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Knee Quiz MS
Knee
107
Anatomy
Professional
09/09/2011

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Cards

Term
What does a grade 1 ligament sprain consist of?
Definition
Incomplete stretching of collage fibers. No loss of function. Minimal Pain. Swelling.
Term
What does a grade 2 ligament sprain consist of?
Definition
Collage fibers may be torn completely. Moderate pain, moderate swelling. Some loss of function and stability.
Term
What does a grade 3 ligament sprain consist of?
Definition
Entire collagen fibers are torn. Profound pain. Intense swelling. Loss of function. Instability.
Term
Where does the ACL originate and attach?
Definition
It originates on the anterior part of the tibia and the posterior part of the femur.
Term
What 2 movements does the ACL resist?
Definition
Anterior translation of the tibia on the femur.
Posterior translation of the femur on the tibia.
Term
What happens when the ACL is torn due to it being a intracapsular structure?
Definition
Joint effusion occurs.
Term
What happens when the MCL is torn due to it being outside the capsule?
Definition
Less swelling and no effusion compared to the ACL.
Term
Who tears their ACL more, females or males?
Definition
Females.
Term
What are the common positions of the hip and knee when an ACL is torn?
Definition
External rotation of hip, valgus stress at knee(lateral blow), internal tibial rotation, and sometimes knee hyperextenstion occurs all while the foot is planted.
Term
What is the most common test performed to test for a ACL tear?
Definition
Lachman examination
Term
At how many degrees is the knee flexed during the lachman exam?
Definition
25-30 degrees of flexion.
Term
At how many degrees should the knee be flexed during the anterior drawer test?
Definition
90 degrees of flexion.
Term
What is needed during all tests to get true results from a ligament test?
Definition
Complete relaxation from the patient.
Term
Which is better for ACL reconstruction surgery, Bone-patellar-tendon-bone graft or semitendinosus autograft? Why?
Definition
Semitendinosus is the better one because it does't have as much pull on the muscle like the patellar tendon does and it also is a bigger muscle.
Term
WHat are the major risks of an allograft surgery for ACL replacement?
Definition
Disease transmission and when you sterilize the muscle being used, it could weaken the graft.
Term
How do surgeons reduce the risk of arthrofibrosis after an ACL surgery?
Definition
Insert drain into knee to evacuate residual bleeding.
Term
While in a brace after ACL surgery, At how many degrees is the knee usually locked into of flexion?
Definition
0 degrees
Term
How many months after surgery is the graft site for an ACL fragile?
Definition
2 months
Term
At how many weeks is avascular necrosis occuring after ACL surgery?
Definition
6-8 weeks
Term
At 3 months, how much percent is the graft of its original strength after ACL surgery?
Definition
50%
Term
How long will it take for an ACL graft to get to full strength?
Definition
As long as 1 year.
Term
How long is the maximum protection phase of ACL recovery?
Definition
0-6 weeks after surgery
Term
How long is the moderate protection phase of ACL recovery?
Definition
6-12 weeks after surgery
Term
How long is the minimal protection phase of ACL recovery?
Definition
12-24 weeks after surgery
Term
What two pieces of equipment should be used to limit stress on the graft after ACL surgery?
Definition
Crutches and brace.
Term
How long after ACL surgery should some become FWB?
Definition
2-6 weeks after sx
Term
What is the main exercise that should be performed during maximum protection phase of ACL surgery to limit anterior sheering forces?
Definition
Co-contractions of the quads and hamstrings.
Term
Which is emphasized to strengthen during max protection phase of ACL surgery, quads or hamstrings?
Definition
Hamstrings are emphasized. Strengthening quads will cause anterior sheer forces.
Term
What exercise should be avoided during max protection phase of ACL that caused stress on graft?
Definition
Open chain knee extension between the angles of 30-50 degrees should be avoided.
Term
What exercises can be done during max protection phase of ACL surgery?
Definition
Calf strengthening, 4 way hip/ankle, isometrics of hamstring, quad, glutes.
Term
During the moderate protection phase of ACL recovery, a patient demonstrates confidence, control and stability and they are allowed to shift weight on their knee, what closed chain exercise is started?
Definition
Leg press in short arc motion.
Term
What exercises are initialized during moderate protection phase of ACL recovery>
Definition
Stationary cycling, standing wall slides, stair steppers, stretching exercises.
Term
When is a pool running program initiated after ACL surgery?
