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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
Nonetheless, the Pittsburgh knee rules offer fewer false positives than do the Ottawa knee rules, though the Ottawa knee rules are more commonly used. [2] 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.
Most commonly, varus and valgus stress to the knee is added. These variations constitute different tests with different statistical performance and should not be confused with the original. According to some sources, the sensitivity of the McMurray test for medial meniscus tears is 53% and the specificity is 59%.
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Gait assessment can be used to differentiate genuine knee pain or pain which referred from hip, lower back or the foot. A person can be asked to perform a duckwalk. This requires the person to squat and walk in that position. In order to perform a duckwalk, the person has to be free of ligamentous tear, knee effusions, and meniscal tears.
Knee replacement involves exposure of the front of the knee, with detachment of part of the quadriceps muscle (vastus medialis) from the patella. The patella is displaced to one side of the joint, allowing exposure of the distal end of the femur and the proximal end of the tibia. The ends of these bones are then accurately cut to shape using ...