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What are s&s of an mcl sprain?
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Pn, swelling, stiffnesslimited flex & ext+ valgusjoint line pn
What is the ROM for an MCL sprain?
Flexion & extension
What is the MOI for an mcl sprain?
Valgus contact or non-contact valgus &/or rotation
What is the MOI for an lcl sprain?
— & tibial internal rotation
What are S&S for an lcl sprain?
Hearing “pop” or tearSwellingPoint tenderness
What is the ROM for an LCL sprain?
Flexion & Extension
What is the MOI for an ACL sprain?
Anterior tibial translation orposterior femoral translation, Noncontact rotational injuries, or Hyperextension
What are S&S of an ACL sprain?
hearing or feeling “Pop”, immediate function loss & swelling within 4-6 hours
What is the ROM for an ACL sprain?
As swelling sets in, theres a decrease in ROM
What are the extrinsic predisposing factors of an ACL sprain?
Muscle strength & fatigueMuscle activation & coordinationQ angleFemaleAnterior pelvic tiltMenstrual cycle
What are the intrinsic predisposing factors of an ACL sprain?
Small ACL sizeNarrow intercondylar notch widthJoint laxity
What is the MOI for a PCL sprain?
posterior tibial translation, landing on anterior tibia with knee flexed, or landing on dorsiflexed ankle
What are the S&S for a PCL sprain?
may be asymptomatic, popliteal fossa pain & tenderness, & effusion develops over time
What is the ROM for a PCL sprain?
— MMT: Quad strength decrease in chronic patients
What is the MOI for a posterolateral corner injury?
Hyperextension w/ varus, & Hyperextension w/ external tibial rotation
What are S&S of a posterolateral corner injury?
“Knee instability”, localized pain, giving way, rapid non-contained edema
What is the MOI for a meniscal tear?
rotation with flexion &/or valgus/varus stress
What are S&S of a meniscal tear?
“clicking” or “locking”Joint line painDecreased motionSwelling
What are the classifications of a tibiofemoral dislocation?
Tibial DisplacementCompletePartialOpenClosedHigh or Low velocity
What is the MOI for a tibiofemoral dislocation?
HyperextensionHyperextension w tibial rotationPosterior tibial displacement w flexed knee
What are S&S of a tibiofemoral dislocation?
Severe painSpasmDeformity“Dimple sign”Suspect w impaired neuro symptoms
What are predisposing factors to IT Band friction syndrome?
Genu varumFoot pronationLeg lengthLateral heel strike
What is the MOI for IT Band friction syndrome?
Repeated flexion & extension
What are the S&S for IT Band friction syndrome?
“Burning”Point tendernessMMT pain, none with AROM
What is disrupted with Anterolateral Rotatory Instability?
ACLAnterolateral & Posterolateral capsuleBiceps femorisLateral meniscus
What do patients complain of with rotary instability?
“giving out or giving way”Decreased strengthDecreased performanceLack of confidence
What are the special tests for IT Band syndrome?
Nobel’s & Ober’s
What is the Unhappy triad in anteriomedial rotary instabillity?
What are the special tests for anteriomedial rotary instability?
CrossoverIsolated ACL & MCLSolcum drawer
What is a discoid menisucus?
Increased thickness & overs a larger area of the tibiaSize, shape & stability causes instability, clicking or locking
What is a meniscal cyst?
Associated w longitudinal tearsOften painlessBreaches joint capsule and fills with synovial fluid
What is an osteochondral lesion?
damage to the bone and cartilage
What are S&S of an osteochondral lesion?
Diffuse painLocking or clunkingIncreased pain & decreased strength when WB
What are the special tests for uniplanar anterior instability?
Anterior drawerLachmansProne lachmans
What are the special tests for uniplanar posterior instability?
Posterior drawerGodfrey’squad activationDynamic posterior shiftExternal rotation recurvatum
What are the special tests for uniplanar medial instability?
What are the special tests for uniplanar lateral instability?
What are the special tests for multiplanar anteriolateral instability?
Slocum drawerCrossoverFlexion/rotation drawerPivot shift
What are the special tests for multiplanar anteriormedial instability?
Crossover Anterior drawerSlocum drawer w/ ER to 15°
What is the special test for a osteochondral lesion?
What are special tests for meniscal tears?
What are the purposes of the patella?
Increase mechanical efficiencyAnterior protectionAbsorption & transmission of joint foreces
What are the planes of the patella?
Frontal & sagittal: TriangularFrontal: superior portion is widerSagittal: Anterior, non-articulating, narrower posterior surface
What are the patella articulations?
Medial, lateral, oddMedial & lateral have superior, middle & inferior factsOdd facet has no articulation support
What is the patella ROM?
Medially: 45-18° into extLaterally: 18-0° into ext
Where is the lateral retinaculum?
Over the vastus lateralis & IT band
Where is the medial retinaculum?
Over the vastus medialis & adductor magnus
What is the primary patella lateral mover?
What is the vastus lateralis supported by?
What movement does the vastus medialis oblique produce on the patella?
Medial & proximal gliding
What is the risk of decreased quad vs hamstring strength?
What do tight calves increase the risk of?
Decreased dorsi = increased pronation → Hip IR & medial patella tracking
What does a medial patella position cause?
Increased q-angle & lateral force
Where are the 4 bursae of the knee?
SuprapatellaPrepatellarSubcutaneous infrapatellarDeep infrapatellar
What are acute MOI’s for patellofemoral?
what is movie goers sign?
After sitting for a while, getting up the anterior knee is swollen
What is the true leg length?
ASIS to medial malleolus
What is a functional leg length?
Belly button to medial malleolus
What is a J-sign?
A superior/lateral glide of the patella during extension
Hyperextension & varus, & Hyperextension & external tibial rotation
What is a positive test for clarkes sign?
Feeling of crunchiness, hurts
What is a positive apprehension test?
Guarding, verbal or non verbal apprehensiopnMedial patellar retinaculum laxity
What is a positive medial synovial plica test?
Symptom reproductionPlica palpation on medial femoral condyle from 60-45°
What is a positive stutter test?
Irregular motion between 40-60°Medial plica syndrome
What are the S&S of patellofemoral pain syndrome?
pain w/ stairs “movie goers”“giving out” & “clicking:
What are the observations for patellofemoral pain syndrome?
End ranges increase painPoint tenderness along medial retinaculumMMT: weak quads, abductors, hip er
What are the special tests for patellofemoral pain syndrome?
What are the MOI for acute patellar disloctions?
Valgus blowtensile stress
What are the S&S for acute patellar dislocaions?
Large blood effusionDeformityPoint tenderness & pain at MPFL, med retinaculum, VMOcannot perform ROM
What are the special tests for acute patellar dislocations?
Apprehension to R/O major ligament involvement
What are the MOI for patellar subluxation?
Change of directionEccentric contraction
What are the S&S of a patellar subluxation?
Medial capsule pain“giving out”
What are the ROM of a patellar subluxation?
pain between 0-30°MMT: weak hip abd & Er
What are the special tests for multiplanar posteriolateral instability?
Posteriolateral drawerReverse pivot shiftDynamic posterior shiftExternal rotation recurvatum test