MSK LQ FALL 2025 > Lecture 7B > Flashcards

Lecture 7B Flashcards

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1
Q

What kind of force causes:

Injury to MCL

A

Valgus Force

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2
Q

What kind of force causes:

Unhappy triad : ACL/MCL/Medial meniscus

and the posteromedial capsule

A

Valgus force

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3
Q

What movement commonly causes injury to ACL and sometimes PCL

can be accompanied by meniscus injuries

A

hyperextension

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4
Q

What are the common mechanisms of injury to the PCL?

A

Flexion w/ posterior translation

Classic dashboard injury

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5
Q

What kind of force causes injury to the LCL and postero-lateral capsule

A

Varus force

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6
Q

Contact MOI for the ACL tear

A

Hyperextension valgus force with FOOT PLANTED

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7
Q

Non Contact MOI for ACL

A

Deceleration/ acceleration valgus force near extension

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8
Q

Hear a pop

Rapid swelling (0-2 hours)

hx of knee giving way

loss of end range ext

MOI: deceleration/acceleration w/ valgus force near extension

A

acl tear

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9
Q

What clinical tests are best to do IN THE CLINIC for ACL injuries

A

Lachman’s

Anterior drawer

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10
Q

What are the special test that are associated with ACl Tear

A

Lachman’s
Anterior Drawer
Pivot Shift

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11
Q

what is the functional limb test associated with ACL

A

6m Single Limb timed hop test
Return to sport
positive if 80% of uninvolved side

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12
Q

cruciate ligaments limit __________

Collateral ligaments limit __________

A

IR

ER

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13
Q

What is a segond fracture

A

ACL tear causes avulsion of the lateral tibial plateau due to excessive internal rotation

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14
Q

concurrent bone bruising is most common over the ___________ condyle

heals slowily

usually accompanies what injury

A

lateral femoral

ACL tear

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15
Q

How do you decide whether or not someone can cope without an ACL or whether they require surgery

A

Use multiple outcome measures, no single outcome measure is sufficient

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16
Q

post-ACL tear: Individuals with highest pre-injury activity level have a ___________ probability of returning to their preinjury activity level

A

lower

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17
Q

what % of ACL injuries can compensate well without surgery

A

1/3

1/3 could return to activity with bracing, strengthening, and activity modification

1/3 would not return to sport without surgery

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18
Q

Inclusion criteria for people who don’t need ACL surgery

A

Isolated ACL injury

Non-repairable meniscal injury

No other ligamentous damage

Full and pain free ROM

No knee joint effusion

MVIC of quad is 70% of uninvolved

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19
Q

What criteria is used to identify people who will benefit from no surgery and just rehab after an ACL tear

