MSK III > knee pathologies > Flashcards

knee pathologies Flashcards

(89 cards)

Study These Flashcards
1
Q

ICF classifications:

A

knee stability and movement coordination impairments:
-ant knee pain
-knee ligament sprain

knee pain and mobility impairments:
-meniscal/articular cartilage lesions
-OA
-soft tissue injuries
-knee joint fx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

ant knee pain causes

A

patellofemoral syndrome
patellar compression syndrome
patellar instability
direct patella trauma
soft tissue lesions
overuse syndromes
osteochondritis dessicans
neurologic disorders

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

patelloofemoral pain syndrome

A

= pain in vicinity of patella worse w/ sitting, climbing, stairs, squatting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

2 factors associated w/ joint compression force of patellofemoral joint

A

force of quad
knee flexion angle

*** inc. flexion -> inc. compressive force (MAX = 60-90 deg)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Q angle

A

angle formed by bisection of 2 lines:
-asis to patella
-patella to tibia tubercle

> 20 = abnormal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

normal pull of quads on patella

A

sup/pos/lat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

lateral directed forces on patella

A

IT band
bowstring force on patella
lat patellar retinacular fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

medial directed forces on patella

A

vastus medialis
raised lat facet of intercondylar groove
med patellar retinacular fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

global causes of lateral tracking

A

-dec height of lateral intercondylar groove
-patella alta

laxity of:
-media patella retinaculum, MCL, medial arch of foot

tightness of:
-lateral patella retinaculum, ITB, hip IR, adductors, hamstrings, G-S

weakness of:
-hip external rotators, abductors, VMO, pos tib

bony malalignment:
-hip coxa varus, XS femoral anteversion, external tibial torsion, XS genus valgum/large Q angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

LE biomechanical changes over time

A
  1. excess subtalar joint pronation
  2. leg length discrepancy
  3. dec G-S/Hamstring/ITB/Quad/Hip IR flexibility
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

patellofemoral pain syndrome chief complaints

A

retropatellar, patellar tendon pain
patellar crepitus
swelling/locking
pain w/ stairs, squatting
pain w/ prolonged flex knee postures
limitations in functional mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

patellofemoral pain syndrome exam findings

A

altered LE alignment
weak hip ABD/ER/Ext.
VMO weakness
dec TFL/HS/Q/G-S flexibility
overstretched med retinaculum
tight lat retinaculum
dec patellar medial glide
pronated foot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

patellofemoral pain syndrome treatment

A

increase flexibility/ROM
mobilize patella
improve muscle performance
improve NM control

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

OKC vs CKC exercises for patellofemoral pain syndrome

A

OKC: as contact area of PF joint dec, force of quad pull inc.
-knee extensions from 90 to 40 deg flexion
-lowest amount of PF joint reaction forces
-greatest amount of patellofemoral contact

CKC: quad force inc. as knee flexion inc.
-0-30 deg, progress to 60 deg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

excessive lateral pressure syndrome
chief complaints

A

lateral retinacular pain
possible medial peripatellar pain
pain w/ stairs, squatting

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

excessive lateral pressure syndrome exam findings

A

lateral patellar tilt
xs tightness of deep lat retinacular
dec patellar medial glide
patellar subluxation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

excessive lateral pressure syndrome treatments

A

treat inflammation/pain
stretch tight lateral structures
joint mobs
stretch HS, Q, ITBB
strengthen quads (VMO)
e-stim

** avoid OKC and bike d/t inc compressive force

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

global patellar pressure syndrome chief complaints

A

diffuse ant knee pain
stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

global patellar pressure syndrome exam findings

A

restricted patellar mobility (all)
restricted tibiofemoral motion
quad atrophy
dec flexibility Hams/Q/ITB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

global patellar pressure syndrome treatment

A

patellar mobs
STM to quads
knee AROM/PROM
strength progression:
-multi angle isos, SLR, mini squats
to
-LP, lunges, wall squats

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

acute patellar dislocation chief complaints

A

significant paiin
stiffness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

acute patellar dislocation exam findings

A

effusion
limited PROM/AROM
TTP med. structures, add. tubercle
(+) patellar mobility apprehension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

chronic patellar dislocation/patellar instability chief complaints

A

giving way, unstable
patella tightness
catching/locking
jumping/popping/snapping
pain medially
apprehension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

