Knee- Meniscus and OA Flashcards

Question

What is a partial meniscectomy?

Answer 1

- removal of tear

Answer 2

- no immobilization - earlier WBing - return to play within 2-6 weeks

Answer 3

- primarily with tears in outer 1/3 due to blood supply - immobilization and/or limited ROM initially - TTWB for 4-6 weeks - return to play in ~ 12 weeks

Answer 4

- sx no better at 2, 6, or 12 months vs sham sx without ARJC

Answer 5

- STRONG RECOMMENDATION AGAINST SX

Answer 6

- often age-related joint changes

Answer 7

- fluid filled cyst due to persistent and excessive inflammation - subsequent weakening of capsule and herniation of fluid

Answer 8

significant effusion

Answer 9

degenerative meniscus tear

Answer 10

limited and painful

Answer 11

popliteal protrusion just near the medial gastroc head

Answer 12

- like degenerative meniscal tear

Answer 13

forceful activity, like all herniations

Answer 14

- difficult to manage in active individuals

Answer 15

rupture may occur and mimic gastoc tear

Answer 16

aspiration and/or surgical repair

Answer 17

- medial femoral condyle and patella articular surface

Answer 18

elite level sports

Answer 19

- older age - previous joint injury, especially meniscus - increasing BMI - occupational activity (deep squats or stairs with or without loads) - quad weakness - NOT just exposure to sport or physical activity which may even be protective

Answer 20

gradual and unknown onset of pain that is worse with WBing

Answer 21

- bone edema with subarticular bone attrition - synovitis

Answer 22

osteophytes or reduction in joint space on imaging

Answer 23

nociplastic pain

Answer 24

- stiffness < 30 min after prolonged positions - limited and painful motion

Answer 25

- antalgic/asymmetrical gait

Answer 26

limited and painful, possible capsular pattern of restriction of flex>ext

Answer 27

consistent block

Answer 28

distraction likely relief of pain, compression likely painful

Answer 29

hypomobile

Answer 30

- possible positive meniscal tests - impaired walking distance and gait velocity with 6 MWT and TUG tests

Answer 31

- quads - hip abductors

Answer 32

joint line tendereness

Answer 33

- POLICED - STM may help - modalities

Answer 34

- massage improved pain and function but less than JMs - better than usual care when individualized with JM

Answer 35

- CPM (weak support) - Estim (MAY help) - electromagnetic devices (MAY help) - US (short term pain relief and function) - accupuncture (MAY help)

Answer 36

- lateral heel wedges not recommended - unloader knee brace may be helpful

Answer 37

- to minimize/avoid limping

Answer 38

May be helpful - better when individualized - greater immediate pain and functional benefits vs massage

Answer 39

locally at the knee and distally as well in the ankle

Answer 40

in ext ROM when combined with STM and MET

Answer 41

short term pain and functional benefits

Answer 42

long term and greater pain relief with equal or greater functional gains when added to exercise

Answer 43

due to not being individualized or combined with MET

Answer 44

strong supporting evidence

Answer 45

Increases anti-inflammatory markers and chondroprotective properties

Answer 46

pain and function - better when individualized

Answer 47

- quads - hip exercises for anti-gravity muscles

Answer 48

- aerobic exercises helped pain and disability - aquatic exercises helped disability - yoga and tai chi compliment traditional exercise - coordination and balance activities help pain and function

Answer 49

- dietary modifications - wt management - pt education and self management

Answer 50

STRONGLY RECOMMENDED ** ex. pillow under knees when sleeping to help with CPP, dont "hang out" in knee extension

Answer 51

12 PT sessions over a year better than 12 sessions over 9 weeks - both focuses on knee but also included adjacent joints

Answer 52

>50% costs associated with - injections - PT - orthotics - prescriptions

Answer 53

if only CPG treatments utilized, costs could be decreased by 45%

Answer 54

- Often over utilization of ineffective interventions and inefficient use of visits

Answer 55

- strong support - more effective than tylenol - includes topical application

Answer 56

strong support

Answer 57

- cortisone has inconclusive support and possible short term relief - hyaluronic acid (synvisc) claims to mimic synovial fluid, strong evidence AGAINST using

Answer 58

adverse effects and NOT effective

Answer 59

- strong recommendation against in nearly all patients with age related joint changes - NO. clinically important benefits vs placebo with pain function or quality of life

Answer 60

- when a TKA is needed it is best but with greater potential of adverse events - timing of TKA influences outcomes (dont wait too long or other bodily areas and function may suffer)

Answer 61

total knee replacement vs partial knee replacement - TKA is more common, increasing prevalence

Answer 62

- 1-2 sessions and cost reduction vs no pre-op PT - AD training - Planning for recovery, initial HEP - expectation management

Answer 63

- better quality of life with 8 weeks of exercise 5x/wk prior to sx - 3x/wk for 4--8 weeks increased strength and function for individuals with severe OA - 3 wk program accelerated functional recovery after TKA

Answer 64

- incise capsule - collaterals remain and possibly the PCL - ACL always removed - forceps adjacent structures - knee dislocated - add prosthetic - close capsule - full range under anesthesia

Answer 65

- decreases mean hospital stay and number of sessions - greater progress with ROM/strength - faster autonomy and normal gait and balance with TKA

Answer 66

- higher intensity - spread visits over a longer duration - single limb training - higher level of functional exercises

Answer 67

- better quad activity and function out to 1 year - no additional adverse side effects

Answer 68

- 0 degrees ext (1-2 weeks) - 110 degrees flexion (6weeks) and 120 degrees overall

Knee- Meniscus and OA Flashcards

(100 cards)