Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSK SB > Adult Hip + Knee Problems > Flashcards

Adult Hip + Knee Problems Flashcards

1
Q

what can go wrong in the hip

A 
altered mechanics
block to movement
failure of bone
degeneration
injury
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what can be causes of block to movement

A

Perthes Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the 4 types of hip joint

A

normal
CAM - high demand more at risk
Pincer - high demand more at risk
Mixed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what can cause failure of bone

A

avascular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what can be an uncommon complication of RA and Perthes disease

A

Protrusio acetabuli
intrapelvic displacement of the acetabulum and femoral head, so that the femoral head projects medial to the ischioilial line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Surgical management of arthritic hip joint

A

Total Hip Replacement (THR)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Surgical management of Pethes hip joint

A

osteotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what are the indications for THR in people over 65 y/o

A 
Reduced walking distance
Pain not controlled by analgesics
Night pain
Impairment of activities of daily living 
Impairment of hobbies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complications/risks of THR

A 
Blood loss
 DVT / PE
 Nerve damage
 Dislocation
 Medical complications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the history for Trochanteric bursitis

A

sharp, localised pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tx for Trochanteric bursitis

A

usually self limiting

treated conservatively +/- injections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what factors are indicative of referral of hip pain from GP

A

pain at night
loss of function
age of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

common causes of hip pain

A 
OA
RA
AS
Fracture 
Referred from back
Malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

rare causes of hip pain

A

Soft tissue
Paget’s disease
Infection
AVN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what is the role of the menisci in the knee

A

distribute load from convex femoral condyles to relatively flat tibial articular surfaces

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

why are medial meniscal tears more common

A

medial meniscus is fixed whilst lateral meniscus is more mobile
medial meniscus under greater amount of sheer stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

what are the roles of the ligaments in the knee

A

MCL resists valgus stress
LCL resists varus stress
ACL resists anterior subluxation of the tibia and internal rotation of the tibia in extension
PCL resists posterior subluxation of the tibia ie anterior subluxation of the femur and hyperextension of the knee

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

which is the only ligament we expect to heal

A

the medial collateral ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

what would a rupture of the MCL, ACL and PCL cause separately

A

MCL rupture - valgus instability
ACL rupture - rotatory instability
PCL rupture - recurrent hyperextension or instability descending stairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what does posterolateral corner or multiligament ruptures cause

A

PL corner - various and rotatory instability

Multi - gross instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what are the patterns of meniscal tear

A

longitudinal - along longitudinal fibres
radial - from the centre (will not heal)
parrot beak - flaps about, folds underneath its self
bucket handle - flicks in and out, catches in inter-condyle notch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

what is a sign of a bucket handle tear

A

knee cannot go straight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what causes meniscal tears in younger patients

A

sporting injury

getting up from squatting position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what causes meniscal tears in older patients

A

atraumatic spontaneous degenerate tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what are 50% ACL ruptures associated with

A

meniscal tears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

how are meniscal tears investigated

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Tx of meniscal tear issues

A

limited healing potential

only peripheral 1/3 has blood supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Tx of meniscal tear

A

arthroscopic repair in acute peripheral tears in younger patients

arthroscopic menisectomy for mechanical symptoms (locking) or failed meniscal repair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are the signs of a bucket handle tear and Tx

A

acute locked knee
springy block to extension

urgent surgery required - arthroscopic repair
if that does not work - partial meniscectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

what can happen if knee remains locked in bucket handle tear

A

fixed flexion deformity

31
Q

surgery helps in degenerate tears - true or false

A

false

steroid injection may help

32
Q

what are the grades of knee ligament injuries

A

grade 1 - sprain
grade 2 - partial tear
grade 3 - complete tear

33
Q

MCL injury prognosis

A

usually heals well unless combined with ACL or PCL rupture

34
Q

Tx for MCL

A

brace, early motion, physic
pain can take several months to settle
rarely requires surgery - advancement or reconstruction with tendon graft

35
Q

ACL function and mechanism for rupture

A

main stabiliser against internal rotation of tibia

usually sporting injury

36
Q

Tx for ACL rupture

A

Physio - to help stabilise knee

ACL repair does not work - reconstruction only

Autograft - patellar tendon or hamstrings
Allograft - achilles

Can stick ACL to PCL for stability

37
Q

rule of 1/3rds for ACL rupture

A

1/3 compensate and are able to function well
1/3 can avoid instability by avoiding certain activities
1/3 do not compensate and have frequent instability or can’t get back to high impact sport

