PF Anatomy
What are the medial forces on the patella?
vastus medialis, raised lateral facet, medial patellar retinacular fibers
When there is increased lateral force at the knee, what is occurring at the hip and foot?
Hip: ADD and IR
Foot: Pronation
Which ACL special test is more sensitive, Lachman or Anterior Drawer? Which is more specific?
Lachman- sensitive and specific
Anterior- specific
T or F: The patella is commonly the culprit for patellofemoral malalignment/maltracking.
FALSE: “Patellofemoral malalignment and/or maltracking may be the result of internal rotation of the femur as opposed to lateral tilt/displacement of the patella”
What would we want to strengthen?
What activities are limited/affected with insiduous pain in the patella?
squatting, stairs, kneeling, prolonged sitting
Explain the screw home mechanism in terms of the tibia, femur, and the patella
tibia- ER, femur- IR, and lateral rotation of patella
What part of the menisci travels posterior during knee flexion? Medial or Lateral?
Lateral meniscus
If the therapist is performing a special test and sits in between the pt's legs and provides a lateral force to the knee, what test is it? Does it rule in or out?
Varus stress test and no its bunz
What are the 3 big risk factors for examining PFPS?
2) excessive pronation
3) limited DF
Stepping down because it requires more knee flexion
What layer of the extensor retinacula is the patella invested in?
A) arciform
B) retinacular
C) capsular
B) retinacular
How do the hamstrings serve as a knee extensor?
When the foot is stationary, it pulls the tibial plateau posteriorly extending the knee and hip
When performing McMurray, how do we test the lateral meniscus?
valgus stress, IR of tibia into extension
What are the 2 most common site of lesions with articular cartilage pathology?
medial femoral condyle
retro-patellar surface
When is the ACL graft the weakest? What is the window to strengthen quads and neuromuscular re-education?
12th week
window: 8-12 weeks
What degree of knee flexion is only the odd and lateral facet in contact with the femur?
> 90 degrees
What structures hold the menisci centrally?
anterior and posterior horn, transverse ligament, and meniscofemoral ligament
Which of the following is NOT part of the Meniscal Pathology Composite Score?
A) Hx of locking or catching
B) Pain or audible click with Thessaly
C) Joint line tenderness
D) Pain with max passive knee flexion
B) Pain or audible click with Thessaly (McMurray)
T or F: Majority of ACL injuries are contact.
FALSE
How would you progress post op ACL if they successfully performed a step down?
A) lunge
B) step up
C) SL sit to stand
C) SL sit to stand
lunge--> step up--> step down --> SL sit to stand
What is the function of the articularis genu?
Small muscle within the quads that pulls superior on the capsule of the suprapatellar pouch so the patella can glide without pinching the bursa
Which ACL band is taut with knee extension?
Posterolateral
If a patient has a Q angle of >20 degrees, what is this indicative of?
>20 associated with current PFPS
Which of the following is NOT indicative of an ACL sprain?
A) hearing or feeling a "pop"
B) hx of giving way
C) hemarthrosis within 2-4 hours
D) loss of end range extension
C) hemarthrosis within 2-4 hours (0-2 hours)
Which of the following is NOT criteria for rehab following ACL rupture?
A) knee effusion
B) able to hop on injured leg without pain
C) full knee ROM
D) giving way: <= 1 episode only
A) Knee effusion