4- Knee Conditions

Question 1

Describe a “total” knee replacement

Answer 1

Resurfacing all 3 compartments of the knee

Question 2

Describe a “partial” knee replacement

Answer 2

Resurfacing 1 compartment of the knee (usually patellofemoral)

Question 3

There is a greater incidence of pain assoc. with knee replacements compared to hip replacements. True/False?

Answer 3

True

Question 4

How do meniscal tears classically occur?

Answer 4

Twisting force

Question 5

Where do patients usually localise meniscal tear injury?

Answer 5

Joint line of the knee
Medial (majority)
Lateral (occasionally)

Question 6

If a patient describes a “locked knee”, what pathology should be suspected?

Answer 6

Bucket-handle mensical tear

Question 7

Define true “locking” of the knee

Answer 7

Mechanical block to full knee extension

Question 8

What is the difference between locking and pseudolocking of the knee?

Answer 8

Pseudolocking will resolve spontaneously/patient describes trick manoevure to overcome the locking

Question 9

How do ACL ruptures classically arise?

Answer 9

Great rotational force upon a planted foot

Question 10

What, clinically, usually accompanies an ACL rupture?

Answer 10

“pop” sound
Haemarthrosis
Rotatory instability (chronic)

Question 11

A rugby tackle from the side will usually cause which ligament to damage?

Answer 11

Medial collateral, causing valgus stress injury

Question 12

A direct blow to the anterior tibia with the knee flexed (car crash) may rupture which ligament?

Answer 12

Posterior cruciate

Question 13

A varus stress injury causes rupture of which ligament?

Answer 13

Lateral collateral

Question 14

Which test is used to define a meniscal tear?

Answer 14

Steinmann’s test

Question 15

Which meniscal tear is more common - medial or lateral?

Answer 15

Medial

it is less mobile

Question 16

Which type of meniscal tear causes a bucket-handle tear?

Answer 16

Longitudinal tear

Question 17

List the 4 types of meniscal tear

Answer 17

Longitudinal
Radial
Oblique
Horizontal

Question 18

Degenerative meniscal tears are usually Steinmann’s positive. True/False?

Answer 18

False

Question 19

Why do meniscal tears have limited healing potential?

Answer 19

Small blood supply

Question 20

What clinical tests will help define ACL rupture?

Answer 20

Lachman test

Anterior drawer test

Question 21

Primary repair of ACL rupture is not effective. True/False?

Answer 21

True

Most get reconstruction

Question 22

What does reconstruction of ACL involve?

Answer 22

Tendon grafting (patellar/temitendinouus-gracilis)

Question 23

What structures are involved in the extensor mechanism of the knee?

Answer 23

Tibial tuberosity
Patellar tendon
Patella
Quadriceps tendon
Quadriceps

Question 24

How does the patellar/quadriceps tendon usually rupture?

Answer 24

Rapid contractile force (lifting heavy weight)

Question 25

What clinical test helps define whether the extensor mechanism of the knee is intact?

Answer 25

Straight leg raise

Question 26

List clinical signs of patellofemoral dysfunction

Answer 26

Anterior knee pain worse going downhill
Grinding/clicking sensation
Pseudolocking