The Knee

Anatomy

100

Where does the ITB insert on the tibia? (e.g. name the eponym for this site)

Gerdy's tubercle

200

Up to what angle is considered a normal Q-angle in females?(extra 100 pt for normal Q-angle in males)

Males-13 degrees Females-18 degrees

300

Name the muscles that attach to the pes anserine? (extra 300 pts to name the nerves that innervate each muscle)

Sartorius, Gracilis, Semitendinosus --> femoral, obturator, and tibial

Mechanisms of Injury

100

What is the eponym for prepatellar bursitis?

Housemaid's knee

200

What is mechanisms of injury of Jumper's knee?

Overuse syndrome of the patellofemoral extensor unit --> High quadriceps loading-jumping, squatting, kneeling, climbing stairs

300

What is O’ Donoghue’s triad?

simultaneous ACL/medial meniscus/MCL injury

400

In Patellofemoral syndrome, name 3 causes of lateral displacement of the patella

Vastus medialis weakness, tibial external torsion, shallow lateral femoral condyle, laterally attached infrapatellar tension on the tubercle

Physical Exam

100

Describe J-sign and what is used to diagnose

Patella runs proximally and laterally with extension

200

Demonstrate a Lachman's maneuver and what is it used to diagnose?

ACL tears

400

Demonstrate/describe Apply's distraction test of the knee test and what is it used to diagnose?

Test for MCL or LCL injury Patient lies prone with fixed heel, traction force applied while rotating tibia internally and externally which reduces pressure on menisci --> Positive test elicits pain, indicates ligamentous damage

500

Demonstrate/describe Nobel's test and what is it used to diagnose?

The patient lies supine, and the knee is flexed to 90 °, Apply pressure with the thumb at the lateral femoral epicondyle while the patient slowly extends the knee, Positive if the patient complains of severe pain over the lateral femoral epicondyle at 30 °

Treatment

100

True or False: Do you inject patellar tendonitis?

False

200

Per the college of rheumatology, what is the 1st line treatment for knee OA?

Tylenol

300

What kind/class of exercises would you prescribe to rehab jumper's knee?

Eccentric exercises (single squats on decline board, lunges)

400

What is the McConnell program used to treat?

Used to treat Patellofemoral syndrome. Tape is placed on the anterior and medial aspect of the knee of everyday and kepts until pt learns when to activate VMO

500

What are the 3 phases of ACL injury recovery/rehab and how long do they last?

Acute Phase 1-2 weeks: allow tissue healing, reduce pain, establish non-painful ROM, maintain general fitness Recovery Phase 2-8 weeks: normalize passive/active ROM, hamstring:quad muscle balance, proprioception Functional Phase 8 weeks-6 months: increasing power/endurance of lower extremities, address specific functional deficits

Mechanisms of Injury Part II

100

What is the eponym for excessive traction and repeated microfracture of the tibial tubercle by the patellar tendon?

Osgood-Schlatter Disease

200

At what degree of knee flexion do you start to get friction of the ITB over underlying structures? (i.e lateral femoral epicondyle)

30 degress

300

What is the most common cause (70% of cases) of a traumatic hemarthrosis?

ACL tears

500

Histologically, what do you see in jumper's knee?

Tendinosis which is characterized by apoptosis of cartilage structures