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MSK > Acute Knee Injury > Flashcards

Acute Knee Injury Flashcards

1
Q

What are common injuries to the knee?

A
  • Fracture
  • Acute/chronic degenerative joint disease
  • Meniscal injury
  • Ligament injury
  • Tendon injury
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2
Q

What needs to be covered in a knee injury history? [EAESCHS]

A
  • Environment: sport or recreation, workplace
  • Activity: sports tackle, jumping
  • Energy: how fast and how heavy
  • Systemic symptoms
  • Chronology: quick or slow onset, previous injury/event
  • Hear/feel pop
  • Swelling: early means haemarthrosis (bleeding into the joint)
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3
Q

What often causes a meniscal injury?

A
  1. Twisting movement on a loaded fixed knee]
  2. Painful squelch
  3. Slow swelling
  4. Painful to weight bear
  5. “locked knee”
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4
Q

What causes an ACL tear?

A
  1. Forward momentum, leg fixed +/- rotation
  2. “Pop”
  3. Quick swelling
  4. Often able to weight bear
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5
Q

What often causes collateral tears?

A
  • Lateralised pain
  • Feel of ‘crack’, sharp pain
  • No or minimal effusion
  • Bruising to one side
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6
Q

What do we do on examination for knee injuries?

A
  • Look, feel and move
  • Look for:
    • scars, bruising, swelling
    • joint line irregularity
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7
Q

What do we feel for on knee examination?

A
  • Feel for effusion
  • Crepitus
  • Heat
  • Tenderness
  • Tissue lump or defects
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8
Q

What movements do we test for knee injury?

A
  • Passive and active
  • Straight leg raise
  • Their range of movement
  • Ligament testing
  • Dynamic testing
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9
Q

What knee injuries are visible on xray?

A
  • Fracture
  • Loose bodies
  • Ligament avulsion
  • Osteochondral defect
  • Degenerative joint disease
  • Lipohaemarthrosis
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10
Q

What knee injuries are visible on ultrasound?

A
  • Tendon rupture
  • Some meniscal tears
  • Swelling
  • Cysts
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11
Q

What are MRI used for in knee injuries?

A
  • For clinical confirmation
  • Variable sensitivity & specificity
  • Not good for DJD or mobile pathology
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12
Q

What is the role of surgery in knee trauma?

A
  • Joint preservation
  • Life-long care of the joint
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13
Q

What are the indications for surgery in knee trauma?

A
  • Failure of conservative Rx
  • Demands of work
  • Demands of sport
  • Problems with daily activities
  • Prevention of future joint injury
  • Fall prevention
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14
Q

What are some non-surgical options for knee trauma?

A
  • Restoration of function
  • Physio
  • Analgesics
  • Swelling reduction
  • Range of motion/normal movement
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15
Q

What is the meniscus?

A

Piece of cartilage that provides a cushion between your femur and tibia.

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16
Q

What are some surgical options for meniscus damage?

A
  • Mensical repair
  • Partial mensicetomy
  • Meniscal tranplantation
17
Q

Name the parts of the menisus.

A
18
Q

Where are the ligaments attached to meniscus?

A

Ligaments around the edge

19
Q

Why are the orientation of fibres arranged in that way?

A

Allows it to take load from all directions

20
Q

How is the vascular supply to the knee relevant in trauma?

A
  • Section with good blood supply [the edge] will live when repaired
  • Section with poor blood supply [the centre] will die on repair
21
Q

Who is eligable for meniscal repair?

A
  • Young
  • Sporty
  • Fresh tears (3 months)
  • Healthy meniscus
  • Where there is good vascularity
22
Q

What are the main techniques of meniscal repair?

A
  • open technique
  • Outside-in
  • Inside-out
  • All inside
23
Q

What is the anterior cruciate ligament (ACL)?

A

Cruciate ligaments control forward and backward movement of the knee. ACL runs diagonally in the middle of the knee.

24
Q

What are some of the treatment options for ACL injury?

A
  • Full ACL rehab
  • ACL reconstruction
    • Acute or delayed
    • Done to prevent further injury, such as osteoarthritis
    • May be done to get patient back to work or to sport
25
Q

What are reasons for surgical intervention for ACL?

A
  • Prevent further injury
  • Back to work
  • Back to sport
  • Prevention of osteoarthritis
26
Q

Why do osteochondral injuries occur in adults?

A

Often happens due to direct trauma: chip off some cartilage and bone.

27
Q

What are the steps to osteochondral repair?

A
  • Debridement
  • Reattachment of fragment
  • Removal of loose bodies
  • Microfracture chondroplasty

MSK (33 decks)

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