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MSK > common orthopaedic conditions of the knee > Flashcards

common orthopaedic conditions of the knee Flashcards

1
Q

What kind of bone is the patella

A

sesamoid bone

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2
Q

What are the extensors of the knee

A

quadriceps

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3
Q

What are the flexors of the knee joint

A

hamstring

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4
Q

Where are the attachment points of the lateral collateral ligament

A

The tip of the fibula and the lateral femoral epicondyle

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5
Q

Why is the lateral meniscus more mobile then the medial meniscus

A

The medial meniscus is attached to the medial collateral ligament while the lateral ligament is not attached to the lateral collateral ligament

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6
Q

What does the anterior cruciate ligament attach to

A

The medial aspect of the lateral femoral condyle

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7
Q

What does the posterior cruciate ligament attach to

A

The medial femoral condyle

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8
Q

What is the common cause of an acute meniscal tear

A

twisting - normally in deep flexion

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9
Q

Which meniscal tear is more common

A

Medial meniscal as it is more fixed

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10
Q

How do meniscal tears present

A

Pain
clicking
Locking
intermittent swelling

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11
Q

What can be done on examination of meniscal tear

A

Look: effusion of the knee and quadricep wasting

Feel: tender joint on the side of the meniscal tear

Movement:
McMurrays test positive
Failed deep squat
Mechanical block to movement
Thassaly’s test positive

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12
Q

What are the investigations for meniscal tears

A

X-ray

MRI - the most sensitive test but has a lot of false positives

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13
Q

What is the most unlikely region on the meniscus for it to heal

A

White zone where it gets its nutrition from synovial fluid

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14
Q

What is the treatment for meniscal tears

A

rest
NSAIDs
physiotherapy: strengthening the hamstring and quadriceps

Surgical: arthroscopy - repair and resection

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15
Q

What is osteoarthritis

A

degeneration of the synovial joints

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16
Q

What is osteoarthritis characterised by

A

Pain and stiffness of the effected joint

bony swelling is common as well

17
Q

How is osteoarthritis managed conservatively

A

Weight loss
analgesia
activity modification
NSAIDs

18
Q

What are the surgical management of osteoarthritis

A

Most common (90%) - total knee replacement: cruciate retaining or cruciate sacrificing

Medial uni-compartmental knee replacement is the most common uni-compartmental knee replacement

19
Q

What is the function of the anterior cruciate ligament

A

Primary restraint to anterior translation of the tibia relative to the femur

20
Q

How does an ACL injury most commonly occur

A

Non contact pivot injury

21
Q

Who is ACL injuries more common in

A

females

22
Q

How does an ACL tear present

A

Acute incident where they heard a pop or crack

Immediate swelling

Deep pain

23
Q

What is done on examination of an ACL tear

A

Look: effusion

Feel

Move - anterior draw
Lachmann’s test

Pivot shift test

24
Q

What investigations are done for ACL injuries

A

X-ray
MRI

25
Q

What is the treatment for ACL tear

A

Focussed quadricep programme - strengthening the muscle

Surgical : ACL reconstruction

26
Q

What is the most common ligament injury in the knee

A

Medial collateral ligament (MCL)

27
Q

What causes MCL tear

A

Severe valgus stress which is usually contact related

28
Q

How does MCL tear present

A

Heard a pop or crack

pain on the medial side of the affect knee

Bruising of the medial knee and swelling

29
Q

What is done on examination for MCL tear

A

Look - medial swelling and bruising

Feel - tender on the medial side and tender at the femoral insertion of the MCL

Movement - painful in full extension

30
Q

What is the investigations done for MCL tear

A

X-ray
MRI - the best way of looking at MCL tears

31
Q

What is the treatment for MCL tears

A

Conservative treatment is the most common:
Rest and NSAIDs
Physiotherapy and brace for comfort
analgesia

Operative - in severe tears or failed conservative treatment

32
Q

What is osteochondritis dissecans

A

Pathological lesion affecting articular cartilage and subchondral bone

33
Q

What are the causes of osteochondritis dissecans

A

Hereditary
trauma
vascular

34
Q

What location is most common for osteochondritis dissecans

A

The lateral aspect of the knee

35
Q

How does osteochondritis dissecans present

A

Activity related pain
poorly localised
recurrent effusions
Mechanical symptoms - lockiun

36
Q

What is the treatment of osteochondritis dissecans

A

Reduced weight bearing

Surgical: arthroscopy and open fixation

MSK (36 decks)

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