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38 Cards in this Set

  • Front
  • Back
MCL and LCL
taut in extension
lax in flexion, allowing tibiofemoral rot, ABD, ADD
ACL - Anteromedial
CKC FL: taut, max at 70 deg
CKC EXT: slight lax
OKC FL: taut
OKC EXT: lax
ACL - Posterolateral
CKC FL: lax
CKC EXT: taut
OKC FL: lax
OKC EXT: taut as full EXT reached
PCL - Anteromedial
CKC FL: taut, max at 80-90 deg
CKC EXT: lax
OKC FL: taut
OKC EXT: lax
PCL - Posterolateral
CKC FL: lax
CKC EXT: taut
OKC FL: lax
OKC EXT: taut
ACL motion restriction
limits medial rotation of tibia winding around PCL and lateral rotation of tibia by stretching over lateral femoral condyle
PCL motion restriction
limits tibial rotation
resists valgus and varus stress to knee
ACL anteromedial injury
damage may occur with knee FL and medial or lateral rotation
ACL posterolateral injury
damage may occur with knee hyperEXT
PCL anteromedial injury
damage may occur with knee FL
PCL posterolateral injury
damage may occur with knee EXT
Knee motion required for ADL
115-120 deg Fl
-5 to -10 deg EXT
Arthrokinematics of CKC knee FL
0-25 deg: ant rot of femoral condyles (post roll of femur)
25-140: ant rot of femoral condyles + ant glide (post roll of femur)
Components of anterior femoral glide during CKC knee FL
ACL tension
condyles slide on post. menisci
post. menisci move posteriorly
Arthrokinematics of CKC knee EXT
140-115 deg: post rotation of femoral condyles (ant roll of femur)
115-0 deg: post rot and post glide of femoral condyles (ant roll of femur)
Components of posterior glide during CKC knee EXT
PCL tension
menisci move anteriorly
Arthrokinematics of OKC knee FL
tibia rotates and glides posteriorly
Arthrokinematics of OKC knee EXT
tibia rotates and glides anteriorly
Purpose of the Screw Home Mechanism
maximum bilateral surface area contact between femoral and tibial condyles
Screw Home Mechanism
CKC EXT: femoral internal rotation occurs as result of longer medial femoral condyle
OKC EXT: tibial external rotation occurs as result of longer medial femoral condyle
Unlocking the Screw Home Mechanism
the popliteus contracts to:
-ER the femur in CKC FL
-IR the tibia in OKC FL
Helfet Test
pt seated with lower leg hanging
PT marks med/lat/midline of patella and tibial tuberosity
PT observes tibial tuberosity position as pt EXT knee
NORMAL: tib tub moves lat during EXT
Knee EXT Muscles
rectus femoris
vastus lateralis
vastus intermedius
vastus medialis
Knee FL Muscles
biceps femoris
semitendinosus
semimembranosus
gastroc
plantaris
popliteus
Tibial ER Muscles
biceps femoris
TFL
Tibial IR Muscles
semitendinosus
semimembranosus
popliteus
gracilis
sartorius
Genu Valgum
MCL, jt capsule tense = med knee pain
increase contact of lat femoral & tibial condyles = lat knee pain, increased lat DJD
Genu Varum
LCL, lateral jt. capsule strain = lateral knee pain
increased contact of med femoral and tibial condyles = med knee pain and increased risk of DJD
High compression force at knee during HEEL STRIKE
bodywt + eccentric hamstring contraction to control extension and stabilize knee
High compression force at knee during FOOT FLAT
body wt + eccentric contraction of quads controlling knee FL and resist buckling
HIGHEST compression force at knee during HEEL OFF
bodywt + compaction of knee occuring with concentric gastroc contraction which is PF the ankle
Role of Menisci
inc. tibial surface area to:
-inc force distribution
-dec unit force on condyles
-inc jt. stabilization
Patellar motion during Knee FL:
0-20 deg
-tibia IR
-dec lateral pull on patella
-patella -> intercondylar groove
-contact: inferior pole
Patellar motion during Knee FL
20-90 deg
-patella follows intercondylar groove
-contact: lat&med facets
-70-90 deg: quad tendon becomes wt bearing structure dec. PF jt. compressive force
Patellar motion during Knee FL
90-135 deg
- >90 deg lateral movement and medial tilting
- odd facet contacts medial femoral condyle at 135 deg
Compression forces at the patellofemoral joint
-result of quad and patellar ligament tension
- 0 to 5 deg: near 0 force
- 45 and up: significant increase in quad and patellar ligament force, greatest above 90 deg
Quadriceps Torques
level walking = .5 x bwt
stair climb = 3-4 x bwt
squats = 7-8 x bwt
Factors of abnormal patellar motion
-tight IT band
-VMO weakness
-rec fem tightness
-abnormal Q-angle
-patellar ligament length abnormality