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valgus stress and internal rotation, ACL test done under anesthesia |
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pinch the med and lateral condyles of the femur and tibia thru varus valgus force and then move the knee thru its ROM looking to elicit pain |
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Appleyy compression/grind |
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grip quad around the patella and ask the pt to contract the quat and if pain positive for chondromalacia |
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Meniscus stand on one leg and rotate on the fixed leg |
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most likely area of m to atrophy around the knee and hardest to rehab |
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ACL injury can be accompanied by |
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Definition
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function of type A synovial cells |
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Definition
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function of type B synovial cells |
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Definition
produce and secrete synovial fluid |
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function of type C synovial cell |
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Definition
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increases the viscosity and elasticity of the articular cartilages and lubricates |
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Definition
Hyaluronan (hyaluronic acid) |
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key lubricating component of the synovial fluid |
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Definition
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lubricates, nourishes, and phagotizes debris in the joint |
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fat globules in the knee effusion |
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cloudy appearance in the knee effusion fluid |
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viscus knee effusion fluid |
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think infection (string sign) |
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color of normal synovial cluid |
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needle shapped long crystals |
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Definition
monosodium urate (uric acid) |
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rhomboid or small rods, pleomorphic shapped crystals |
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Definition
Calcium pyrophosphate dihydrate (CPPD) |
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knee aspiration occurs at |
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snapping, swelling, stiffness, giving out |
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mechanical sx are indicative of |
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twisting injury of knee with foot planted |
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tend to displace toward the cruciate ligs middle of the joint |
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xray view of patella from top down |
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best MRI view for meiscal tear dx |
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procedure of choice for meniscal tear |
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Definition
Arthroscopy, most get partial menisectomy - want to preserve as much of the meniscus as possible |
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a meniscus that developmentally covers the entire condyle and is not frisbee shapped not crescent shaped |
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dont do anything unless it tears |
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internal rotation of a hyperextended knee would injur which ligament |
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fx of the lateral condyle of the tibia |
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a Segond fx is indicative of what? |
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acutely the ______ meniscus tends to be torn |
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chronically the ___________ meniscus tends to be torn |
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Definition
posterior horn medial meniscus |
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an ACL is not repaired it is |
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______ is a contraindication for ACL reconstruction |
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recontruct ACL from a piece of the hamstring tendon |
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Definition
Bone Tendon Bone autograft |
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used to shrink the ACL - DONT EVER DO IT LEADS TO ACL RUPTURE |
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Prevents anterior posterior movement |
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Prevents rotation in relation to the femur |
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Rare High energy trauma Dashboard injury Knee dislocation |
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lift supine legs by the toes and see hyperextension of the knee |
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significant sign on of PCL injury |
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Genu Recurvatum (+) posterior drawer test |
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intersecting lines from the ASIS and the tibial tuberosity thru the middle of the patella for an anle |
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A large Q angle predisposes to |
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Definition
patellar subluxation or dislocation |
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dislocation of the patella can cause an |
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patella normally dislocates |
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cut the lateral retinaculum around the patella and suture the torn medial retinaculum by pication |
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Definition
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tuber osity is osteotomized with attached patellar ligament and the tuberosity is shifted to more medial position and fixed with screw which reduces the Q angle |
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Definition
Tibial tuberosity transfer |
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what procedure reduces the Q angle |
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Definition
Tibial tuberosity transfer |
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pain around the knee cap pain with stairs crepitance |
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Definition
Chondromalacia or Patellofemoral syndrome |
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lateral movement of the patella in extension above the trochlear groove |
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shave patellay bak to stable margins |
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last line procedure, remove patella, no moreterminal quadriceps function |
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openly (not arthroscopically) realign patella |
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pain and swelling on the anterior knee where the prepatellar bursa is, cleaning on knees sliding into a base for baseball |
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Definition
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Irritation of the patellar tendon at the tibial tuberosity may be accompanied by tibial tuberosity fx |
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Definition
Osgood Schlatters Disease |
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-ages 10-15 -pain and tenderness at the inferior pole of the patella -calcification and abnormal formation of inferior pole of the patella |
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Definition
Sindig Larsen Johansen Disease or Jumper's Knee |
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Definition
brace ofr osgood Schlatters disease |
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-associated with posterior horn meniscal tears -resolve if you take care of intrarticular problems -caused by OA or meniscal tear or somthing that is causing problems with synovial sack making a one way valve -commonly the common fibular nerve can be pinched with this pathology and the nerve can be injured when attempting to excise |
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exits bw semimembanosus and medial head of gastroc |
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normally self resolving in children |
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key part of ddx for Bakers cyst |
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ACL, MCL, Medial meniscus |
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Definition
Chronic Triad of O'Donoghue |
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ACL, MCL, Lateral meniscus |
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Definition
Acute Triad of O'Donoghue |
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isolated joint pain and tenderness MCL |
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rupture of MCL with joint instability |
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ossification of the medial collateral ligament at its femoral insertion usually due to trauma with subsequent hemorrhage (no eponym for ossification of the lateral collateral ligament!) |
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Definition
Pellegrini Stieda Disease |
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boney avulsion, chonric MCL lesion at the origin of the MCL |
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Definition
Pellegrini Stieda Disease |
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locking and popping of the knee |
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lateral aspect of the medial femoral condyle is a classic site for |
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Xray tunnel view is the standard view for an |
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arthroscopic mosaicplasty |
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bone plugs from other sites in body and transplant into the lesion |
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Definition
mosaicplasty and osteoarticular transfer system (OATS) procedures |
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replacement of only the medial/lateral compartment of the knee |
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pain in the knee can be caused by a |
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hip pathology radiates pain to the knee via the |
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knee replacement that allows the joint to rotate a little bit when you extend the knee to lock it out |
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medial compartment hemireplacement that has polyethylene middle piece that is free floating but will possibly dislocate |
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