A

Single hop test of 80% equivelant to other side

No more than 1 episode of giving way since time of injury

KOS ADL scale and sports activity scale of 80%+

Global Rating scale 60%+

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20
Q

patients are more likely to receive a surgery for ACL if they have

a ____ level of activity

more episodes of giving way

_______ KOS-ADL score

__________ score on the international knee documentation committee Subjective knee form 2000

_____ limb symmetric index on the 6m timed hop test and on quadricep strength index

A

Higher

Lower

Lower

Lower

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21
Q

Fall with hyperflexed knee and ankle plantarflexion

Loss of knee ext with ROM testing or gait

A

PCL injury

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22
Q

What copers are you more likely to see PCL or ACL

A

PCL but they typically take longer to heal when compared to ACL

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23
Q

What are the 3 clinical tests for PCL tear

A

Posterior Drawer

Posterior sag sign

Positive valgus stress test at 0 degrees

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24
Q

What special test is best for MCL

A

Valgus stress test at 20-30 knee flexion

grade 1- 2mm joint space opens on CONTRALATERAL SIDE

grade 2- 3-5mm

grade 3- 5-10mm

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25
T or F, the MCL does well non-operatively
T
26
When is Surgery indicated for the MCL
boney avulsion combined with ACL or 3 months of no progress
27
What clinical test is best for LCL injuries
Varus Stress test at 30 degrees knee flexion
28
Anteriomedial stability resists what direction of force?
Anterior and ER
29
Anterolateral stability resists what direction
Anterior and IR
30
Posteriomedial stability resists what force
Posterior and IR force
31
Posterolateral stability resists what force?
Posterior and ER force
32
Excessive valgus force with tibial ER motion causes what injury
Anteromedial rotary instability
33
Excessive valgus force with tibial IR motion will cause what kind of injury
Anterolateral rotary instability
34
What kind of drawer test is best for anterolateral instability? What about anteromedial?
Anterior drawer with IR Anterior Drawer with ER
35
Traumatic forcing knee into ext and tibial IR causes.... Ext + ER causes....
Posterio-medial instability Posterio-lateral instability
36
What test is best for posteromedial instability postero-lateral instability
posterior drawer with IR Dial test/Posterior drawer test with ER of 15
37
MOI for: Posterolateral corner injury
direct hit on proximal tibia with extended knee posterior force on a flexed knee with tibia ER
38
If you are performing the Posterior lateral Rotation test INC ROM at 90 INC ROM at 30
Indicates PCL injury Indicates PL corner Injury 10 degrees from side to side
39
Posterolateral corner injury grades of 1, 2, 3 which requires surgery
grade 2 or more
40
What population is ACL tear the most common in
young female athletes
41
What interventions have strong evidence for ACL tear?
A level - Therex, NMES, NM education B- Immediate immobilization, cryotherapy, supervised rehab C- CPM, Knee bracing, early weight bearing
42
What level of evidence: Programs should use ACL injury prevention program prior to athletic training sessions in games, especially female athletes, those under 18, soccer players
Grade A
43
What level of evidence: Programs should incorporate multiple components of control, strength, plyometrics in training
A
44
History of catching/locking Forceful twist MOI Joint line tenderness Pain or click with Mc Murray test
Meniscal injury
45
What variables help predict meniscal injuries
* Catching/locking * forceful twist, especially medial * joint line tenderness * forceful hyperextension or max flexion * McMurrays test 4+ predict 81%
46
What's the difference betwen an articular cartilage injury and a meniscus injury
Meniscus has delayed effusion, Articular cartilage has immediate hemarthrosis Articular cartilage injury has pain that is intermittent
47
T or F: the diagnosis of Osteoarthritis of the knee should be made by radiographs alone
F
48
Altman's criteria for knee OA
50+ Knee crepitus Boney enlargements boney tenderness morning stiffness less than 30 mins No palpable warmth
49
What is kellgren-lawrence scale for knee OA
Ranks radiographs by how bad the osteoarthritic changes look
50
T or F: Manual therapy + exercise was proven to be better for knee OA than exercise alone
T
51
How can hip mobs benefit knee OA patients?
short term increase in knee ROM and decreased pain so if they have a hip issue pull on their hip! (after asking contras)
52
CPR for knee OA patients who would benefit from hip mob
Pain with ipsilateral hip distraction Ipsilateral knee flexion passive ROM is under 122 Ipsilateral hip IR is less than 17 Pain or paresthesia in ipsilateral hip or groin Ipsilateral anterior thigh pain
53
What relationship does BMI have to OA patients
BMI has a strong relationship to pain and function in patients with knee OA
54
What are the 4 components of OA treatment
Exercise! Weight control! Mob and exercise for knee ROM Check hip
55
What impairments are associated with PFPS
Dec quad strength Dec flexibility Dec coordination control of femur/tibia rotation, overpronation, patellar positions
56
how much increased wb compression does the knee experience with walking? running?
walking +25-50% bodyweight running 5-6x bodyweight
57
What gender experiences PFPS more
Women
58
What 3 areas of the body can cause PFPS
Abnormal femur/tibia motion Controlling hip and pelvic motion Ankle/foot motion
59
Pt has been sitting for over 30 mins and experiences pain after getting up
PFPS!!!!!!!!!!!!
60
What test will patients with PFPS have the most pain on?
Step down test
61
What are the 5 critera for lumbopelvic manip for Tx of PFPS
side to side diff of hip IR 14+ Ankle DF over 16 Navicular drop over 3mm No self reported stiffness in sitting 20+ mins Squatting reported as most painfu lactivity atleast 3/5 gets you a 94% probability
62
What interventions have strong evidence for Meniscus and articular cartilage injuries
B level: Progressive knee motion progressive WB therex NMES
63
Pt has MCL injury with boney avulsion, ACL tear 3 months of no progress and still has instability with varus force
operative MCL injury
64
When working with a patellar tendinopathy what kind of loading do you want to start with ?
Iso 5 times sec 45 s at 70 % MVIC Pain below 3/10 when performing this
MSK LQ FALL 2025
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