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The Ottawa knee rules are a set of rules used to help physicians determine whether an x-ray of the knee is needed. [1] They state that an X-ray is required only in patients who have an acute knee injury with one or more of the following: Age 55 years or older; Tenderness at head of fibula; Isolated tenderness of patella
Passive range of motion (or PROM) – Therapist or equipment moves the joint through the range of motion with no effort from the patient. Active assisted range of motion (or AAROM ) – Patient uses the muscles surrounding the joint to perform the exercise but requires some help from the therapist or equipment (such as a strap).
The Injury Severity Score (ISS) is an established medical score to assess trauma severity. [1] [2] It correlates with mortality, morbidity and hospitalization time after trauma. It is used to define the term major trauma. A major trauma (or polytrauma) is defined as the Injury Severity Score being greater than 15. [2]
The mechanism of injury, location, character of the knee pain, the presence of a "pop" sound at the time of the injury (indicates ligamentous tear or fracture), swelling, infections, ability to stand or walk, sensation of instability (suggestive of subluxation), or any previous traumatic injuries to the joint are all important historical features.
Abbreviated Injury Score-Code is on a scale of one to six, one being a minor injury and six being maximal (currently untreatable). [1] An AIS-Code of 6 is not the arbitrary code for a deceased patient or fatal injury, but the code for injuries specifically assigned an AIS 6 severity. [1]
The Ottawa knee rules count even a limping step as a step. Pittsburgh counts only a complete heel/toe plant as a step. This key difference likely accounts for the difference in specificity. The use of the Pittsburgh knee rules reduces the use of knee radiographs by 52%. [3]
Side-to-side movements of the knee should be avoided. The patient is allowed to bear weight as tolerated and should perform quadriceps strengthening exercises along with range of motion exercises. The typical return-to-play time frame for most athletes with a grade III medial knee injury undergoing a rehabilitation program is 5 to 7 weeks.
A patient's self-reported pain is so critical in the pain assessment method that it has been described as the "most valid measure" of pain. [ 2 ] [ 3 ] The focus on patient report of pain is an essential aspect of any pain scale, but there are additional features that should be included in a pain scale.