38
Q

when is surgery indicated for ACL rupture

A

rotatory instability not responding to physio
return to high intensity sports
multiligament reconstruction

39
Q

surgery can treat pain and prevent arthritis in ACL rupture - true or false

A

false

does not treat pain or prevent arthritis

40
Q

what does LCL injury cause

A

varus and hyperextension

rotatory instability

41
Q

complication of LCL injury

A

common peroneal nerve palsy

42
Q

what does LCL injury often occur in combination with

A

PCL/ACL injury

43
Q

Tx of LCL

A 
Complete rupture needs urgent repair if early (within 2-3 wks)
 Later reconstruction (hamstring or other tendon)
44
Q

MOI of PCL rupture

A

Direct blow to anterior tibia, (Dashboard / Motorbike) or hyperextension injury

45
Q

what can be seen in a PCL rupture

A

popliteal knee pain

brusing

46
Q

isolated PCL rupture common - true or false

A

false

usually with other injury

47
Q

complications post PCL rupture

A

instability – recurrent hyperextension/feeling unstable when going down stairs

48
Q

MOI of knee dislocation

A

high energy injury

49
Q

complications of knee dislocation

A

Popliteal artery injury
Nerve injury - common peroneal nerve
Compartment syndrome

50
Q

Tx of knee dislocations

A

emergency reduction
recheck neurovascular status
vascular surgery if needed
multi-ligament reconstruction

51
Q

MOI of patellar dislocation

A

rapid turn to direct blow

52
Q

who is more likely to get patellar dislocation and why

A

females adolescents
ligamentous laxity
valgus knee
torsional abnormalities

53
Q

how many get recurrent patellar dislocations

A

10%

54
Q

what happens when you fall onto flexed knees with quads contraction

A

extensor mechanism rupture

55
Q

risk factors for extensor mechanism rupture

A

previous tendonitis
steroids
chronic renal failure
drugs e.g. Ciprofloxacin

56
Q

signs of extensor mechanism rupture

A

unable to straight leg raise

palpable gap

57
Q

what type of swelling are ACL and fractures associated with

A

haemarthrosis - blood, immediately swells

58
Q

what type of swelling is associated with meniscal or chondral injury

A

effusion - next day swelling

59
Q

what does pain on the joint line suggests

A

meniscal/chondral, generalised haemarthrosis

60
Q

football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability - injury?

A

ACL rupture

61
Q

Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking

A

Meniscal tear

62
Q

what is hyaline cartilage comprised of

A

water, collagen, proteoglycans and chondrocytes

63
Q

what do chondrocytes secrete

A

collagen
PGs
Enzyme
Regulate ECM

64
Q

how does hyaline cartilage get nutrition

A

synovial fluid and subchondral bone

65
Q

what are defects of articular cartilage

A

trauma - ligament injury, dislocation

atraumatic - Osteochondritis dissecans, Osteoarthritis, Inflammatory arthritis

66
Q

what type of cartilage injuries heal

A

only full thickness injuries - healing still not perfect

67
Q

why is healing in cartilage injuries not perfect

A

healing with fibrocartilage
greater friction
less wear resistant

68
Q

what is Osteochondritis dissecans

A

when An area of the surface of the knee loses its blood supply and cartilage +/- bone can fragment off
most common in teens
can heal spontaneously

69
Q

how is Osteochondritis dissecans TX if detachment is seen on MRI

A

can pin in place with internal fixation

70
Q

what are cartilage regeneration techniques

A

Drilling / microfracture - simplest + cheapest
Osteochondral autograft or allograft - for larger defects
Mosaicplasty
MACI – membrane induced autologous chondrocyte implantation

71
Q

early OA non operative treatments

A

Weight loss, stick, exercise, analgesics, activity modification
Hyaluronic acid injections
Steroid injection - acute flare ups

72
Q

who gets knee replacement

A

elderly patients with end stage arthritis

TKR lasts 15-20 years

73
Q

Sx of Osteochondritis dissecans

A

Pain after exercise
Intermittent knee swelling
Locking may occur

Seen in ages 13-21 commonly

MSK SB (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions