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Review Question - QID 1070

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QID 1070 (Type "1070" in App Search)
A 21-year-old female presents with left knee pain for six months. The symptoms are worse climbing stairs and sitting for long periods of time. On physical exam she has a stable knee with no effusion and pain with compression of the patella. Her Q angle is 21 degrees. What is the first step in management?

arthroscopic lateral retinacular release

1%

24/2706

tubercle elevation and medialization

1%

23/2706

strict immobilization and non-weight bearing for four weeks

1%

18/2706

open chain exercises and a focus on seated leg extensions

8%

206/2706

closed chain exercises with focus on quadriceps and hamstring strengthening

90%

2422/2706

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This patient has anterior knee pain with an increased Q angle (normal is 17 degrees in a female). The first line of treatment is physical therapy. Rehab should focus on isometrics and closed chain exercises.

Hungerford et al investigated the patellofemoral joint reaction force (PFJR) during closed chain exercises versus and open chain exercise. They found an increase in the PFJR during open chain exercises and with seated leg extensions that can cause further wear and irritation of the patellofemoral joint.

Incorrect Answers:
Answer 1 & 2: Surgery would not be indicated as the first line of treatment.
Answer 3: Immobilization would lead to deconditioning and stiffness and is not indicated.
Answer 4: Open chain exercises and with seated leg extensions that can cause further wear and irritation of the patellofemoral joint.

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