Acute injuries of the knee Flashcards

1
Q

List 5 possible pathologies of the knee

A
fracture 
tendon injury 
meniscal tear 
ligament injury 
acute on chronic degenerative joint disease
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2
Q

Important questions in the history for environment, activity and energy

A

sports - workplace - how fast - how heavy - sports tackle - jumping

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3
Q

Chronology questions in history

A

quick or slow onset

previous injury or event

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4
Q

Other questions in the history

A

hear or feel a pop or crack
swelling - early or late?
systemic symptoms

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5
Q

early swelling in a knee indicated what?

A

haemarthrosis

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6
Q

history of a meniscal injury

A
twisting movement on a loaded fixed knee 
"locked knee"
painful squelch 
slow swelling - quicker in young 
painful to weight bear
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7
Q

history of an ACL tear

A

forward momentum, leg fixed +/- rotation
“pop”
quick swelling
often able to weight bear

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8
Q

History of collateral tears

A

lateralised pain
feel of crack, sharp pain
no or minimal effusion
bruising to 1 side

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9
Q

4 things to look for when examining the knee

A

scars, bruising, swelling, joint line irregularity

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10
Q

process of examining a joint

A

look, feel, move

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11
Q

5 things to feel for in joint examination

A
crepitus 
tissue lumps or defects 
heat
effusion 
tenderness
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12
Q

5 techniques of movement in joint examination

A
active and passive 
range of movements 
straight leg raise 
dynamic testing 
ligament testing
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13
Q

3 imaging modalities used

A

x-ray, USS and MRI

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14
Q

List some things x-rays are good at picking up

A

fracture-loose bodies - lipohaemarthrosis - ligament avulsion - osteochondral defect - DJD

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15
Q

USS used for

A

tendon rupture - some meniscal tears - swelling - cysts

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16
Q

What is MRI not good for?

A

DJD or mobile pathology

17
Q

List some indications for surgery

A

failure of conservative management

work, sport, problems with daily activities, prevent further joint injury and falls

18
Q

Non surgical managements

A

physio - analgesia - swelling reduction - ROM

19
Q

3 surgical treatments for meniscal tears

A

repair - partial meniscectomy - meniscal transplant

20
Q

shape of the 2 menisci

A

medial is semi-circular and lateral is almost circular

21
Q

Where are the tensile stresses which help to balance the radial component of loading force developed?

A

circumferentially orientated collage fibres

22
Q

Where do periminiscal capillary plexus arise from?

A

branches of inferior medial and lateral geniculate arteries

23
Q

What 2 vessels do the perimeniscal plexus go on to form?

A

circumferential and penetrating radial

24
Q

who gets meniscal tears?

A

young - sporty - fresh tears up to 3 months - healthy meniscus

25
Q

what zones do meniscal tears occur?

A

red/red or red/white

26
Q

Repair techniques for meniscal injuries

A

open, all inside, inside-out or outside-in

27
Q

Briefly explain the smith and nephew technique for the repair of meniscal tears

A

device passed through meniscus allowing “t” to be deployed. Knots tied outside joint and pushed snuggly against meniscus

28
Q

2 treatments for ACL tear

A

full ACL rehab - ACL reconstruction

29
Q

Reasons for ACL surgery

A

prevent further injury
back to work
back to sport
prevent OA

30
Q

Treatment of osteochondral injuries

A
debridement 
reattachment of fragment 
ACI 
removal of loose bodies 
microfracture chondroplasty