Acute Injuries of the Knee Flashcards
Knee joint type
Hinge-type synovial joint
Articular surfaces of the knee joint
Femoro-tibial (lateral medial) and the femoropatellar
What questions should be asked with theres a presentation of a knee injury
Type of injury, systemic symptoms (indication of infection), chronology, sounds
How does a meniscal injury of the knee occr
Twisting movement on a loaded fixed knee
What will the patient describe if they have a meniscal injury
Slow swelling, painful “squelch”, painful to weight bear and a locked knee
How does an ACL tear occur
Forward momentum on a fixed leg with or without rotation
Clinical presentation of ACL tears
Painful pop, quick swelling, able to weight bear with strange dull pain
Collateral tear clinical presentation
Lateralised pain, “crack” and sharp pain, no swelling, bruising on the other side of the knee
X-rays are the fastest way of showing up
• Fractures • Loose bodies • Ligament avulsion • Osteochrondral defect • Degenerative joint defect Lipohaemarthrosis
Ultrasound useful for
- Tendon rupture
- Meniscal tears
- Swelling
- Cysts
Indications for knee surgery
- Failure of conservative treatment
- Demands of work
- Demands of sport
- Problems with daily activities
- Prevention of further joint injury
- Prevention of falls
Non-surgical management of acute knee injuries
- Restoration of function
- Physiotherapy
- Analgesia
- Swelling reduction
- Range of motion
- Normal movement
Why is surgery indicated for meniscal tear in young patients
It protects the joint surface and reduced risk of degenerative changes further down the line
State the different surgical options for meniscal repair
- Meniscal Repair
- Partial meniscectomy
- Meniscal transplantation
Load transmission of meniscus
The radial component of the loading force is balanced by tensile stresses developed in the circumferentially orientated fibres.
Who is entitled to meniscal repair
- Young
- Sporty
- Fresh tears – up to three months
- Healthy meniscus
- Red/red or red/white zones are what are surgically repaired
Failure rate of meniscal repair
1:5
State the ways in which ACL can be repaired
Full ACL rehab, ACL reconstruction
State the reasons for surgery of ACL
- Prevention further injury
- Back to work
- Back to sport
- Prevention of osteoarthritis
Different methods of Osteochondral injury repair
- debridement
- Reattachment of the fragment
- Removal of loose bodies
- Microfracture chrondroplasty – stimulate the surface underneath to promote bleeding. The surface forms a super-clot which then turns into hyaline cartilage.
