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Year 3 Trauma And Orthopaedics > Knee > Flashcards

Knee Flashcards

1
Q

Ligaments of knee

A

Medial/ lateral collateral ligament

Anterior/ posterior collateral ligament

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2
Q

ACL injury

A

Landing or sudden deceleration - strong quadricep contraction with valgus collapse and femur internal rotation

Hyper-extension - femur posteriorly slides behind tibia with quadriceps contraction

Twisting injury - changing direction

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3
Q

Meniscal injury mechanism

A

Twisting injuries whilst felxed and weight bearing

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4
Q

Symptoms of meniscal injury

A

Locking and giving way

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5
Q

Unhappy triad

A

Trauma to lateral knee causes tear of:

  • medial collateral ligament
  • medial meniscus
  • ACL
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6
Q

Special tests to assess ACL

A

Anterior drawer test

Lachman’s test

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7
Q

PCL injury mechanism

A

Dashboard injury

Fall on front of knee

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8
Q

Medial collateral ligament mechanism of injury

A

Valgus stress

Skiing

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9
Q

Baker’s cyst

A

Bulge and feeling of tightness behind knee

Cause - knee trauma, OA, inflammatory arthritis, gout

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10
Q

Foucher’s sign

A

Increase in tension of Baker’s cysts on extension of knee

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11
Q

Infrapatellar bursitis

A

When kneeling on knees like praying

- Clergyman’s bursitis

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12
Q

Prepatellar burstis

A

When kneeling on hands and feet

- housemaid’s bursitis

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13
Q

ACL surgery

A

Gold-standard is autograft repair
• Usually semitendinosus ± gracilis (can use patella
tendon)

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14
Q

Osteochondritis Dissecans

A

• Piece of bone and overlying cartilage dissects off into
joint space.
• Commonly knee (med. fem. condyle), also elbow, hip and ankle.
• Young adult / adolescent
• Symptoms: pain, swelling, locking, ↓ ROM
• X-ray: loose bodies, lucent crater
• Mx: arthroscopic removal

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15
Q

Knee OA presentation

A

Pain around knee - can radiate to thigh and hip

Crepitus

Pain exacerbated by exercise and relieved by rest

Joint stiffness - reduced ROM

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16
Q

Mx of knee OA

A

Lifestyle modification

Total knee replacement - gold standard

17
Q

ACL injury presentation

A

Immediate swelling

Significant pain

18
Q

Segond injury

A

Bony avulsion of the lateral proximal tibia - pathognomic of ACL injury

19
Q

Ix for Meniscal tears MCL, PCL and ACL injury

A

Xray - rule out other causes

MRI scan - gold standard

20
Q

ACL injury mx

A

RICE
Conservative - splint and rehab
Surgical - tendon or artifical graft

21
Q

Presentation of medial collateral ligament injury

A 
May pop 
Immediate medial joint line pain
Swelling after hours 
Tender along joint line 
May be able to weight bear
22
Q

MCL injury mx

A

RICE
Strength training for 6 weeks
Analgesia

Grade II - moderate injury, with an incomplete tear:
- knee brace, strength training for 10 weeks

Grade III - severe injury, with a complete tear :
- Knee brace, crutches, strength training for 12 weeks

23
Q

Indication for surgery in medial collateral ligament injury

A

Distal avulsion on MRI

24
Q

Medial meniscus

A

Less circular than lateral meniscus

Attached to MCL

25
Q

Purpose of menisci

A

Shock absorber

Increase articulation surface area

26
Q

Types of meniscal tear

A

Longitudinal - bucket handle - central tear separates from lateral fragment

Vertical

Transverse (Parrot-beak)

Degenerative

27
Q

Clinical features of meniscal tears

A

Tearing sensation in the knee

Intense sudden onset pain

Swells slowly - 6 - 12 hours

Locked in flexion - unable to extend

Tenderness

Joint effusion

28
Q

Test for meniscal tears

A

McMurray’s Test* and Apley’s Grind Test

29
Q

Mx of meniscal tears

A

RICE

Larger tears - arthroscopy

If tear is in outer third - can be sutured

Inner third - trimmed

30
Q

Complications of meniscal tears and tx

A

OA

Arthroscopy can cause - DVT, damage to local structures such as the saphenous nerve and vein, the peroneal nerve, and the popliteal vessels

31
Q

Clinical features of patella fracture

A

Anterior knee pain
Worse with movement
Unable to straight leg raise

Swollen and bruised
Patella defect

32
Q

Bipartite Patella

A

Congenital condition whereby there is failure of patella fusion, leaving two separate bone fragments of the patella joined only by fibrocartilaginous tissue

  • asymptomatic
33
Q

Ix for patella frcature

A

Xrays - AP, Lateral , skyline

CT

34
Q

Mx of patella fractures

A

Non displaced, minimally displaced - conservative

  • RICE
  • brace or cylinder cast- early weight bearing in extension

Displaced or compromised extension - surgery

  • ORIF with tension band wiring
  • screw fixation if simple fracture
35
Q

Complications of patella fractures

A

OA

Loss of ROM

Year 3 Trauma And Orthopaedics (25 decks)

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