knee

Question 1

what is the purpose of the menisci

Answer 1

shock absorbers

Question 2

which menisci is more fixed

Answer 2

medial (lateral more mobile)

Question 3

what tendons keep the patella in place

Answer 3

quadriceps + patellar

Question 4

what is the function of the ACL

Answer 4

prevent tibia rotating

Question 5

function MCL

Answer 5

resist valgus force

Question 6

function LCL

Answer 6

resist varus force

Question 7

RF early knee OA

Answer 7

meniscal tears, ligament injuries, abnormal alignemt, inflammation arthritis, hobbies

Question 8

indication knee replacement for OA

Answer 8

substantial pain!! (and disability)

Question 9

signs OA knee

Answer 9

swelling, crepitus, limited range of motion

Question 10

how do meniscal tears usually occur

Answer 10

twisting injury

Question 11

symptoms meniscal tear

Answer 11

pain on joint line // effusion following day // locked knee cannot straighten (bucket handle)

Question 12

what tests can be used to determine meniscal tear

Answer 12

steinmanns: (flex hip and knee and externally rotate foot) // thessaly (weight bear on slightly bent knee and twist)

Question 13

most common site for meniscal tear

Answer 13

medial

Question 14

symptoms of a bucket handle meniscal tear

Answer 14

locked knee and cannot fully extend (mechanical obstruction from meniscus)

Question 15

invx for meniscal tear

Answer 15

MRI

Question 16

criteria for meniscal repair

Answer 16

longitudinal (bucket handle) // acute // young

Question 17

what is involved in meniscal repair

Answer 17

stitch to bed

Question 18

if not suitable for meniscal repair what surgery can be done

Answer 18

arthroscopic partial menisectomy

Question 19

mx degenerative meniscal tear

Answer 19

steroid injection

Question 20

causes of ACL rupture

Answer 20

high rotational force eg skiing, lateral blow, rugby, football

Question 21

symptoms ACL rupture

Answer 21

pop heard or felt // hemoarthrosis within hour // deep pain // rotatory instability

Question 22

what tests can be done for ACL tears

Answer 22

ant draw test/ lachmanns: patient flat on bed and knee 30 flexed, pull calf forward

Question 23

when is ACL reconstruction considered (repair not often done)

Answer 23

professional sports people // if sedentary activity // failed physio

Question 24

what is ACL reconstruction sirgery

Answer 24

tendon graft through tibiofemoral tunnel and attach to knee

Question 25

what injuries can cause PCL tears

Answer 25

direct blow to tibia eg dashboard injury (uncommon isolated injury)

Question 26

test for PCL rupture

Answer 26

posterior draw test (same as ant but push back)

Question 27

how do MCL tears occur

Answer 27

strong valgus force

Question 28

symptoms MCL tear

Answer 28

laxity + pain when forced into valgus position

Question 29

mx MCL tear

Answer 29

brace --> MCL tightening --> reconstruction and tendo graft

Question 30

what nerve can be damaged in LCL rupture

Answer 30

peroneal

Question 31

what is damaged in the unhappy knee triad + what causes it

Answer 31

high force lateral knee blow --> ACL, MCL, meniscal

Question 32

what is the most common knee injury

Answer 32

ACL tear

Question 33

what are common complications from a patella dislocation

Answer 33

thrombosis, popliteal artery damage, compartment syndrome

Question 34

how can patella dislocations sometimes spontaneously reduce

Answer 34

straighten leg

Question 35

invx patella dislocation

Answer 35

Xray

Question 36

RF patella dislocation

Answer 36

laxity, female, genu valgum, high riding patella, femoral neck anteversion

Question 37

how can extensor mechanism (quadriceps or patella tendon) ruptures occur

Answer 37

fast contractile force eg weightlifting, fall, degenerative

Question 38

which tendon in extensor mechanism ruptures are likely in older vs younger patients

Answer 38

patella in young and quadriceps in old

Question 39

RF extensor mechanism rupture

Answer 39

tendonitis (quinolones) // chronic steroid ise // diabetes / RA / renal failure

Question 40

invx extensor mechanism rupture

Answer 40

straight leg test (gap) // Xray or USS if obese

Question 41

what is chondromalacia patella/ patellofemoral dysfunction

Answer 41

patella and femur not alligned properly

Question 42

when/ who does chondromalacia patella/ patellofemoral dysfunction occur

Answer 42

teenage girls esp after knee injury/ dislocation

Question 43

signs and symptoms chondromalacia patella/ patellofemoral dysfunction

Answer 43

ant knee pain worse going downhill or at rest // pseudolocking // quads wasting

Question 44

mx chondromalacia patella/ patellofemoral dysfunction

Answer 44

physio, taping, surgery

Question 45

symptoms osteochondritis dissecans (osgood)

Answer 45

knee pain + swelling after exercise // knee catching and locking // painful clunk when extending knee

Question 46

signs osteochondritis dissecans (osgood)

Answer 46

joint effusion, tenderness at medial femoral condyle

Question 47

invx osteochondritis dissecans (osgood)

Answer 47

xray or MRI

Question 48

who is usually affected by osteochondritis dissecans (osgood)

Answer 48

children and young adults

Question 49

what causes IT band synrdome

Answer 49

running

Question 50

symptoms IT band syndrome

Answer 50

tenderness 2-3cm above lateral joint line

Question 51

mx IT band syndrome

Answer 51

stretches and physio

Question 52

what are baker's cysts

Answer 52

distension of knee bursa that looks like a cyst

Question 53

what can cause bakers cysts

Answer 53

OA in adults

Question 54

symptoms ruptured bakers cyst

Answer 54

pain, reness, swelling

Question 55

where does the swelling occur in bakers cyst

Answer 55

behind the knee