Exam 4 Study Guide: Knee

Anterior cruciate ligament tear/sprain

 MOI: Sudden twisting, puts the knee in an unnatural position.

signs/symptoms: Popping sound, immediate pain after 6-24 hrs, feeling of instability or that knee will give out. 

special tests & treatment plans: RICE to help swelling. Hinged braces. Special test-> Lachman’s test or Anterior drawer test.

Posterior cruciate ligament tear/sprain

MOI:Direct blow to anterior tibia  driving it posteriorly. 

signs/symptoms: Pop or snap heard/felt, Joint effusion within 12-24 hrs, Limited ROM, and posterior sag. 

special tests & treatment plans: RICE, pain meds and physical therapy. Special test ->Posterior drawer test

Medial Collateral ligament tear/sprain

 MOI: Valgus stress (forces to the outside of the knee forcing it inwards), sudden twisting motion.

signs/symptoms: Pain, pop felt/heard, mild/moderate swelling, point tender/

special tests & treatment plans: Grade 1&2: RICE, knee brace, Pain med. Special test ->Valgus stress test

Lateral collateral ligament tear/sprain

 MOI: A blow to the inner medial side of the knee or a twisting motion that forces the knee joint to bow outward.

Signs/symptoms: Pain, mild/moderate swelling, point tender, pop heard/felt, decreased range of motion.

Special tests & treatment plans: Rice. Medication / physical therapy. Surgery can be needed, depending on how bad the injury is. Special test ->Vargas stress test

Meniscus tear

 MOI:A forceful twist or rotating of the knee with/while bearing weight. 

Signs/symptoms: Pain, swelling, joint line tender, clicking/catching or locking sensation, possible popliteal cyst.

Special tests & treatment plans:  Rice. Medication/physical therapy. Surgery can be needed. Special test- McMurray’s Test & Thessaly’s Test

*4 different types of meniscus tear

• Longitudinal tear

• Bucket head tear

• Horizontal tear

• Parrot beak tear

Know blood supply zones of meniscus

Red-Red Zone

• Outer 1/3

• Good vascular supply

Red-White Zone

• Middle 1/3

• Minimal blood supply

White-White Zone

• Inner 1/3

• Avascular

Know the functions of the meniscus

• Is deepen articular surface of Tibia

• Cushions any stresses placed on the knee joint 

• Maintains spacing between the femoral condyles & trivial plateau

• Helps stabilize the knee, especially the medial meniscus when knee is flexed at 90 degrees

Patellar tendinitis

 MOI: Repetitive stress from repeated high-impact movement (jumping, running)

Signs/symptoms: Pain, inflammation, possible mild swelling, point tender, crepitus, pain w/ passive stretching and active and resistive knee extension. 

Special tests & treatment plans:  RICE and medication

Patellofemoral stress syndrome

 MOI: Results from lateral deviation of the patella as it tracks in the femoral groove

Signs/symptoms: tenderness of lateral patella, swelling, dull ache in the center of the knee, Pushing down on the patella causes pain and crepitus, and Athlete apprehensive when the patella is forced laterally

Special tests & treatment plans: strengthening, taping, orthotics.

Patellar dislocation

 MOI: Direct trauma to the knee and external rotation is placed on a knee with a planted foot.

Signs/symptoms: Immediate and severe pain. Swelling. Visible deformity where the kneecap appears out of place. Shifted outside of the knee. Inability of straightening the knees “popping” or “cracking”

Special tests & treatment plans: Manual positioning of knee cap, physical therapy, brace

Tibiofemoral dislocation

 MOI:Due to the high energy trauma like direct impacts or hard falls 

Signs/symptoms:An inability to walk or bear weight. A deformed swollen knee.Intense pain.A feeling of instability 

Special tests & treatment plans:Immediate closed reduction, repair of vascular or nerve injuries and stabilization of the knee. This is a followed by a long period of rehabilitation

Osgood Schlatter

 MOI:Overuse injury, Common to adolescents (esp. males) due to rapid growth spurts; characterized by swelling over tibial tuberosity of 1 or both knees. Muscle tightness, repetitive jumping & running during growth spurts can cause excessive tractioning of tibial tuberosity

Signs/symptoms:Pain over tibial tuberosity, Severe pain with jumping, running, or kneeling, Severe pain after activity. The front of the knee appears enlarged and a bony, prominence can be felt with chronic cases, and Pain relieved with rest

Special tests & treatment plans: Activity modification, pain management, ice, physical therapy.

Q angle

 Is what measures the alignment of the kneecap, formed by lines from the hip bone (ASIS) to the kneecap (patella) and from the kneecap to the shin bone (tibial tuberosity)

Patella alta

• Patella sits higher than normal when the athlete is standing. High riding patella Patella baja

Patella baja

Patella sits lower than normal. Low riding patella.

Genu varum

Also called “bowlegs.”

2 Types:

Structural: reflects a deviation of the femur and tibia.

 Functional: postural; associated with knees that are hyperextended and femurs that are internally rotated. 

Places more tension on lateral structures. 

Also causes an abnormal compression to the medial aspect of the knee

Genu valgum

Knock knees

Genu recurvatum 

•  Hyperextended knees.Commonly occurs as a compensation for lordosis, or swayback posture.There is a weakness and stretching of the

hamstring muscles. Can produce anterior pressure on the knee joint and posterior ligaments and tendons.

Sesamoid bone

 Patella also known as the ->floating bone

Pes anserine

Tendon insertion of the sartorius, gracilis, and semitendinosus muscles.