knee pathos

ACL subjective

MOI frequently plant and cut or twisting, complaints of instability, decelerating or accelerating with non contact dynamic valgus near full ext, feeling or hearing pop at time of injury, swelling within 2 hours of injury, hx of knee giving way or buckling

ACL observation

quad atrophy, ambulates with stiff knee gait

knee triage and screening

non MSK, r/o fx with Ottawa Knee Rules

ACL motion test

loss of ROM

ACL muscle performance

quad weakness, possibly hamstring weakness

ACL special tests

Lachman best, also pivot shift and anterior drawer

PCL subjective

fall on flexed knee with foot in plantarflexion, MVA where proximal tibia hit dashboard, may have swelling but not as much as ACL, bruising, localized posterior pain in knee

PCL observations

look for bruising

PCL motion tests

restricted ROM from effusion

PCL muscle performance

hamstring weakness, potential quad weakness

PCL special tests

posterior drawer, posterior sag sign

MCL or LCL subjective

MCL: lateral hit, valgus force (with ER from cutting or pivoting)
LCL: medial hit, varus force
worse pain with partial tears

MCL or LCL observation

can ambulate even with complete rupture

MCL or LCL motion tests

end range knee extension and flexion limited due to pain

MCL or LCL muscle performance

more muscle weakness with complete tear

MCL or LCL special tests

MCL: valgus stress test
LCL: varus stress test

meniscus tear subjective

plant and cut or twisting with foot on ground, mechanical sx, feel tear or hear pop at time of injury with severe pain, delayed swelling, pain with twisting in full weight bearing, hx of catching or locking

meniscus tear motion

pain with hyperextension, pain with forced flexion

meniscus tear muscle performance

quad weakness

meniscus tear special tests

McMurray’s if full ROM, Steinman sign I if not
Thessaly if other tests negative but high suspicion of meniscal tear
Ege’s test

patella tendinopathy subjective

anterior well localized pain at proximal attachment of patella ligament to inferior pole, exacerbated by physical activity or prolonged knee flex

patella tendinopathy observation

increased BMI may be risk factor

patella tendinopathy motion

decreased quad and hamstring flexibility, limited ankle dorsiflexion may increase risk of developing

patella tendinopathy muscle performance

quad weakness

patella tendinopathy special tests

decline single leg squat, palpation

PFPS subjective

insidious onset poorly defined localized ant knee pain, worse pain with sitting/squatting/stairs/running

PFPS motion

patella hypomobility or hypermobility

PFPS muscle performance

resisted isometric quad contraction

PFPS special tests

patellar tilt test, pain with squatting

knee OA subjective

over 50, women, high BMI, diffuse tenderness and AM stiffness < 30 min, clicking and catching, insidious onset or hx of trauma

knee OA observation

antalgic gait, loss ROM, effusion, redness

knee OA motion

loss ROM, limited PAM, clicking or catching