Professional Documents
Culture Documents
ANTERIOR CRUCIATE
INJURIES
SURGERIES PERFORMED
1. Bone-tendon-bone with middle 1/3 of patellar tendon
2. Semitendinosis and gracilis: fold them in so have a 4 tendon bundle
3. Allograph: bone-tendon-bone patellar tendon from cadaver
Key in surgery is correct isometric placement of the graph.
Patellar tendonitis
Patellofemoral pain/chondromalacia
COLLATERAL LIGAMENT
INJURIES
KNEE REHAB
PATELLOFEMORAL PAIN
SYNDROME
OTHER FACTORS
CAUSING PFPS:
1. Overpronation
2. Anteversion
3. Weak Hip ER & ABD
4. Tibial Varum
5. Increased Q angle
ILIOTIBIAL BAND
SYNDROME
SHIN SPLINTS
ANKLE SPRAINS
JOBST
INTERMITTENT
COMPRESSION
DEVICE
ROM exercises
Strengthening
Proprioception
Agility
Running/jumping
Syndesmotic
Injury
ACHILLES TENDONITIS
ACHILLES TENDON
RUPTURE
PLANTAR FASCITIS
Over pronation
Pes cavus foot
Tight calf muscles
Tibial varum
Anteversion
Weak ER of hip
Pharmacology
NON STEROIDAL
ANTIINFLAMMATORY
DRUGS (NSAIDS)
Treatment of inflammatory arthritic
diseases
Treatment of the itises
Common NSAIDs
(OTC)
Bayer
(aspirin)
Tylenol
(acetaminophen)
Aleve
or Naprosyn
(naproxen)
Advil
(ibuprofen)
Celebrex (celecoxib)
Voltaren (diclofenac)
Lodine (etodolac)
Nalfon (fenoprofen)
Indocin (indomethacin)
Orudis, Oruvail
(ketoprofen)
Toradol (ketoralac)
Daypro (oxaprozin)
Relafen
(nabumetone)
Clinoril (sulindac)
Tolectin (tolmetin)
Vioxx (rofecoxib
Dosing
Depends
Avoid
Trial
and Error
Every
Must
on Goal
CORTICOSTEROIDS
ACTION
Stabilizes cell membranes which
decreases release of inflammatory
mediators
Inhibits migration of inflammatory cells that
are attracted to the injured area.
INDICATIONS
INFLAMMATORY DISEASES: RA, Lupus,
Ankylosing Spondylitis
NO! Acute musculoskeletal injuries
???? Chronic musculoskeletal injuries
ADMINISTRATION
ORAL: Used in tx of diseases which affect
multiple joints; Dose pack for chronic
musculoskeletal problems
LOCAL INJECTION: Used for tendinitis,
bursitis, fasciitis
TOPICAL USE: Dermatologic effects only
ANALGESICS
Allow early initiation of rehab
Improve quality of life for persons with
chronic pain
Allow patients to tolerate surgery
NON-NARCOTIC
Acetaminophen: Has central nervous
system effect through cental inhibition of
prostaglandins
Aspirin: Has peripheral effect through
peripheral inhibition of prostaglandins
NSAIDS: Have analgesic effect on
nervous system as well as decreased
inflammation
NARCOTIC
Common property: bind to opioid
receptors in brain
Results in significant elevation of pain
threshold; can be addictive
INDICATIONS
Mild/moderate musculoskeletal pain: nonnarcotics; acetaminophen first choice;
NSAIDS may be more logical if
inflammation is causing pain, ie acute
injuries and inflammatory arthritis
Osteoarthritis: acetaminophen
Chronic musculoskeletal pain:
acetaminophen
Continued
Acute postoperative pain: narcotics; can
be given IV or IM
Chronic, Severe pain: narcotics
See Table 3 for commonly used analgesic
drugs
SIDE EFFECTS
ACETAMINOPHEN: generally safe; liver
toxicity
ASPIRIN/NSAIDS: as previously covered
NARCOTICS: respiratory suppression;
sedation, nausea and vomiting; urinary
retention; euphoria/dependence
ANTIBIOTICS
Used to treat or prevent bacterial
infections which can occur postoperatively
or post compound fracture
Classified based on chemical structure
and effectiveness against certain bacteria
(Table 4)