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Ortho > Knee > Flashcards

Knee Flashcards

1
Q

Patellofemoral joint reaction force is influenced by two things

A

Quadriceps force & knee angle

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2
Q

During knee flexion and extension, the patella is pulled superiorly by ___________ and inferiorly by ____________

A

Quadriceps tendon / patellar tendon

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3
Q

Combination of quadriceps tendon and patellar tendon pulls produces __________ of patella on femur, it varies with knee flexion.

A

Posterior compressive force

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4
Q

In extension, there is small contact area between patella and femur, minimal posterior compressive vectors of __________ and ___________ muscles maintains low joint stress.

A

Vastus medialis and Vastus lateralis

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5
Q

The frontal plane patellofemoral joint stability is unique in its potential for

A
  • frontal plane instability near full extension
  • degenerative changes resulting from PFJ stress
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6
Q

What are the longitudinal stabilizers of the knee, providing medial & lateral stability of patella during flexion

A
  • quadriceps tendon
  • patellar tendon
  • patellotibial ligament
  • capsule
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7
Q

What are the transverse stabilizers of the knee

A
  • superficial portion of extensor retinaculum
  • medial and lateral patellofemoral ligament
  • large lateral lip of femoral sulcus
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8
Q

The medial and lateral patellofemoral ligament attach the patella to the _________ medially and _______ laterally.

A

Adductor tubercle / IT band

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9
Q

An umbrella term used for pain arising from the patellofemoral joint itself or adjacent soft tissue

A

Patellofemoral pain syndrome

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10
Q

Patellofemoral pain syndrome causes posterior knee pain which could be misleading because the pain can be felt in all aspects of the knee including the popliteal fossa. True or false

A

False, anterior knee pain

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11
Q

What are synonyms to PFPS

A

Patellofemoral joint pain & anterior knee pain

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12
Q

What are the muscular etiologies of PFPS

A
  • quadriceps weakness
  • hamstring tightness
  • calf muscles tightness
  • hip muscle weakness or tightness
  • tight IT band
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13
Q

What are remote factors of PFPS

A
  • femoral internal rotation
  • knee valgus
  • tibial rotation
  • subtalar pronation
  • muscle strength & inflexibility
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14
Q

What are local factors to PFPS

A
  • patella position
  • soft tissue tension
  • neuromuscular components of medial and lateral vasti
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15
Q

What are other diagnosis that may be used for pain at or around the kneecap

A
  • chondromalacia patallae
  • patellar tendonitis
  • fat pad irritation
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16
Q

Symptoms of chondromalacia patella occur after prolonged 90 degrees of knee flexion sitting position or are aggravated by activity, what are examples of these symptoms

A
  • crepitation
  • sense of tightness or “fullness” in knee area
  • quadriceps muscle strength may cause the leg to “give out”
  • mild swelling
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17
Q

Actual fraying and damage to the underlying patellar cartilage is called

A

Chondromalacia patella

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18
Q

also known as jumpers knee, most common in athletes who’s sport involves frequent jumping such as basketball and volleyball, however even people who don’t participate in jumping sports can get it, what is it ?

A

Patellar tendinitis

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19
Q

What is the main symptom of patellar tendinitis and when can it be felt most

A

Pain (usually between kneecap and tibial tuberosity) / climbing stairs or rising from a chair

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20
Q

How do we prevent patellar tendinitis

A
  • don’t play through pain
  • strengthen your muscles (eccentric exercises)
  • improve your technique
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21
Q

What are other names used for fat pad irritation

A

Hoffa’s syndrome & fat pad impingement

22
Q

Examination test to assess for medial patellar glide, performed in 30 degrees knee flexion, this assesses for what ?

A

Limitation of mobility in the superficial lateral patellar retinaculum

23
Q

Examination test to assess for superior patellar glide, performed in 30 degrees knee flexion, this assesses for what ?

A

Limitation of mobility of the inferior patellar tendon and soft tissue structures

24
Q

Examination test to assess for inferior patellar glide, performed in 30 degrees knee flexion, this assesses for what ?

A

Limitation of mobility of the quadriceps tendon and other quadriceps muscles

25
Q

The moving patellar apprehension test is done with patient supine, the clinician translates patella laterally while moving from extended to flexed position, how do we indicate if it’s a positive test ?

