Chapter 47 - Radiographic Evaluation and Surgical Anatomy of the Knee Flashcards
when to get non-weightbearing XRs?
trauma setting - no increased risk of fracture displacement
what does a segond fracture indicate
lateral capsular avulsion (meniscotibial ligament)
pathognomonic for ACL tear, but not necessary for ACL ter
avulsion of the medial femoral epicondyle indicates what?
proximal MCL tear - stieda-pelligrini lesion
what location is most common for stress fracture on knee radiographs
proximal medial tibia - vertical radiolucency
increased radionuclide activity can be present for how long post operatively?
1 year
indium 111
tagged white blood cell scan
concentrates in areas of infection
technetium 99
may help identify infection, neoplasia, occult fracture, bone healing, active phases of heterotopic ossification, implant loosening, failure of osseointegration
what does the broader anterior to posterior length of the lateral femoral condyle allow?
allows INTERNAL rotation of the knee when in full extension
what type of collagen makes up the ACL?
type I and III
primary blood supply to the acl
middle genicular a
primary nervous supply to the acl
posterior articular branch of the posterior tibial nerve
posterior cruciate ligament main blood supply
middle geniculate artery
nerve supply to pcl
posterior articular branch of the posterior tibial nerve
popliteus tendon insertion/origin
originates DISTAL to the joint (eg on the posterocentral tibia)
inserts anterior and distal to the LCL on the lateral femoral epicondyle
superficial MCL things
tibial collateral ligament
deep to semitendinosis and gracillis
origin on the medial femoral condyle sulcus
broad insertion 4-6cm distal to the joint line
- anterior fibers , tight in first 90 degrees of flexion
- posterior fibers, tight in full extension
what attaches the medial meniscus to the deep MCL?
coronary ligaments
blood supply to MCL
superomedial and inferomedial geniculate aa
what is the largest posterior ligamentous structure?
oblique popliteal ligament
what structures make up the posteromedial knee?
semimembranosis tendon
capsule
oblique popliteal ligament
posterior oblique ligament
semimembranosis tendon has how many insertions?
five:
posterior oblique tendon
oblique popliteal ligament
posterior capsule and posterior horn of the medial meniscus
tibia deep to mcl
popliteus aponeurosis
what complication with knee ROM can be seen post closing wedge tibial osteotomy?
patella baja
loss of knee flexion
middle geniculate artery is a branch of what?
popliteal artery
similar to the superior, and inferior medal and lateral geniculates which are branches of the popliteal a
descending geniculate is the only one that is a branch of the femoral a
relationships of the peroneal nerve
courses deep the biceps femoris tendon, distal to the fibular collateral ligament as it crosses the joint line, and courses around the fibular head to enter the anterior compartment of the knee
infrapatellar branch of the saphenous n
most commonly injured during medial parapatellar approach
courses from superomedial to inferolateral distal to the patella
can aso get trapped btwn the sartorius and the mfc
when may a lateral parapatellar approach be useful?
valgus knees
lateral uni
what vascular structure is at risk in a quad turndown
superior lateral geniculate a. if the connecting incision from the v is taken to distally
when may a medial femoral epicondyle osteotomy be advantageous?
severe, fixed varus deformity
MPFL dynamics
lax in extension
tight in flexion
related to its femoral insertion - proximal and posterior to the ME