Definition
Mimimum protection phase.
Term
What exercises can be started during minimal protection phase of ACL?
Definition
Standind knee extension with theraband, balance board, mini trampoline, progressive proprioceptive exercises, plyometrics.
Term
During nonoperative rehab of ACL, how long is the maximum protection phase>
Definition
ranges from 2-4 weeks.
Term
During non operative rehab of ACL, how long is the moderate protection phase?
Definition
ranges from 3-12 weeks
Term
During non operative rehab of ACL, how long is the minimal protection phase?
Definition
ranges from 10-16 weeks.
Term
Where does the PCL originate and attach?
Definition
Originates on posterior tibia and inserts on anterior femur.
Term
What two actions does the PCL resist?
Definition
posterior translation of tibia on femur and anterior translation of femur on tibia.
Term
What are common ways the PCL is torn?
Definition
Dashboard injury and knee hypereextension injuries.
Term
What is the difference at the point when you tear an ACL vs PCL?
Definition
You hear a pop with ACL tear, you do not with PCL tear.
Term
What are the common signs of a PCL tear?
Definition
Patient will have limp, pain in back of knee, and lack flexion of knee.
Term
What is the most common test to see if the PCL is torn?
Definition
Posterior drawer test?
Term
How many degrees is the knee flexed during the posterior drawer test?
Definition
90 degrees of flexion.
Term
What is the sign of a positive posterior drawer test?
Definition
Tibia will sag or sublux.
Term
What position is the patient in for the Godfrey tibial sag test?
Definition
Supine, both knees flexed to 90 degrees. Examiner holds knee and looks for tibia to sag or sublux.
Term
How quick does PCL recovery treatment begin?
Definition
Day after surgery.
Term
What are the weight bearing restrictions for PCL?
Definition
Vary from full weight bearing to partial weight bearing for 4-6 weeks after surgery.
Term
What exercise should be avoided during max protection phase after PCL surgery?
Definition
Hamstring isometrics greater than 30 degrees.
Term
What exercises should be done during max protection phase after PCL surgery?
Definition
Quad setting, 4 way SLR, patella mobs, ROM exercises for full knee extension.
Term
What is the main difference between ACL and PCL recovery phases?
Definition
Quad should be emphasized more during PCL. Hamstrings should be emphasized more during ACL.
Term
WHen does return to sport occur after PCL surgery?
Definition
6-9 months after surgery.
Term
WHat type of patients will have non operative PCL recovery?
Definition
Grade 1 and 2 PCL tears.
Term
When may closed chain exercises start after non operative PCL tear?
Definition
2-4 weeks out.
Term
When is typical return to sport after non operative PCL tears?
Definition
6-8 weeks.
Term
What type of stress tears an MCL?
Definition
Valgus stress (lateral blow)
Term
What are some signs and symptoms of MCL tear?
Definition
Hear a pop, ecchymosis, swelling, walking with a limp, pain in back of knee, hesitant to extend knee due to pain.
Term
WHat is the most sensitive test for MCL tears?
Definition
Valgus stress test.
Term
During a valgus stress test, how many degrees is knee flexed to?
Definition
30 degrees of flexion.
Term
True or False, Grade 1-3 MCL tears are treated nonoperatively.
Definition
True, grade 1-3 MCL tears are treated non operatively with crutches and a brace.
Term
When does the moderate protection phase of the MCL begin?
Definition
2 weeks.
Term
What type of stress do you not want to create during MCL recovery?
Definition
Valgus stress.
Term
When does general return to sport occur after MCL tear?
Definition
8-12 weeks after injury
Term
How many percentage of collagen are meniscus?
Definition
90%
Term
WHat are the main functions of meniscus?
Definition
Stability, shock absorption, load transmission, nutrition, lubrication, joint stress reduction and increase contact area/congruity.
Term
What are the most common type of meniscal tear?
Definition
Flap/Oblique tears, 81% of meniscus tears.
Term
When do vertical longitudinal tears of meniscus most occur?
Definition
Younger individuals.
Term
When do complex/degenerative meniscal tears most occurs?
Definition
Individuals over 40.
Term
What type of meniscal tear occurs with shear forces from axial compression?
Definition
Horziontal tears.
Term
WHat are common symptoms of meniscal tears>
Definition
Pain, swelling and locking of knee.
Term
Which type of test has been the most accurate test to determine a meniscal tear?
Definition
Thessaly test.
