Knee meniscal and lig

MOI for ACL

deceleration and acceleration motions w/ noncontact valgus load at/near full knee ext (massive eccentric quad contraction)

presentation of ACL tear

hearing/feeling pop

tense hemarthosis w/in 12 hrs of injury

giving away

special tests for ACL

anterior drawer

lachman

lever/Lelli sign

pivot shift

describe anterior drawer test

• flex knee to 90 so that foot is flat and lower leg is not rotated

• provide quick anterior force

  • + abnorm ant mvmt

what is anterior drawer good for

Sn Sp about the same (good for in and out not acutely)

describe lachman test

• 30 degrees of flexion

• tibia is ant translated relative to femur

  • + soft end feel or increased translation

What is the lachmans test good for

about the same (good for in and out)

describe the lelli test

• on fist under calf

• posterior force applied over distal 1/3 femur

  • + heel does not rise

What us lelli’s good for

mixed results but definitely good for ruling in

cluster for ACL

ant drawe

piviot shift

lever or lachmans

describe the pivot shift test

• start knee ext, med rot tibia, valgus stress

• knee passively flexed to 90

  • +sublux of tibia followed by reduction at 30-40 flex

What is piviot shift good for

ruling in

What makes the pivot shift different from the other tests in the cluster

considers the rotation aspect of the ACL

special tests for PCL

posterior drawer

posterior sag

describe posterior drawer

posterior thrust of knee in 90 degree flex

• + nondiscrete end feel or increased transaltion

What is the posterior drawer good for

both ruling in and out

describe posterior sag test

place patient in resting 90/90 '

• + prox tibia post relative to anterior aspect of femoral condyles

What is posterior sag test good for

good for out, great for in

special tests for MCl/LCL

valgus/varus stress test

position for valgus/varus stress test

knee flexed to 90 degrees

What is the varus/valgus stress test good for

ruling out

define grade 1 laxity

joint space opening is w/in 2 mm if the contralateral side

define grade 2 laxity

joint space opening 3-5 mm more than contralat side at 20-30 degrees knee flex

<2 mm more than normal knee in full ext

define grade 3 laxity

joint space opens 5-10 mm more than normal knee in20-30 degree knee f`lex and ext

what provides the rotary stability of the knee

antmed, antlat, postmend, post lat ligs

bony alignment

menisci