A

A positive test is indicated by symptoms of instability with the test

26
Q

Examination test to determine patellar tilt for assessment of what ?

A

Deep patellar retinacular fibers

27
Q

Test for tightness of deep lateral structures is done by attempting to tilt in a medial direction, inability to obtain a neutral position indicates what ?

A

Tightness of deep lateral structures

28
Q

What are common interventions used for treatment of PFPS

A
  • manual therapy
  • open vs. closed chain exercises
  • quadriceps strengthening
  • patellar taping (kinesio-McConnel)
  • orthotics
  • proximal muscle strengthening
  • modalities
29
Q

when the knee is bent at 30 degrees, just as your foot strikes the ground in running , this region of 30 degrees of knee flexion is called

A

impingement zone

30
Q

repetitive sliding can create excess friction especially when the knee is bent at 30 degrees, it is the pinching of irritated structures over the outside of the knee, thereby producing

A

ITB friction syndrome

31
Q

joint condition in which bone underneath the cartilage of a joint dies due to lack of blood flow, this bone and cartilage break loose causing pain and possibly hindering joint motion, this is called

A

osteochondritis dissecans

32
Q

children and adolescents between the ages of _________ who are highly active in sports may be at risk of getting osteochondritis dissecans

A

10 and 20

33
Q

when a child is active, the quadriceps muscles pull on the patellar tendon which in turn pull on the tibial tubercle, in some children this repetitive traction on the tubercle leads to inflammation of the growth plate and the tibial tubercle may become very pronounced, this is called

A

osgood-schlatter disease

34
Q

causes of ACL injury

A
  • cutting (rotation)
  • hyperextension (straight knee landing)
35
Q

what can be associated with ACL injury

A
  • articular cartilage injuries
  • associated meniscal injury
  • knee OA
36
Q

unhappy triad consists of

A
  • ACL
  • medial collateral ligament
  • medial meniscus
37
Q

what are tests that we can perform to check the ACL

A

lachman and anterior drawer tests

38
Q

normal knees have a 10mm anterior translation and a soft end point, true or false

A

False / 4mm & solid end point

39
Q

in the lachman test, we apply a gentle anterior force to the tibia. A translation of more than 4mm (increased translation) and no solid or firm end point (soft end point) indicates an ACL injury. True or false

A

true

40
Q

what is an example of ACL reconstruction

A

graft harvest of patellar tendon / hamstring tendon

41
Q

Rehabilitation after ACL reconstruction includes

A
  • PT before surgery (ROM & inflammation)
  • early WB-ROM to full passive ROM
  • early quadriceps and hamstring activity
  • swelling and pain
  • closed chain to open chain
    -LE strengthening and stretching
    -perturbation training (neuromuscular and proprioception)
42
Q

weight bearing protocols in first 2 weeks after ACL reconstruction surgery

A
  • initially brace is locked and crutches are used
  • may walk without crutches if no pain or effusion
  • may unlock brace once able to perform SLR without lag
  • may discontinue use of brace at 6 weeks once adequate quad control is achieved
43
Q

allograft and hamstring autograft continue PWB with crutches for _______ unless instructed otherwise, immediately post ACL op

A

6 weeks

44
Q

we can use retrograde massage and ankle pumps for swelling management in ACL immediate post op phase, true or false

A

true

45
Q

criteria for entrance into the return to sport phase include

A
  • min international knee documentation (IKDC) subjective knee score:70
  • no post op history or negative pivot shift
  • minimum baseline strength
46
Q

minimum baseline strength for entrance into the return to sport phase after ACL reconstruction surgery

A

knee extension peak torque / body mass
300 degrees: 40% M / 30% F
180 degrees: 60% M / 50% F

47
Q

if a PCL injury results in an avulsion fracture, surgery is needed to reattach the ligament, knee function after this surgery is often quite good. True or False

A

True

48
Q

stage 1 and 2 of medial collateral ligament injuries require stabilization in varus or valgus position, and for how long is conservative management done ?

A

valgus position / 2-6 weeks

49
Q

for lateral collateral ligament injuries, first _____ weeks are restricted weight bearing

A

4 weeks

50
Q

what are causes of meniscus tears

A
  • twisting or turning quickly
  • lifting something heavy or playing sports
  • age

Ortho (4 decks)

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