KIN 2236 || with 100% Correct Answers.
Acute Knee Injuries History correct answers - bleeding into the joint
- swelling (hemoarthorosis) usually happens <4 hours post injury
What ligament is most often injured in acute knee injuries correct answers - ACL tears (72%)
Paediatric- most common injury correct answers - patellar dislocation
Ottawa Knee Rules correct answers order a knee radiograph when at least one of the following is
present:
1. age greater than 55 or less than 18
2. tender over fibular head
3. Tender over patella
4. Inability to flex 90°
5. Inability to walk 4 steps
Be suspicious of... correct answers - high speed injuries
-younger patient who may avulse a body fragment
- clinical suspicion of loose bodies
Acute dislocation correct answers - patelle moves laterally out of its groove and onto or over the
femoral condyle
MOI of acute dislocation correct answers -forceful knee external rotation (tibia ER/ femur IR)
- foot planted
-+/- laterally directed force
- knee usually neat full extension
Signs/symptoms of acute dislocation correct answers - report of knee popping
- pain
- fast swelling
- loss of knee function
- tenderness over medial border of patella
- positive lateral apprehension test
- RULE OUT ACL BECAUSE OF FAST SWELLING
- FLEX HIP AND SLOWLY EXTEND THE KNEE, PATELLA SHOULD RELOCATE AND
IF NOT DO NOT FORCE
LCL correct answers - round fibrous cord that is extra capsular
- supported by muscles
- contributes at 20-30° knee flexion
- less common but complicated
- usually VARUS loading/ hyperextension
MCL correct answers - thickening of capsule
, - primary stabilizer (20-30°)
- muscles help in full extension
- muscles help in full extension
- 40% of all knee injuries
-VALGUS force/ without rotation
- occurs in isolation
Ligament sprains signs and symptoms correct answers - pain over structure
Grade 1: pain with no laxity
Grade 2: pain with some laxity and discount end point
Grade 3: Variable pain with gross lax point
- swelling a little for LCL
- swelling for Grade 2 MCL
General ligament principles correct answers - collateral ligaments get tighter with external
rotation
-medial rotation makes cruciate (cross) ligament tighter
ACL Injuries correct answers - occurs with or without contact
- usually during cutting or single leg landing
- 2-8x more likely in females
MOI of ACL injures correct answers -valgus after MCL
-declaration/internal rotation
- quads active
Quads Active Mechanism correct answers - rapid declaration
-untoward landing
- shoe surface interface friction
anterior tibial dislocation by quads
ACL Exam findings correct answers - resiticted movement in extension
- lateral joint tenderness- often mistakes for LCL
- + anterior drawer and Lanchman's test (looking for pain, laxity and end point)
PCL correct answers - 1 in 10
-common in MVA's
- common in car accidents
-hyperflexion
-varus and values following collateral and ACL
PCL injuries signs and symptoms correct answers - pop
-poorly defined Bain back of one
-minimal swelling
- posterior drawer test
-SAG test is positive
Acute Knee Injuries History correct answers - bleeding into the joint
- swelling (hemoarthorosis) usually happens <4 hours post injury
What ligament is most often injured in acute knee injuries correct answers - ACL tears (72%)
Paediatric- most common injury correct answers - patellar dislocation
Ottawa Knee Rules correct answers order a knee radiograph when at least one of the following is
present:
1. age greater than 55 or less than 18
2. tender over fibular head
3. Tender over patella
4. Inability to flex 90°
5. Inability to walk 4 steps
Be suspicious of... correct answers - high speed injuries
-younger patient who may avulse a body fragment
- clinical suspicion of loose bodies
Acute dislocation correct answers - patelle moves laterally out of its groove and onto or over the
femoral condyle
MOI of acute dislocation correct answers -forceful knee external rotation (tibia ER/ femur IR)
- foot planted
-+/- laterally directed force
- knee usually neat full extension
Signs/symptoms of acute dislocation correct answers - report of knee popping
- pain
- fast swelling
- loss of knee function
- tenderness over medial border of patella
- positive lateral apprehension test
- RULE OUT ACL BECAUSE OF FAST SWELLING
- FLEX HIP AND SLOWLY EXTEND THE KNEE, PATELLA SHOULD RELOCATE AND
IF NOT DO NOT FORCE
LCL correct answers - round fibrous cord that is extra capsular
- supported by muscles
- contributes at 20-30° knee flexion
- less common but complicated
- usually VARUS loading/ hyperextension
MCL correct answers - thickening of capsule
, - primary stabilizer (20-30°)
- muscles help in full extension
- muscles help in full extension
- 40% of all knee injuries
-VALGUS force/ without rotation
- occurs in isolation
Ligament sprains signs and symptoms correct answers - pain over structure
Grade 1: pain with no laxity
Grade 2: pain with some laxity and discount end point
Grade 3: Variable pain with gross lax point
- swelling a little for LCL
- swelling for Grade 2 MCL
General ligament principles correct answers - collateral ligaments get tighter with external
rotation
-medial rotation makes cruciate (cross) ligament tighter
ACL Injuries correct answers - occurs with or without contact
- usually during cutting or single leg landing
- 2-8x more likely in females
MOI of ACL injures correct answers -valgus after MCL
-declaration/internal rotation
- quads active
Quads Active Mechanism correct answers - rapid declaration
-untoward landing
- shoe surface interface friction
anterior tibial dislocation by quads
ACL Exam findings correct answers - resiticted movement in extension
- lateral joint tenderness- often mistakes for LCL
- + anterior drawer and Lanchman's test (looking for pain, laxity and end point)
PCL correct answers - 1 in 10
-common in MVA's
- common in car accidents
-hyperflexion
-varus and values following collateral and ACL
PCL injuries signs and symptoms correct answers - pop
-poorly defined Bain back of one
-minimal swelling
- posterior drawer test
-SAG test is positive
