Knee Lab

Question 1

1. What are the components of knee observation? 
A) General 
B) Anterior/Posterior 
C) Lateral 
D) Gait Pattern

Answer 1

A) Symmetry, bruising, scaring, redness, looseness of tissue, muscle bulk and pt willingness to move.
B) Height of landmarks, Q angle, Tubercle Sulcus angle, genu valgum and varum, squinting patella, tibial torsion.
C) Genu Recurvatum, Osgoode-Shlatter, Patellar Path.
D) Antalgic gait, circumduction, knee hyperextension, walking aid.

Question 2

What are the components of a swelling assessment?

Answer 2

1. History
2. General observation (local vs general)
3. Girth Measurement
4. Special Tests (patellar tap and brush tests)

Question 3

How do you take a circumference measure for knee swelling?

Answer 3

1. Palpate the joint line and take measure around joint line.
2. Measure 5 and 10 cm above and below the patella.
3. Take measures.
   * Always follow the same method for placing the tape measure.

Question 4

How is the Brush Test performed?

Answer 4

1. Rub hand on medial side of knee 3-4 times.
2. Brush opposite hand down lateral side of knee.
   Positive test: Bulging at medial joint line.

Question 5

How is the Patellar Tap Test performed?

Answer 5

1. Hold the top of the patella w/ 1 hand (around top edge).
2. Gently tap w/ an index finger or 3 fingers.

Positive Test: Downward movement of the patella (i.e. moves down before making contact with femur)

Question 6

What are the steps for transfers for a pt following TKR?

Answer 6

1. Introduce to pt, assess level of alertness and readiness to move.
2. Ask if there are any contraindications to mvt.
3. Plan the environment (IV line, tables, folly cath).
4. Ask pt height and adjust the walker.
5. Teach pt how to use a walker and explain how transfer will be done.
6. Put on shoes.
7. Have pt come to the edge of the bed. Adjust the bed height and head of bed.
8. Cross unaffected leg under affected leg. Encourage pt to use upper body and leg to turn. Or if they cannot cross legs, physio supports legs during transfer.
9. Stand up w/ at least one hand on bed.
10. Move: walker, affected side, unaffected side.
    To return to bed use a cross leg technique as well.