single leg stand @ 20 dedress
• Childress/Duck Walk
• Eges Test:
  
  • Medial: Knees 30-40 cm apart + Heels point together (Max hip EROT) + Squat 90 degrees then up
  • Lateral: Knees 10-25 cm apart + Toes point together (Max hip IROT) + Squat 90 degrees then up
  • Anterior: Early in squat
  • Posterior: Late in squat

Question 6

Special Tests: Patellofemoral pain syndrome

Answer 6

• Patellar grind test
• J-sing
• Medial Glide Test
  
  • <1 quadrant= Lateral tight
  • >3 quadrant=Hypermobility
• Patellar Tilt test

Question 7

Special Tests: Patellar instability

Answer 7

Patellar apprehension test

Question 8

Q angle

Answer 8

ASIS to Patella

Tibial tuberosity to patella

Question 9

Risks of increased Q angles

Answer 9

Patellar subluxation

Patellofemoral syndrome

Question 10

Causes of increased q angle

Answer 10

• Femoral anteversion
• Tibial external torsion
• Tight lateral retinaculum
• Pes planus
• Weak hip adductors

Question 11

Bursa of the knee (6)

Question 12

Functional knee ROM

Answer 12

Walking:

• Flexion: 65 degrees

Stairs:

• Flexion: 90 degrees

Stand from Sitting:

• Flexion: 110 degrees

Question 13

Special Test: Valgus Stress Test

Answer 13

MCL: Knee flexed 25-30 degrees + Full Extension

• Increased laxity w/ knee in full extension usually indicates other ligament are injured as well

Question 14

Most sensitive test for ACL

Answer 14

Lachman

Question 15

Positive test for McMurray

Answer 15

Pain + Clicking

Question 16

Positive test for bounce home test

Answer 16

Pain reproduced

Knee does not fully extend

Question 17

Most common cause of knee pain in OP setting

Answer 17

Petellofemoral pain syndrome

Question 18

Signs for patellofemoral pain syndrome

Answer 18

• Theater Sign: increased knee pain and stiffness after prolonged sitting
• Circle Sign: Difficulty localizing area making circle around anterior knee w/ finger