WEEK 12 Knee

Question 1

T/F: most ACL injuries occur w/o contact & when landing after jump

Answer 1

True

Question 2

What are the 3 intrinsic factors of ACL injuries?

Answer 2

• joint laxity
• larger Q angles
• narrow intercondylar notch

Question 3

Which muscle is an ACL agonist to prevent anterior tibial translation?

Answer 3

Hamstring

Question 4

Which muscle is an ACL antagonist to anterior tibial translation?

Answer 4

Quads

Question 5

What 2 other structures does ACL injury also injure?

Answer 5

• MCL
• medial meniscus

Question 6

Which surgical option has these pros & cons? - pros: less invasive w/ quicker return to function - cons: disease & infection & weaker than autograft

Answer 6

Allograft

Question 7

Which surgical option is strong @ implantation & undergoes ligamentation (gradual bio transformation of tissue)?

Answer 7

Autografts

Question 8

Which stage of ligamentation is this? - 1-3 wks - cells of graft die bc blood supply interrupted - collagen matrix remains intact

Answer 8

Necrosis

Question 9

Which stage of ligamentation is this? - 6-8 wks - new blood vessels grow into graft - process occurs peripheral –> central

Answer 9

Revascularization

Question 10

Which stage of ligamentation is this? - 8 wks + - new cells proliferate into graft from extrinsic sources (synovial fluid & bone marrow & intrinsic sources (surviving cells)

Answer 10

Cellular proliferation

Question 11

Which stage of ligamentation is this? - 8 wks + - cell proliferation continues - new cells proliferate into graft from new blood sources as well as synovium, ostium, & fat pads

Answer 11

Collagen formation, remodeling, maturation

Question 12

Which phase of ACL rehab is this? - 0-14 days after - maintain ROM & decrease inflammation

Answer 12

1: Acute inflammatory

Question 13

Which phase of ACL rehab is this? - 15-21 days after - restore normal ROM, achieve full extension ROM, minimize swelling

Answer 13

2: Reparative

Question 14

Which phase of ACL rehab is this? - 22-60 days after - progress to this when there’s pain-free ROM & no functional limitations - increase agility, progress to return to sports

Answer 14

Remodeling

Question 15

Which phase of ACL rehab is this? - 60-360 days - progress when there’s no functional limitations - correct contributed factors, retraining muscle

Answer 15

Remodeling

Question 16

What are the 3 areas of focus for LE flexibility for ACL rehab?

Answer 16

• Hamstrings
• ITB
• Hip flexors

Question 17

Which is the most common ligament injury?

Answer 17

MCL

Question 18

Long-term use of ________ can weaken knee ligaments.

Answer 18

Corticosteroids

Question 19

MCL restrains (varus/valgus) stress. & (internal/external) rotation of tibia –> blow to outside of knee most common cause of injury

Answer 19

• Valgus
• ER

Question 20

MCL injury most commonly occurs @ which attachment?

Answer 20

Femoral

Question 21

T/F: MCL has a pop feeling same as ACL

Answer 21

False (tearing)

Question 22

MCL injury pt will have pain w/ knee (flexion/extension)

Answer 22

Extension

Question 23

Sudden or violent twist or wrench of _________ joint results in stretching/tearing of ACL & MCL.

Answer 23

Tibiofem

Question 24

Sudden or violent twist or wrench of tibiofib joint results in stretching/tearing of which ligament?

Answer 24

LCL

Question 25

LCL injury occurs most commonly @ _________ attachment.

Answer 25

Fibular

Question 26

Which knee ligament is the least common sprain?

Answer 26

LCL

Question 27

The most common method of injury of LCL is direct varus force w/ foot (dorsi/plantar)flexed & knee in extension.

Answer 27

Plantar

Question 28

What other 3 structures is related to LCL injury?

Answer 28

- Peroneal n - Posterolateral capsule - PCL

Question 29

T/F: LCL pt will feel pop in knee

Answer 29

True

Question 30

What 2 ways can meniscal injury be diagnosed?

Answer 30

- Arthroscopically - MRI

Question 31

Which meniscus is more commonly injured bc it's less mobile?

Answer 31

Medial

Question 32

What type of tear is vertical w/ displacement of inner margin & most often associated w/ ACL & seen more in medial meniscus?

Answer 32

Bucket-handle

Question 33

What type of tear is most often found in medial aspect of lateral meniscus, is associated w/ ACL tear, commonly results from trauma & seen in young, active individuals?

Answer 33

Radial tear

Question 34

What type of tear is degenerative & found in older adults w/ OA?

Answer 34

Horizontal

Question 35

What type of tear is the most common, usually involves posterior portion, & is associated w/ ACL?

Answer 35

Longitudinal

Question 36

What type of tear is displaced flap that is secondary from radial, bucket-handle, or horizontal tear?

Answer 36

Flap

Question 37

What type of tear is full-thickness tear that runs obliquely from inner edge of meniscus out into body of meniscus?

Answer 37

Oblique

Question 38

Traumatic meniscus tears occur when compressive force couples w/ rotation while knee is (flexed/extended).

Answer 38

Flexed

Question 39

Which individuals are recommended for meniscus surgery?

Answer 39

- Younger than 50 - Over 50 but active

Question 40

Partial meniscectomy recommended for tears that occur in _________ region of meniscus & meniscal repairs recommended for tears that occur in the outer edges (vascular).

Answer 40

Avascular