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2. McMurray test: a combination of valgus stress, extension, and external rotation of the knee joint are used to assess the integrity of the medial meniscus. A combination of varus stress, extension, and internal rotation of the knee joint, are used to assess the integrity of the lateral meniscus. Both test positions elicit an audible or palpable clicking sensation over the medial or lateral knee joint line if either meniscus has been injured.
flexed, internally and externally
the knee. rotate the tibia on the femur.
the test is considered positive for a torn medial meniscus, usually in the posterior position.
With the leg externally rotated and in valgus, slowly extend the knee. If click is palpable or audible, With the leg externally rotated, place a valgus stress on the knee.
3- The medial-lateral grind test: from a starting position of full extension, alternating varus and valgus stresses are applied as the knee is alternately flexed and extended to and from a position of 45 degrees flexion. A longitudinal meniscal tear produces a grinding sensation along the lateral or medial joint line according to the involved side. Prolonged grinding indicates a complex meniscal tear or injury of both menisci.
Surgical procedure: the procedure is almost universally done today by arthroscopic means. Partial meniscectomy is indicated in unstable tears that are not repairable due to location or configuration and In this procedure, the surgeon removes only the damaged or unstable portion of the meniscus, and balances the residual meniscal rim.
1- Control of pain and edema
2- Obtaining and maintaining full ROM
3- Regaining proper quadriceps strength.
4- Immediate weight bearing as tolerated
5- Return to activity
1- Diminish Swelling and pain
2- Improve ROM
3- Reestablish quadriceps muscle activity
1- Reestablish full non painful ROM
2- Restore and improve muscular strength
3- Proprioceptive training
4- Gradual return to functional activities
Criteria for progression to Phase 3: Satisfactory clinical examination (minimal effusion)
1- Maintain full ROM
2- Enhance muscular strength and endurance
3-Return to sport/functional activities
(1) Swelling does not occur with activity.
(2) Full ROM has been regained,
(3) There is equal bilateral strength in knee flexion and extension,
(4) The athlete can successfully complete functional performance tests.