Professional Documents
Culture Documents
Chapter 6
Assessment of Acute
Knee Injuries
injuries
Identify and discuss the common acute injuries to the
knee
Review the following components of injury
Mechanism of injury
Signs
Symptoms
Stress tests
Special tests
Tensile
Meniscal injury
Chondral lesion
Shear
Fracture
Dislocation
Rotational
History
Location of pain
Bursitis
Patellofemoral syndrome
Osgood-Schlatter disease
Patellar/quadriceps tendinitis
Sinding-Larsen-Johansson disease
Iliotibial band syndrome
Bakers cyst
Osteoarthritis
Differential Diagnosis
Osgood-Schlatter disease
Anterior
Sinding-Larsen-Johansson
disease
Degenerative joint disease
(OA)
Osteochondral defect (OCD)
History
History
Location of pain
Differential Diagnosis
Location of pain
MCL sprain
LCL sprain
Pes anserine
Medial
bursitis/tendinitis
OA
History
Lateral
History
Location of pain
Differential Diagnosis
Posterior
Differential Diagnosis
posterior horns
PCL tear
Bakers cyst
Popliteus tendinitis
History
Mechanism of injury
Observation
Deformity
Locking?
Effusion
Instability?
Recent treatment
Previous injury/previous treatment
Observation
Observation
Observation
Palpation
Knee alignment
Genu valgum
Genu varum
Genu recurvatum
Palpation
Medial
MCL
Meniscus
Pes anserine tendons
Pes anserine bursa
Medial femoral condyle
Medial facet of patella
Medial retinaculum
Anterior
Patella
Patellar tendon
Quadriceps tendon
Joint line
Tibial tubercle
Palpation
Lateral
LCL
Lateral meniscus
Iliotibial band
Gerdys tubercle
Lateral femoral condyle
Lateral retinaculum
Palpation
Posterior
Hamstring tendons
Posterior joint line (posterior horns of menisci)
Popliteal fossa
Stress Tests
Valgus
ROM
Flexion
Extension
Varus
Lachman
Full extension
Anterior drawer
Posterior drawer
Slocum rotary drawer
30 flexion
Full extension
Anterior Drawer
Lachman
Posterior Drawer
Special Test
MCL Sprains
History
MOI
Signs
Symptoms
MCL Sprains
MCL Sprains
Observation
Stress tests
Palpation
Special tests
MCL Sprains
Stress tests
MCL Sprains
Management
Special tests
1st degree
MCL Sprains
Management
2nd degree
PRICE
NSAIDs
Hinged brace
Crutches w/PWB when
necessary
Early ROM
Strengthening (closed chain)
Usually out for 3-4 wks
Should be protected when returned to play
PRICE
NSAIDs
Early ambulation is recommended (use crutches
if patient walks with limp)
Early ROM
Strengthening (closed chain)
Usually out for 1-2 wks
Should be protected when returned to play
MCL Sprains
Management
3rd degree
PRICE
Knee
immobilizer
Crutches - NWB
NSAIDs
Usually out for
6 wks or longer
Must be protected when
returned to play
LCL Sprains
LCL Sprains
History
MOI
Signs
Stress Tests
Arcuate Ligament
Complex
Special Tests
Symptoms
LCL Sprains
ACL Sprains
Management
ACL Sprains
Females are 2-8 times more likely to
ACL Sprains
MOI
ACL Sprains
MOI
Predisposing Factors
Intrinsic
Anatomical
Arthrokinematic
Hormonal factors
Predisposing Factors
Extrinsic
Position
of no return
Muscle strength & conditioning
(quad to ham ratios)
Neuromuscular factors
Recruitment
Less joint stiffness
Longer electromechanical delay
ACL Sprains
Stress Tests
ACL Sprains
Signs
Symptoms
ACL Sprains
Management
Initial
PRICE
NSAIDs
Crutches PWB
Hinge brace
Special Tests
ACL Sprains
Management
Surgical options
PCL Sprains
Anatomy
PCL Sprains
MOI
PCL Sprains
Stress Tests
PCL Sprains
Signs and Symptoms
PCL Sprains
Management
Special Tests
Meniscal Injuries
Function of menisci?
10
Meniscal Injuries
Meniscal Injuries
MOI
Signs
Symptoms
Stress tests
Special tests
Meniscal Injuries
Meniscal Injuries
Other types of tears
Flap tear
Meniscal Injuries
Meniscal Injuries
Management?
11
Meniscal Injuries
12