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. |
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Term
| What happens when the ACL is torn due to it being a intracapsular structure? |
|
Definition
|
|
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. |
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|
Term
| Who tears their ACL more, females or males? |
|
Definition
|
|
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. |
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|
Term
| What is the most common test performed to test for a ACL tear? |
|
Definition
|
|
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
|
|
Term
| What is needed during all tests to get true results from a ligament test? |
|
Definition
| Complete relaxation from the patient. |
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Term
| Which is better for ACL reconstruction surgery, Bone-patellar-tendon-bone graft or semitendinosus autograft? Why? |
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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. |
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|
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
|
|
Term
| How many months after surgery is the graft site for an ACL fragile? |
|
Definition
|
|
Term
| At how many weeks is avascular necrosis occuring after ACL surgery? |
|
Definition
|
|
Term
| At 3 months, how much percent is the graft of its original strength after ACL surgery? |
|
Definition
|
|
Term
| How long will it take for an ACL graft to get to full strength? |
|
Definition
|
|
Term
| How long is the maximum protection phase of ACL recovery? |
|
Definition
|
|
Term
| How long is the moderate protection phase of ACL recovery? |
|
Definition
|
|
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
|
|
Term
| How long after ACL surgery should some become FWB? |
|
Definition
|
|
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. |
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|
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. |
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|
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. |
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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. |
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|
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
|
|
Term
| During non operative rehab of ACL, how long is the moderate protection phase? |
|
Definition
|
|
Term
| During non operative rehab of ACL, how long is the minimal protection phase? |
|
Definition
|
|
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
|
|
Term
| How many degrees is the knee flexed during the posterior drawer test? |
|
Definition
|
|
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
|
|
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
|
|
Term
| When may closed chain exercises start after non operative PCL tear? |
|
Definition
|
|
Term
| When is typical return to sport after non operative PCL tears? |
|
Definition
|
|
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
|
|
Term
| During a valgus stress test, how many degrees is knee flexed to? |
|
Definition
|
|
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
|
|
Term
| What type of stress do you not want to create during MCL recovery? |
|
Definition
|
|
Term
| When does general return to sport occur after MCL tear? |
|
Definition
|
|
Term
| How many percentage of collagen are meniscus? |
|
Definition
|
|
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
|
|
Term
| When do complex/degenerative meniscal tears most occurs? |
|
Definition
|
|
Term
| What type of meniscal tear occurs with shear forces from axial compression? |
|
Definition
|
|
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
|
|
Term
| What degree is the knee flexed to for the thessaly test? |
|
Definition
|
|
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
|
|
Term
| How long will running start after partial or subtotal menisectomy? |
|
Definition
|
|
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
|
|
Term
| How long should FWB wait after meniscal repair? |
|
Definition
|
|
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
|
|
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
|
|
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
|
|
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
|
|
Term
| Flexion of knee is limited to 100 degrees after patella fracture surgery for how long? |
|
Definition
|
|
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
|
|
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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