Term
What degree is the knee flexed to for the thessaly test?
Definition
5-20 degrees.
Term
Will a zone 1 tear of a meniscus require surgery?
Definition
No should heal itself since it has a vascular supply
Term
Will a zone 2 tear of meniscus require surgery?
Definition
May or may not need surgery. Sometimes has blood supply, sometimes does not.
Term
Will a zone 3 tear of meniscus require surgery?
Definition
yes it will due to no blood supply.
Term
After a subtotal or partial menisectomy, how long with someone be PWB?
Definition
1-14 days after surgery.
Term
How long will running start after partial or subtotal menisectomy?
Definition
6-8 weeks after surgery.
Term
Return to competition is seen how long after subtotal/partial menisectomy?
Definition
2-4 months after surgery.
Term
After meniscal repair, what degree is knee flexion resisted to?
Definition
90 degrees.
Term
How long should FWB wait after meniscal repair?
Definition
4-6 weeks.
Term
WHat are indications for a meniscal transplant?
Definition
Prior menisectomy, continued pain, normal alignment and joint stability.
Term
Patients over 55 contraindicate meniscal transplant for what reason?
Definition
They have arthritis.
Term
What type of weight bearing and ROM will a patient be restricted to after meniscal transplant?
Definition
NWB and 0-90 degrees of flexion.
Term
When will running and return to sport occur after meniscal transplant?
Definition
running at 4-6 months and return to sport at 6-9 months.
Term
After articular cartilige lesion surgery, what type of machine may be prescribed and why?
Definition
CPM to heal tissues and increase ROM>
Term
At how many weeks after articular cartlige lesion surgery should the person be FWB?
Definition
8-10 weeks after.
Term
After articular cartilige lesion surgery, when should the patient have normal gait mechanics and be FWB? When should they be returning to sport?
Definition
Normal gait mechanics and full ROM occurs at 2-6 months. Return to sport occurs at 6-12 months.
Term
What is the most common disability of the knee joint?
Definition
Patellofemoral disability.
Term
What will the patients complain of with PFP?
Definition
Anterior knee pain with prolonged sitting, stair ambulation and squatting.
Term
What 3 muscles with increase PFP if tight?
Definition
Hamstrings, rectus femoris, and IT band./
Term
What things should be done at the beginning of treatment for non operative PFP?
Definition
Ice, NSAIDS, avoided activeies that cause pain such as running. Strengthening of quads.
Term
WHat type of release will surgeons do for PFP?
Definition
Lateral release.
Term
How long is immobilization used after distal realignment for PFP?
Definition
4-6 weeks, crutches, NWB progession to FWB over 6 weeks.
Term
When does the diagnosis of chondromalacia occur?
Definition
At time of surgery. Has to be seen.
Term
With what type of fracture will avascular necrosis occur at the patella?
Definition
Transverse fracture because vascular portion of patella is in center leaving proximal fracture prone to AVN.
Term
How are non displaced patella fractures treated?
Definition
COnservatively with immobilization in full extension for 4-6 weeks.
Term
After surgery for patella fracture, what degree is the knee immobilized at?
Definition
20 degrees of flexion.
Term
Flexion of knee is limited to 100 degrees after patella fracture surgery for how long?
Definition
6 weeks.
Term
What weight bearing should occur after patella fracture surgery?
Definition
WBAT for first few weeks progressing to FWB 3 weeks after surgery.
Term
When is a high tibial osteotomy initiated?
Definition
advanced DJD present.
Term
When does a high tibial osteotomy occur?
Definition
10 years before a TKR. Temporary.
Term
What type of patients have success after a high tibial osteotomy?
Definition
Under 50 years of age with knee flexion greater than 120 degrees.
Term
What are the contrindications for a TKR?
Definition
Active or recent septic arthritis, extensor mechanism, sever nuerologic disorder, neuropathic joint.
Term
Contrainred/conforming implants sacrifice with ligaments?
Definition
Cruciates, ACL PCL. can be both.
Term
True or False, Noncemented implants have been shown to have better success at 15 years versuses cemented implants.
Definition
False, Cemented implants have better survival rate.
Term
What exercises are initiated immediately after TKR?
Definition
Quad, ham, glute isometrics, ankle pumps, short arc terminal knee extension, active assisted SLR.
Term
When should the PTA expect the biggest amount of gains after a TKR?
Definition
first 3 months, can occur for first year.
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