Knew

Question 1

Knee ligaments and cartilage

Answer 1

ACL, PCL, MCL, LCL

Medial meniscus, lateral meniscus

Question 2

Anterior lateral knee muscles

Answer 2

Quads, sartorious, gracillis, tensor fascia lata (IT band)

Question 3

Posterior knee muscles

Answer 3

Hamstrings, gastrocnemius

Question 4

Knee joint compartments

Answer 4

Medial compartment, lateral compartment, patellofemoral compartment

Question 5

What is a total knee arthroplasty

Answer 5

All 3 compartments are replaced

Question 6

What is partial or unicompartmental arthroplasty

Answer 6

Only 1 compartment replaced, usually the medial.

Question 7

What is Patellofemoral arthroplasty

Answer 7

Only the patella is replaced

Question 8

What is revision arthroplasty

Answer 8

Old hardware removed and replaced with a new prosthesis. May involve a bone graft

Question 9

Indications for surgery

Answer 9

Severe knee pain that limits function. 
Night pain 
Unstable knees 
Severe deformity 
Decreased ROM 
Unstable fractures

Question 10

Causes of knee pain

Answer 10

Osteoarthritis
Rheumatoid arthritis
Post traumatic arthritis
Failed TKR

Question 11

Knee arthroplasty components

Answer 11

Femoral, tibial, patella

Question 12

Surgical procedures: fixation

Answer 12

Cemented: acrylic cement
Uncememted: bone in growth
Hybrid: cemented tibial component, cementless femoral component

Question 13

Surgical procedure: bone cuts

Answer 13

Collateral ligaments are sparred. Patella surface may also be prepared

Question 14

Knee bones

Answer 14

Patella, femur, tibia, fibula

Question 15

complications of surgery

Answer 15

infection 
blood clots (DVT) 
excessive bleeding 
delayed wound healing 
laxity 
contractures 
prosthetic loosening

Question 16

max protection phase - rehab

Answer 16

weeks 1-4

goal: reach 0-90 degrees flexion

Question 17

inpatients- max protection phase

Answer 17

goals: decrease pain and swelling. independent mobility
cryotherapy (icing)
mobilise patient- in/ out of bed, sit to stand, walking with a walker, stairs
exercise

Question 18

weight bearing post op

Answer 18

always decided by surgeon
cemented- WBAT immediately
cementless- veries from NWB to PWB for at least 6-8 weeks

Question 19

max protection inpatient exercises

Answer 19

static quads, inner range quads, quads over roll, knee flexion

Question 20

max protection phase outpatients

Answer 20

goal: reach 0-90 degrees of knee flexion

exercises

Question 21

moderate to min phase

Answer 21

weeks 4-8+
goal- reach 0-120 degrees knee flexion
move to full weight bearing
exercises- patella mobilization closed kinetic chain strengthening, proprioceptive training, aerobic training, ROM exercises and stretching

Question 22

ACL

Answer 22

front of tibia to back of the femur

prevents femur sliding backward

Question 23

PCL

Answer 23

front of the femur to the back of the tibia

prevents femur sliding forward

Question 24

how does ACL injury happen ?

Answer 24

direct blow
twisting knee when foot is planted
land incorrectly- hyper extends + twists knee

Question 25

torn ACL symptoms

Answer 25

``` pop sound knee gives out significant pain significant swelling decrease ROM, unable to reach full extension ```

Question 26

surgical repair for ACL

Answer 26

autograft- comes from the patient, most common is a bone- patellar tendon-bone graft allograft- graft material comes from another person

Question 27

ACL surgical procedure: arthroscopic surgery

Answer 27

femoral and tibial bone tunnels are drilled, graft is passed into these tunnels, bone to bone healing begins.

Question 28

ACL max protection phase- rehab

Answer 28

up to week 6 graft is weak and excessive forces must be avoided control swelling- ice ambulate with assistive device protect joint with range-limiting hinge brace regain patellar mobility increase knee flexion and extension ROM as tolerated- week 2 up to 90 degrees flexion. week 3-4 up to 125 degrees flexion

Question 29

ACL weight bearing post- op

Answer 29

for 2 weeks weight bearing restricted to WBAT with two crutches

Question 30

ACL ROM restrictions and protection

Answer 30

typically locked in full extension for 1-2 weeks unlocked will allow 90 degrees of flexion after 3 weeks up to 125 degrees braces may be worn up to 3 months common brace is G2

Question 31

ACL mod to min protection phase - rehab

Answer 31

``` weeks 5-13 post op focus on increasing function use of closed kinetic chain exercises and proprioception achieve full ROM: flexion and extension achieve FWB ```

Question 32

ACL min protection phase- rehab

Answer 32

week 12 onwards, up to 6 months or a year | increase intensity of activity - depending on functional goal of client- increase strenght, endurance, power.