Acute Injuries of the Knee Flashcards
What do you need to find out in a history of knee injury?
Environment
- Sport or recreation
- Workplace
Activity
- Sports tackle
- Jumping
Energy
-How fast and hor heavy
Systemic symptoms
Chronology
-Quick or slow onset
-Previous injury or event
(injure 1 knee -> more likely to injure other)
Swelling
- Early or late onset
- Early means haemarthrosis
What is heard/ felt in a meniscal tear?
Often a squelch is described
What kind of action causes a meniscal injury?
Twisting moment on a loaded fixed knee
What are the signs and symptoms of a meniscal injury?
swelling? weight bearing?
Slow swelling (quicker in the young)
Painful to weight bear
“Locked” knee
What kind of action causes an ACL tear?
Forward momentum, leg fixed +/- rotation
Someone tackling you
What are the signs and symptoms of an ACL tear?
swelling? weight bearing? sound?
“Pop”
Quick swelling
Often able to weight bear
What are the signs and symptoms of a collateral tear?
pain? sound? swelling?
Lateralised pain
Feel of “crack”, sharp pain
No or minimal effusion
Bruising to one side
How can bruising give clues to an injury?
no bruising? Post? Lateral?
No bruising -> likely intra-articular
Post -> post capsular tear
Lateral -> lateral collateral ligament
What should you feel for when examining a knee?
Effusion Crepitus Heat Tenderness Tissue lumps or defects
What can x-rays show you in knee problems?
Fracture Loose bodies Ligament avulsion Osteochondral defect Degenerative joint disease Lipohaemarthrosis
What can ultrasound show you in knee problems?
Tendon rupture
Some meniscal tears
Swelling
Cysts
When is MRI used in knee problems?
For clinical confirmation
variable sensitivty and specificity
Not good for DJD or mobile pathology
What are the indications for surgery?
Failure of conservative Rx Demands of work Demands of sport Problems wth daily activity Prevention of further joint injury prevention of falls
How do you treat meniscus tear?
Meniscal repair
Partial meniscectomy
Meniscal transplantation
Explain the bribrous structure of the meniscus
Circumferential “hoop” fibres
Superficial randomly orientated fibres
Radially orientated “tie” fibres
