Knee

Question 1

What are the risk factors for PFPS?

Answer 1

• Increased medial patellar mobility
• Decreased quadriceps flexibility
• Decreased lower extremity explosive strength (vertical jump)

Question 2

Describe plica syndrome

Symptoms?

Answer 2

• thickened and inflamed synovial folds
• usually only the medial plica

Symptoms:

• snapping sensation
• buckling
• knee pain with sitting

Question 3

Describe Osteochondritis Dissecans

• Most common area affected?
• Symptoms?
• XRays: what view?

Answer 3

• lesion affecting articular cartilage & subchondral bone
  Most common: posteriolateral aspect of the medial femoral condyle
  Symptoms:
  Pain: vague, poorly localized
  Recurrent effusions
  XRays:
• Tunnel (notch) view

Question 4

What are the 5 structures of the posteriorlateral Corner

Answer 4

2 muscles:
- lateral head of gastroc
-popliteus
3 ligaments:
- popliteofibular ligament
- LCL
- Arcuate ligament

Question 5

What does the PLC serve as the primary restraint to?

Answer 5

Varus stress (LCL most important)
ER forces

Question 6

What does the PCL resist?

Answer 6

Resists posterior displacement of the tibia in relation to the femur

Question 7

MOI of a PCL injury?

Answer 7

Direct blow to the anterior aspect of the proximal tibia when knee is flexed:

• Football
• Soccer
• Skiing

Question 8

What test is most SN for a PCL injury?

Most SP?

Answer 8

SN: Posterior Drawer test

SP: Quadriceps Active Test

Question 9

What % of ACL injuries are:
Direct contact:
Non-contact:

Answer 9

Direct contact: 30%

Non-contact: 70%

Question 10

ODonohue’s Triad:

Shelbourne & Nitz Triad:

Answer 10

ODonohue’s Triad:
- ACL, MCL, and Medial meniscal tear

Shelbourne & Nitz Triad:
- ACL, MCL + meniscus

Question 11

Who is at risk for an ACL tear?

Answer 11

• Increased genu valgum

- Decreased knee flexion with landing

Question 12

What does OATS stand for?

Answer 12

Osteochondral Allograft or Autograft Transplantation

Question 13

MCL rehab; in early rehab what position should the knee be kept in to minimize loading to the MCL?

Answer 13

knee flexed

Question 14

Portion of the ACL most often injured when the knee is in extension?

Answer 14

Posterior bundle

Question 15

Special test most likely to detect an injury to the anterior bundle of the ACL?

Answer 15

Anterior drawer test

Question 16

Why is the Lachmann’s test useful in detecting ACL tears?

Answer 16

Anterior and posterior bundle are equally stressed

Question 17

When does the ACL experience the most stress/strain?

Answer 17

0-50 deg of flexion

Question 18

What is the primary component of articular cartilage?

Answer 18

Type II collagen

Question 19

Hyaline cartilage is replaced by?

Answer 19

Fibrocartilage

- decreased resilence

Question 20

What are the key principles to treat patellar dysfunction?

Answer 20

• Emphasize quad strengthening
• Normalize gait mechanics
• Restore volitional control of the quads

Question 21

What are the 5 diagnostic criteria to diagnose a mensical pathology? (4 of 5 = SP 96%)

Answer 21

1. Joint Line tenderness
2. Pain with maximum passive knee flexion
3. Pain with forceful knee hyperextension
4. Pain or audible click with McMurry
5. History of mechanical catching or locking by the patient

Question 22

ACL Non-copers have:

Answer 22

• deficits in quadriceps strength
• vastus lateralis atrophy
• quadriceps activation deficits
• altered knee movement patterns
• reduced knee flexion moment
• greater quadriceps/ham­string cocontraction