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Published byJuliet Wade Modified over 9 years ago
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Knee Boney Anatomy Femur Medial condyle & epicondyle
Medial condyle of tibia Femur Patellar surface femur Lateral condyle & epicondyle Head fibula Tibial tuberosity Fibula
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Medial Collateral Ligament
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MCL Mechanism of Injury Valgus Stress
MCL Sprain 1st Degree nd Degree rd Degree
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Valgus Stress Test Stresses MCL Valgus Stress at 0 - 5º
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Lateral Collateral Ligament
LCL-
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Stresses lateral structures
MOI of LCL Injury Varus Stress Test Stresses lateral structures Varus Stress Varus Stress at 0 º and 25 º to 30º of flexion
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Anterior Cruciate Ligament
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ACL Tear Signs and Symptoms Anterior instability Mechanism Swelling
Deceleration injury IR of femur with knee flexed and foot planted Hyperextension of knee Swelling Pop at time of injury Pain with AROM PROM Anterior instability Decreased strength Giving way or buckling Signs and Symptoms
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Grading Anterior Instability Medial view Right knee
Anterior Drawer Test Grading Anterior Instability Medial view Right knee Stabilize Foot Check for hamstrings relaxation Thumbs either side patellar tendon Apply anterior force Grade amount of translation
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Lachman’s Test Better test than Anterior Drawer
Takes opposition of hamstrings out of play Knee flexed 15 º - 30º Stabilize femur Apply anterior force to tibia
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Pivot Shift Test Gold standard test for ACL Leg is externally rotated
Valgus force is applied as leg is flexed Positive test indicated by clunk sensation
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Posterior Cruciate Ligament
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Posterior Sag Test Posterior Cruciate vs Anterior Cruciate
Athlete supine Both knees flexed 90’ Observe laterally
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Posterior Drawer Test PCL ACL Athlete supine Knee flexed 90’
Foot neutral Sit on foot to stabilize it Posterior force applied at tibial plateau Positive test indicates PCL injury
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Medial and Lateral Meniscus
Medial meniscus “C” shaped Lateral meniscus more circular shaped Mechanism of Injury Squat with rotation Internal rotation of femur on fixed tibia
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Joint Space Orientation
Lateral Meniscus Medial Meniscus Medial Joint Space Lateral Joint Space
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Mc Murray Test Flex knee fully
Palpate medial & lateral joint spaces with one hand Rotate tibia opposite to femur as knee is extended Palpable pop and/or pain indicate a positive test
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Apley’s Compression Test
External rotation of tibia tests medial meniscus Internal rotation of tibia tests lateral meniscus Apley’s Distraction Test Unloads the meniscus Stressess MCL and LCL
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