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Orthopaedics > Knee > Flashcards

Knee Flashcards

1
Q

What may predispose to early OA in the knee?

A

previous meniscal tears
ligament injuries
malalignment eg genu varum/valgum

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2
Q

what is a high tibial osteotomy

A

may be helpful in treating patients with medial OA - OSTEOTOMY OF THE PROXIMAL TIBIA

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3
Q

When do meniscal tears classicaly occur

A

twisting force on a loaded knee

they can also occur due to degeneration of the menisci

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4
Q

What is the clinical picture of a meniscal tear

A

localised pain in a specific knee compartment
effusion
catching or locking of the joint
haemarthrosis within an hour of the injury
rotator instablility with the knee giving way

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5
Q

What do valgus stess injuries usually cause?

A

Tear the MCL
damage ACL
risking lateral tibial plateau fracture

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6
Q

When would a PCL rupture occur

A

a direct blow to the anterior tibua in a flexed knee (motercycle crash) or hyperextension
varus stress

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7
Q

What injuries can varus stress cause

A

LCL and PCL

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8
Q

Which menisci tears more commonly

A

the medial meniscus- it is more fixed than the lateral

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9
Q

What is a bucket handle tear

A

a large longitudinal tear where a large meniscal fragment is able to flip out of its normal position and displace anteriorly or into the intercondylar notch where the knee lock and is unable to fully extend

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10
Q

Why are meniscal tears difficult to heal

A

the meniscus only has an arterial blood supply in it outer third

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11
Q

When should a meniscal repair be considered

A

in younger patients with a fresh longitudinal tear involving the outer thirs of the meniscus

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12
Q

When may a partial menisectomy be beneficial

A

in patients who have pain that does not settle for thee months

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13
Q

In what group of patients Is menisecotmy not beneficial

A

knees with arthritis changes on x ray and MRI

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14
Q

What test can be used to determine if there has been an ACL rupture

A

Lachmans and Anterior drawer test = excessive translation of the tibia

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15
Q

Who is a candidate for ACL replacement surgery

A

professional sportsmen/women

those who’s knee gives way on sedentary activities

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16
Q

Where is the tendon graft for an ACL replacement usually from?

A

patellar tendon, semitendinosis and gracilis

17
Q

How are acute MCL tears usually treated

A

hinged knee brace

18
Q

How can chronic MCL instability be treated

A

tightening (advancement) or reconstruction with tendon graft

19
Q

How are LCL ruptures usually treated

A

surgically with either early repair or late reconstruction with tendon graft

20
Q

How are PCLs usually treated

A

Cadaveric Achilles tendon allograft

21
Q

Which age group do patellar tendon ruptures tend to occur in

A

younger people (less than 40)

22
Q

What age group does the quadriceps tendon tend to rupture?

A

Older people (over forty)

23
Q

What are the predisposing factors to an extensor mechanism rupture in the knee

A 
tendonitis history
steroids
diabetes
RA
renal failure (chronic)
24
Q

Which antibiotic can cause tendonitis

A

Quinolone (ciprofloxin)

25
Q

Which test determines if the extensor mechanism is intact

A

straight leg raise

26
Q

What does a high patella signify

A

patellar tendon rupture

27
Q

what does a low patella signify

A

quads rupture

28
Q

What causes patellofemoral dysfunction

A

the pull of the quadriceps muscle can pull the patella slightly laterally- excess lateral force can cause anterior knee pain

29
Q

What predisposes to anterior knee pain

A

gender (girls)
hypermobility
genu valgum
femoral neck anteversion

30
Q

What are the symptoms of anterior knee pain

A

worse going down hill
grinding or clicking
pseudolocking

31
Q

Where does the patella usually dislocate

A

laterally

32
Q

What predisposes to patellar dislocation

A 
ligamentous laxity
females
shallow trochlear groove
genu valgum
femoral neck anteversion
patella alta (high riding patella)
33
Q

What happens when the patella dislocated

A

medial patellofemoral ligament tears
osteochondral fracture may occur
lipo haemarthrosis

Orthopaedics (25 decks)

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