Articular Cartilage And Meniscal Injuries Flashcards
How is the meniscus often injured?
Twisting
How is pain in meniscus injuries?
Worse with movement and better with rest
What may people with a meniscus injury complain of?
Locking
Longitudinal meniscal lesion
Most common type
Bucket handle lesion
Longitudinal can lead to bucket handle and this is where the catching of knee happens
What are good prognosis for healing of a meniscal tear?
Age < 35
Peripheral damage
Longitudinal tear
Short tear
Acute injury
Stable knee
What are the hallmark findings for joint line tenderness in a meniscus tear?
Good sensitivity
What are the hallmark findings for effusion in a meniscus tear?
Mild-mod over 1-2 days
What are the hallmark findings for positive entrapment test in a meniscus tear?
Mcmurrays
Apleys
Squat
What are the hallmark findings for quad inhibition in a meniscus tear?
Atrophy over first week or two following injury
What is a traumatic articular cartilage injury?
Ligament damage
What is a non traumatic articular cartilage injury?
Repetitive microtrauma (asymptomatic and non progressive)
What is a lavage surgery?
Short term pain relief (sham surgery)
What are treatments for a low demand lesion of < 2.5 cm?
Debridement
Microfracture
What are treatments for a high demand lesion < 2.5 cm?
Microfracture
AOT
What are treatments for low demand lesions of 2.5-4 cm?
Microfracture
AOT
ACI
What are treatments for a high demand lesion of 2.5-4 cm?
AOT
ACI
OAT
What are treatments for a lesion of > 4 cm?
ACI
OAT
What are risk factors of anterior knee pain?
Age
Active
Women
Rear foot runner
Increased Q angle
Increased tibial ER
Patellar mal alignment
Weak quads
Tight ITB, hamstrings
What is the difference between a subluxation and dislocation?
Subluxation- partial
Dislocation- full
What are causes of anterior knee dislocation?
Trauma
Non contact twisting
Blow to medial side of knee
What is the function of articular cartilage?
Reduce friction
Fluidity of joint
How do traumatic cartilage lesions usually occur?
ACL or fracture
How does a non traumatic articular cartilage lesion usually occur?
Age or Repetitive motions
Grade 1 focal articular cartilage lesion
Softening
Grade 2 focal articular cartilage lesion
Fibrillation
Grade 3 focal articular cartilage lesion
Partial thickness
Grade 4 focal articular cartilage lesion
Full thickness with exposed bone
Which type of surgery is performed for a grade 1 articular cartilage lesion?
No surgery indicated
Which type of surgery is performed to repair an articular cartilage lesion which is less than 2.5 cm deep for a younger highly active individual?
Microfracture
Which surgery is allowed WBAT immediately following the procedure?
Debridement
What is indicative of both a meniscal tear and anterior knee pain?
Pain while performing a squat
What is the most common site for fractures in the knee?
Patella and tibial plateau
What is osteocondral?
Damages to cartilage or bone
Why do most osteochondrals occur?
Patellar dislocation or ACL injury
What causes a tibial plateau?
Trauma
Excessive varus, valgus, or compressive forces
Who often gets a tibial tubercle?
Young male athletes
When does a tibial tubercle happen?
Eccentric loading of the quads
What is a segond fracture?
Avulsion fracture associated with anterolateral ligament
What causes of segond fracture?
Excessive tibial IR
Varus stress
What is the most important complication in a tibial femoral dislocation?
Potentially limb threatening
What can a tibial femoral dislocation result in?
Fractures or ligament disruption
How long are fractures immobilized for?
4-6 weeks
What is the most common type of salter Harris epiphyseal complex fractures?
Type 2
What is the most severe type of salter Harris epiphyseal complex fractures?
Type 5
What is osteochondritis dissecans?
Idiopathic lesion of subchondral bone
If you cannot find much with a physical exam what disease does that indicate?
OCD
What criteria would cause you to lead a patient to his physician for further testing?
Thought and calf swelling on affected side
Tenderness along deep venous system
Pitting edema
Does a bucket handle meniscus tear need surgery?
Yes
Does a longitudinal meniscus tear need surgery?
No
