Knee Rehabilitation Post-Operation

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Questions and Answers

What occurs during closed kinetic chain exercises like squats?

Simultaneous flexion and extension of the ankle, knee, and hip. (correct)

Only the knee joint flexes.

No significant forces act on the knee.

Isolation of the hip joint movement.

What is a risk associated with deep squatting?

Increased ACL stress due to hip flexion.

Reduction in compressive forces on articular cartilage.

External rotation of the femur causing meniscal tears. (correct)

Decreased stress on the crural ligaments.

Which statement is true regarding stress on the ACL during squats?

Minimal stress occurs between 0° and 60° of knee flexion. (correct)

Greater flexion angles significantly reduce stress on the ACL.

Stress on the ACL remains constant throughout the squat.

Stress is highest during full depth squats.

How does increased hamstring activity affect the knee during squats?

It decreases ACL stress due to hip flexion and trunk inclination. Signup and view all the answers

What are potential consequences of excessive shearing forces during a squat?

Damage to the cruciate ligaments. Signup and view all the answers

How does deep flexion during squats affect the menisci?

It increases the medial meniscus compression. Signup and view all the answers

What is a common misconception about the relationship between squat depth and knee health?

Optimal squat depth varies based on individual anatomical factors and conditions. Signup and view all the answers

What contributes to tension on the collateral ligaments during deep squatting?

Internal and external rotation of the femur and tibia. Signup and view all the answers

What is the primary restraint to lateral translation of the patella?

Medial patellofemoral ligament Signup and view all the answers

During knee flexion, which part of the patella initially contacts the femoral trochlea at 20° of flexion?

Inferior pole Signup and view all the answers

Which structure is primarily responsible for anterior translation of the tibia during open kinetic chain (OKC) extension?

Anterior cruciate ligament (ACL) Signup and view all the answers

What result occurs due to tightness of the retinacular structures?

Abnormal patellofemoral kinematics Signup and view all the answers

What contributes 10% of the restrictive force against lateral translation of the patella?

Medial meniscopatellar ligament Signup and view all the answers

After how many degrees of flexion does the odd facet of the patella contact the medial femoral condyle?

135° Signup and view all the answers

What is emphasized in the treatment of patellofemoral pain historically?

Strengthening the vastus medialis obliquus (VMO) Signup and view all the answers

What is the main type of motion at the femorotibial joint during extension in a closed kinetic chain?

Anterior roll with posterior slide Signup and view all the answers

What is the role of the quadriceps muscle in the context of the patellofemoral joint?

Acts as a dynamic restraint Signup and view all the answers

In knee flexion within open kinetic chain, what is the movement of the tibial plateaus?

They roll posteriorly and slide anteriorly. Signup and view all the answers

Compressive forces applied to which structures must be considered when planning therapeutic exercises for knee conditions?

Femorotibial joints and ligaments Signup and view all the answers

How does a lesion of the cruciate ligaments affect knee movement?

It alters arthrokinematics, leading to abnormal translations. Signup and view all the answers

Which statement about the patellofemoral joint is accurate concerning loading forces?

Compressive forces increase during knee flexion. Signup and view all the answers

What occurs to the tibia during the last 30° of extension in an open kinetic chain movement?

It performs an external rotation. Signup and view all the answers

What is a potential consequence of abnormal movements due to cruciate ligament injuries?

Early degenerative changes in the knee Signup and view all the answers

Which factor is NOT relevant when considering therapeutic exercises for knee conditions?

Trainers' personal exercise preferences Signup and view all the answers

Study Notes

Rehabilitation in the Post-Operative Period of Knee Fractures and Arthritis

Rehabilitation of the knee is a major area of intervention for physical therapists
High incidence of sports and work injuries, increasing rates of osteoarthritis and joint replacement surgeries due to population aging contribute to the need for rehabilitation
High costs associated with revision surgeries due to complications
Patients want to regain their functional level after injury or surgery
Current scientific evidence shows effective rehabilitation programs enabling restoration of healthy functional levels

Biomechanical Factors in Knee Rehabilitation

Understanding joint surface movement and compressive forces is crucial for manual therapies and exercise in knee fracture patients
Most of the information won't be applicable to patients with total knee arthroplasty (TKA) or partial knee arthroplasty (UKA), except for patients without patellar coverage, who need to consider patellofemoral forces
Forces on the tibiofemoral and patellofemoral joints and ligaments and menisci should be considered during exercise prescription
Ligament injuries affect motion and can lead to early cartilage or meniscus damage

Neurophysiological Factors in Knee Rehabilitation

The knee is a highly complex system with interconnected components
Intra-articular components sense and transmit signals to the spinal cord and brain
The knee has sensory receptors that are sensitive to stretching and pressure, essential for conscious perception
Sensory feedback plays a role in knee function and pain
Arthrokinase (AMI) is common in patients with knee injuries and surgery
Edema, inflammation, and instability affect sensory input and can lead to reduced activation in the quadriceps

Knee Joint Rehabilitation Methods

Open-chain and closed-chain exercise are used in knee rehabilitation
Knee extension using an open-chain mechanism isolates the quadriceps
Knee flexion using a closed-chain mechanism involves multiple joint activation
Exercise prescription for specific conditions must account for different amounts of stress on different parts of the knee
The position of the feet can also influence the loading on the knee, with narrow stance (feet closer together) producing less compression compared to wide stance.
The squat exercise is often discussed and reviewed to determine optimal joint load distribution and minimize injury risk

Evaluation of Patients Post-Knee Surgery

Objective, functional assessments (e.g., timed tasks like sit-to-stand and timed walk tests, gait analysis etc.) are crucial beyond patient-reported outcomes (e.g., questionnaires)
Pre-operative strength, ROM, and pain can predict functional results at 1 and 2 years post-surgery.
Lower BMI scores are associated with better functional outcomes.
Post-operative quadriceps strength can be monitored with methods such as electromyography for long-term success
Continuous passive motion (CPM) devices have limited effect, particularly for long-term results
Neuromuscular electrical stimulation (NMES) might enhance recovery, although more research is needed

Progressive Strength Training

High-intensity progressive strength training programs can yield better long-term results compared to standard care programs for TKA patients
This approach includes exercises for the quadriceps, other muscle groups, and joint mobility
The intensity of exercises needs to be monitored to prevent issues or injuries
The programs typically show significant improvement in strength and function over time

Hydrotherapy

Hydrotherapy is a widely used technique for post-operative rehabilitation in knee conditions
Reduced weight-bearing, improved joint mobility, and pain reduction are major benefits of water-based exercise
Evidence is mixed, and additional studies are needed to quantify the benefits over other types of exercises.

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Description

This quiz explores the essential aspects of rehabilitation following knee fractures and arthritis. It covers the importance of effective rehabilitation programs, the biomechanical factors involved, and the impact of joint injuries on recovery. Ideal for physical therapy professionals looking to enhance their understanding and skills in knee rehabilitation.