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31

“A lachman is as good as?”

“An MRI”

32

Anterior drawer test?

ACL

“These suck”

33

Lachman test sensitive and specificity? (ACL)

Sensitivity: 87%
Specific: 93%

34

Anterior drawer test sensitive and specificity? (ACL)

Sensitive: 48%
Specific: 93%

35

Pivot shift test sensitive and specificity? (ACL)

Sensitive: 61%
Specific: 97%

36

Joint line tenderness sensitive and specific? (Meniscus)

Sensitive: 76%
Specific: 95%

37

Thessaly test sensitive and specific? (Meniscus)

Sensitivity: 90ish
Specific: 95%

38

McMurray test sensitive and specific? (Meniscus)

Sensitivity: 52%
Specific 97%

39

Positive McMurrays test?

Pain or pop

Slide 33

40

Thessaly test

Pt stands in one foot while holding you for balance. They rotate internal and external.
Positive test will get popping and clicking

Conducted with foot at 5* them 20* flexion with the foot flat

Slide 32

41

Posterior sag test?f

PCL
Knee at 90* and the tibia is not a straight line

Slide 35/36

42

Dial test?

PCL

Symmetric: normal
Asymmetric: abnormal

Pt lying prone and feet should mirror each other when knee is flexed at 30*

Slide 37

43

What is noble’s test?

(ITB)

Palpate lateral femoral condyle
Flex and extend knee

Pos: pain at site of palpation

44

Ottawa knee rules?

When to order an x ray

Age >55 or <18
Unable to walk
TTP on patella
TTP on fibular head
Unable to flex 90*

45

How accurate is the ottawa knee criteria?

100% sensitive

Reduced radiographs by 49%

46

What to look for on lateral images of knee?

Patella alta/baja
Patellar poles
Fat pads/bursa
Evaluate avulsion fx

47

What is patella alta/baja?

Patella Alta: high riding patella

Patella baja: low riding patella

Not affect knee mobility

48

What is Sunrise imaging?

Patella rising over knee like the sun over the mountains

49

Sunrise imaging assesses?

patellofemoral joint
Patellar tilt
Lateralization
Depth of trochlear groove

50

What is a pellegrini stiega?

Avulsion fx of MCL on femur

51

What should you look for in the joint space between femur and tibial heads?

Discoid meniscus:
1. Squaring
2. Widening
3. Cupping

52

How common are ACL ruptures?

200,000 ACL rupture per yr in the US

1 in 3500 people

53

Should i fix acl ruptures?

Yes:
Reconstruction is demonstrated to reduce sequelae of chordal and meniscal injury.

54

Who is more likely to get ACL rupture? Why?

Females > males
Wider pelvis (wide Q)
Greater flexibility
Less muscle development
Hypoplastic vastus medialis oblique
Narrow femoral notch
Genu valgum
External tibial torsion

55

ACL bundles?

2 of them

AM: tight in flexion
PL: tight in extension

56

What is the primary stabilizer of the knee against anterior translation?

The ACL

57

What tends to cause acl rupture?

Rotational (twisting)
Hyperextension force

Usually noncontact injuries

58

What is the knee terrible traid?

Concomitant injuries:
1. Meniscal tear
2. Medial collateral ligament
3. ACL rupture

59

Why is blood in the joint bad?

Blood is an irritant

60

What is a risk (uncommon) with disruption of multiple ligaments of the knee?

Popliteal artery

It is a limb threatening emergency