acute patellar dislocation treatments

A

immobilization in extension
quad neuromuscular re-ed
dec. inflammation
begin motion and strengthening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
chronic patellar dislocation/patellar instability exam findings
effusion TTP med retinaculum patella hypermoobiility (esp. lat) patella alta quad atrophy iinicreased Q angle extension subluxation during TKE (+) apprehension w/ lat glide
26
chronic patellar dislocation/patellar instability treatment
patellar stability pain free quad strengthening orthotics bike, swimming OKC: 90-40 deg
27
knee ligament injury grades
1: -incomplete tear, tendon continuous, sx minimal; 1-2 weeks heal 2: -incomplete tear, c/o instability when WB or pivoting, more pain and swelling; 3-4 weeks healing 3: complete tear, significant pain/swelling, difficulty bending/straightening, giving way; requires surgery
28
LCL injuries MOI
varus force to knee w/ foot planted; severe hyperextension
29
LCL injuries chief complaints
may hear pop lateral knee pain locking/catching w/ movement giving way stiffness
30
LCL injuries exam findings
swelling lateral TTP antalgic gait (+) varus test at 0 and 30 deg
31
LCL injuries treatment
avoid varus forces and tibial IR forces for 6-8 weeks normalize quad strength facilitate dynamic stabilization
32
MCL injuries MOI
valgus stress blow to lateral knee
33
MCL injuries chief complaints
may hear or feel pop medial knee pain locking or catch w/ movement giving way stiffness
34
MCL injuries exam findings
swelling medial TTP antalgic gait (+) valgus test at 0 and 30 deg
35
MCL injuries treatment
avooid valgus forces and tibial ER for 6-8 weeks noramlize quad strength facilitate dynamic stabilization avoid full extension early in rehab (elongates 20% beyond full length)
36
PCL injury MOI
significant trauma dashboard injury in MVA fall on hyperflexed knee w/ foot PF *most taut in flexion -ant fibers: flexion -pos fibers: extension
37
PCL injury chief complaints
may feel pop pain behind knee paon w/ kneeling instability giving way
38
PCL injury exam findings
abrasion or contusion on sup/ant tibia (suggest pos directed force) minimal swelling pain > 90 deg flexion may lack 10-20 deg flexion (+) neurovascular findings (+) pos drawer (+) pos sag (+) pos instability tests
39
PCL injury interventions
quad strengthening calf strengthening CKC: squats, lunges, knee ext OKC: knee ext 45-20 deg balance and proprioception return to sport 12-16 weeks
40
PCL rehab phases
1 day to 1 month: -control inflammation, full knee extension, knee flexion to 90, quad strength 3/5 + -q sets, ankle pumps, SLR flex/abd/add 1-3 months: -knee flexion to 125 -quad strength 4/5 + -progress CKC 3-9 months: -no limitation in ADLs, limited low impact actvities -progress CKC 9-12 months: -return to PLOF
41
Posterolateral Corner (PLC) 3 most important stabilizing structures of pos/lat knee
LCL popliteus tendon popliteofibular ligament -static and dynamic stability -prevent hyperextension, tibial ER -stability in low angles of knee flexion -helps PCL
42
Posterolateral Corner (PLC) injuries MOI
-posterolateral directed force to the anteromedial tibia -knee hyperextension -severe tibial external rotation while knee flexed
43
Posterolateral Corner (PLC) injuries chief complaints
pain at med/lat joint or pos/lat knee instability/giving way into hyperextension
44
Posterolateral Corner (PLC) injury exam findings
-varus thrust gait (unload lat compartment) -hyperextension thrust (genu recurvatum instability) (+) posterolateral drawer (+) dial (+) ext rotation recurvatum (+) varus stress test (+) reverse pivot shift (+) standing apprehension
45
Posterolateral Corner (PLC) rehab interventions
-NWB immobilize 6 wks -early quad activation -90 deg flex by 2 wks, full 6 wks -balance week 7 -no CKC at 70 deg -no isolated hamstring 4 months
46
meniscus injury MOI
WB twisting hyperflexion degenerative overuse
47
types of meniscal tears
vertical: -most common bucket handle: -common w/ ACL + med. meniscus peripheral tear: -disrupts function, joint contact stresses *** most are pos horn
48
meniscus injuries chief complaint
twist injury w/ tearing sensation joint line pain swelling catching, popping, locking
49
meniscus injuries exam findings
pain w/ forced hyperextension or max flexion joint effusion joint line TTP (+) McMurray's (+) Thessaly
50
meniscus injury conservative treatment
control swelling restore knee PROM minimize quad strength loss initial NWB strengtheing avoid squatting, pivoting, cutting, running until healed
51
meniscus injury surgical repair
inner 2/3 tear = menisectomy -no precautions post op -avoid twisting/high impact 4-6 wks peripheral 1/3 tear = mensical repair -complete vertical tear age < 40 + min OA = allograft -NWB/PWB 6 wks
52
menisectomy rehab
pain/swelling control joint mobs ROM gait training regain strength *avoid twisting and repetitive impact 4-6 wks *typical recovery 2-6 wks
53
allograft transplant rehab
NWB/PWB - 6wks immediate ROM CKC limited to 0-60 deg proprioceptive training low impact exercise at 8 wks strenuous work 3-4 months running 4-5 months light-mod sports 6-9 months
54
articular cartilage injuries
no direct blood supply (can't repair itself) *if injury penetrates bone beneath cartilage -> underlying bone will supply blood to area -> improve healing
