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53 Cards in this Set
- Front
- Back
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What special tests are designed to detect meniscus problems in the knee?
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McMurray and Apley's
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True or False: the outer third of the meniscus has a blood supply so its potential to heal are good.
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True
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How long after meniscus repair (MR) surgery is FWB allowed?
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4-6 weeks after a peripheral repair and 6-8 weeks after a central repair or transplant
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What is the criteria used to progress a MR to the moderate protection phase of rehab?
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Minimal joint effusion and pain, evidence of superior gliding of the patella with quad setting, full active knee ext, and 120 degrees of knee flexion
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What is the criteria used to progress a MR to the minimum protection phase of rehab?
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By 12-16 wks post-op there should be no pain or jt effusion, full active ROM and LE strength should be at 60%-80% level
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True or False: treatments should be progresed slower with central zone meniscus repairs then those done in the peripheral zone.
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True
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What should a PTA do if a patient who had a meniscus repair experiences a clicking sensation in the knee during exercises?
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Contact the MD immediately
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What tests are used to detect an ACL injury?
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Lachman's, Ant Draw and Pivot Shift
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True or False: the medial meniscus is torn more frequently then the lateral.
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True, remember that the MM also attaches to the MCL. The LM is not attached to the lateral tibial plateau as firmly as the MM.
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What structures are commonly used to reconstruct a torn ACL?
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Middle third of the quad and hamstrings
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True or False: Exercises should be porgressed more gradually when a hamstring tendon is used to reconstruct the ACL.
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True
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True or False: when performing resisted OKC knee extension exercises after an ACL reconstruction, the range of 90 to 45 degrees should be avoided.
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False, 45 to 15 degrees should be avoided because the ACL graft is subjected to increase tensile forces at this ROM
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Why are closed kinetic chain exercises emphasized after ACL reconstruction?
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This kind of exercises product very little anterior translation of the tibia
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A PTA is instructing a patient who had an ACL recontruction to perform a squatting in the upright position. What special instructions should the PTA include?
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When performing the squat, the patient should be told that the knees should not move anterior to the toes as the hip descends.
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True or False: patients who have undergone meniscal repaire surgery, should not perform exercises that involve deep squattting, deep lunges, twisting or pivoting for at least 4-6 weeks.
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False, 4-6 months
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What gait deviation is assoicated with weak quadriceps?
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Anteiror lurch of the trunk during Initial contact.
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What gait deviations is associated with weak hamstrings?
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Recurvatum (hyperextension) during stance, the knee snaps into extension at terminal swing
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What gait deviation is associate with a weak Soleus?
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Hyperextenison of the knee during pre-swing
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What gait deviation is assoiciated with a weak Gastrocnemius?
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Hperextension of knee at the end of loading response and just prior to pre-swing.
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What hip deformiity is commonly associated with PF mal-tracking syndrome?
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Anterversion
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What anatomical landmarks are used in measuring the Q angle?
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ASIS, mid-patella and tibial tuberosity
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True or False: an over-stretched lateral retinaculum is an impairment that is assoicated with PF dysfunction.
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False, medial retinaculum
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True or False: the MCL is a secondary constraint to anterior tibial translation.
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True
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True or False: patellar dislocations predominently ocurr in a medial direction.
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False, lateral direction
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True or False: a common complication following TKR is an extensor lag.
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True
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What criterion is used to determine when a patient can progress from the MaxPP to the ModPP after ACL reconstruction?
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Minimal pain and swelling, full active knee extension (no extensor lag), MVIC 50-60% of uninvolved side, >110 degrees of knee flexion, no evidence of joint laxity (determined by athromery measurements)
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Ture or False: PCL injuries are more common then ACL injuries.
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False
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True or False: PCL injuries ocurr as a result of hyper-flexion injuries?
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True, remember that they are also know as "Dashboard" injuires as well
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True or False: rearfoor hyper-pronation is commonly seen in patients with PF problems because it is associated with excessive internal tibial torsion.
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True, this inturn can place excessive amounts of stress in the periarticular structures around the PF joint and a greater lateral pull on the patella becasue of a greater valgus force.
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What criterion is used to determine when a patient can progress from the ModPP to the MinPP after ACL reconstruction?
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No pain, full active ROM, MVIC 75% of univolved side, no evidence of joint laxity (determined by athromery measurements)
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True or False: during the first 6-8 weeks after ACL reconstruction, the graft goes through a process of avascular necrosis.
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True
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Surgical invention for PF problems can be classified into 5 categories, name them.
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1. Alter the alignment of the PF jt. 2. correct imbalances of static stablizers of the patella and knee 3. decrease abnormal Q-angle 4. improve tracking of the patella and 5. debride or repair the articular surface of the patella
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What are the post-op goals of rehab assoiciated with all of the PF surgeries?
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COntrol pain & swelling, prevent or reduce the adverse effects of immoblization, restore post-op knee ROM quickly and safely, maximize the function of the extensor mechanism, esp the VMO, develop stability and flexibility in the joints distal and proximal to the knee and behavior modification.
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Which of the PF surgical procedures is designed to reduce a lateral tilt of the patella?
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Lateral Retinacular Release (LRR)
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In general, how long does the MaxPP last for a LRR? What should rehab focus on?
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2 wks, control pain and swelling, restoration of quads function and regaining ROM, and maintaining adequate patellar mobility to prevent adhesions
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What is the emphasis of rehab for the ModPP S/P LLR?
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Attaining full AROM, quad function and flexibility.
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What PF surgery is indicated for patients who have a hx of recurrent patellar subluxation or dislocation?
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Proximal Realignment of the Extensor Mechanism (PREM)
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What strutures are repaired with a PREM procedure?
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The medial patellofemoral ligament is tightened or imbricated, and the VMO is is advanced to a more central and distal location to improve its length tension relationship.
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How does the post-op managment of PREM differ from an LLR?
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Longer MaxPP and more gradual progression of exercise and WB
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True or False: rehab after a Distal Realignment of the Ext Mechanism should progress slower then a LRR and PREM?
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True
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What tissue is involved in a Distal Realignment of the Ext Mechanism
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Medial transfer of the tibial tubercle. The goal is to decrease laterally directed forces on the patella.
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What can WB activities begin after a cemented TKA?
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The next day
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What is the capsular pattern for the knee?
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Flexion loss is greater than extension loss
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What structures are tight with a knee flexion contracture?
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Post capsule and hamstrings
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What is an extensor lag in the knee?
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The patient has full passive extension but cannot actively extend the knee
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What way should the tibia be rotated to detect a medial meniscus tear when performing a McMurry test?
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Externally
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What modification should be made when in the rehab of an ACL reconstruction when a hamstring tendon is used?
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Knee flexion strengthening should progress slower
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What kind of force should be applied to the knee to check the integrity of the MCL?
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Valgus
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Which direction should the tibia be mobilized when performing a joint mobilization technique to gain flexion?
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Posterior
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True or False: a superior patellar mobilization technique is used to increase knee flexion.
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False, superior
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True or False: a individual who undergoes an ACL reconstruction should be able to return to sports.
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TRUE
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True or False: patient who undergo a TKA should expect to regain full active knee flexion.
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False, the amt of knee flexion obtained after a TKA is usually 100-110 degrees
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True or False: hamstring strengthening exercises should be emphasized with PCL injuries.
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False, the quads should be strengthened
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