55
surgical treatment of articular cartilage injury
GOAL = restore micro-articulation of cartilage -> allow restoration of biomechanical/physiological function of knee MAN IDEA = penetrate vascular area of bone below cartilage -> bleeding -> fibrin clot -> stem cells/fibroblasts -> fibrocartilage
56
rehab post articular cartilage surgery: Proliferation Phase
0-4 weeks -healing -dec pain/swelling -inc ROM -quad control -WB limited 3-4 wks
57
rehab post articular cartilage surgery: Transition Phase
6-12 weeks requirements for this stage: -full PROM ext -knee flex 120 -min pain/swelling Goals: -improve ROM/strength -maximize function
58
rehab post articular cartilage surgery: Remodeling Phase
12-16 weeks requirements for this stage: -full ROM -HS strength 20% uninvolved -Quad Strength 30% uninvolved -balance testing 30% uninvolved -bike/walk 1.6 km or bike 30 min Goals: -strength -endurance -maximize function
59
rehab post articular cartilage surgery: Maturation Phase
26-52 weeks requirements for this stage: -full pain free ROM -strength 80% uninvolved -no pain/inflammation Goals: -unrestricted functional activities
60
knee OA
= degen. of articular cartilage, inflammation of synovium, changes to underlying sunchondral bone sx of inflammation, swelling, hot, painful
61
risk factors for OA
-physical demanding occupations -certain sports -older age -female -obesity -previous injury
62
knee OA chief complaints
pain up/down stairs walking on inclines stiffness painful WB knee instability
63
knee OA exam findings
-swelling -muscle weakness -loss of ROM -genu varum -temperature -dec joint space, osteophytes
64
knee OA treatment
-joint preservation/sparing education -weight reduction -NWB or low compressive activities -LE strength/ROM/CV endurance -balance training -ADL training -manual therapy
65
osteotomy
= removal of a wedge of bone from tibia or femur medial compartment = tibial lateral compartment = femoral candidates: -40-60 y/o, uni. OA, no PF sx
66
ITB friction syndrome chief complaints
-pain w/ repetitive motion -no trauma -pain up/down stairs -pain free walking level surfaces -diffuse ant/lat knee pain
67
ITB friction syndrome exam findings
-TTP lat fem condyle or gerdy's tubercle -pain free MMT -weak hip ABD -prominent lat fem condyle -cavus foot -LLD internal tibial torsion -genu varum (+) obers (+) noble compressions
68
ITB friction syndrome treatment
-heat/ice -STM/cross friction -hip ABD strength -ITB stretch -correct biomechanical faults
69
plica syndrome chief complaints
clicking ant knee pain giving way pseudolocking *med more common
70
plica syndrom exam findings
palpable snap over medial condyle (+) medial plica test (+) medial plica shelf test (+) stutter test
71
plica syndrome treatment
e-stim for pain stretch quads, HS, G-S iso's patellar bracing
72
fat pad syndrome chief complaints
ant knee pain @ inf patellar pole pain w/ knee extension in various positions
73
fat pad syndrome exam findings
-pos patellar tilt -pain w/ knee ext. or hyper ex -inf patellar edema -TTP fat pad (+) bounce test
74
fat pad syndrome treatment
-avoid direct pressure -rest -dec inflammation -biomechanical interventions
75
fat pad syndrome MOI
d/t trauma or direct blow fat pad caught b/w femur and tibia w/ knee ext.
76
bursitis MOI
infrapatellar: -mechanical irritation or trauma prepatellar: -minor trauma -long periods of kneeling pes anserine: -swimmers, runners
77
bursitis exam findings
TTP over bursa and surrounding area local swelling TTP medial joint line/ER tiibia decreased ROM temp inc
78
bursitis treatment
activity modifications stretching strengthening correct biomechanical faults
79
patellar tendinosis (jumper's knee) MOI
d/t repetitive loading of extensor mechanism -eccentrically overload tendon during deceleration/landing/jumping
80
patellar tendinosis chief complaints
insidious onset inf patellar pain subsides at rest inc after activity
81
patellar tendinosis exam findings
TTP patellar tendon, inf pole swelling inf pole pain w/ resisted knee ext Quad/HS tightness
82
patellar tendinosis treatment
modify activity dec inflammation stretching eccentric strengthening
83
osgood-schlatter disease/SLJ syndrome chief complaints
8-13y/o girls 10-15 y/o boys pain during athletics
84
osgood-schlatter disease/SLJ syndrome exam findings
TTP tibial tubercle/inf pole (SLJ) swelling tibia tubercle/inf pole pain w/ resisted extension
85
osgood-schlatter disease/SLJ syndrome treatment
modify activity dec inflammation stretching Quad/HS/ITB strengthen quad/HS
86
osteochondritis dissecans
WB portion of med/lat fem condyles = fragment of articular cartilage w/ bone becomes separated from rest of articular area
87
osteochondritis dissecans chief complaints
retropatellar pain w/ squatting, kneeling, stairs catching sensation w/ flexion giving way/locking quad weakness joint effusion
88
osteochondritis dissecans exam findings
associated w/ maltracking general swelling
89
osteochondritis dissecans treatment
possible NWB 3-6 months dec inflammation restrict ROM
MSK III
flashcards
Decks in class (18)
# Cards
Brainscape helps you reach your goals faster, through stronger study habits.
© 2026 Bold Learning Solutions. Terms and Conditions