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MSK Pathology > Knee > Flashcards

Knee Flashcards

1
Q

What in the knee has the thickest hyaline cartilage in the body?

A

retropatellar surface

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2
Q

Which joint contains the menisci?

A

tibiofemoral joint

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3
Q

What is the main role of the ACL?

A

prevents abnormal internal rotation of tibia

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4
Q

What is the PCL for?

A

prevents hyperextension and anterior translation of femur

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5
Q

How is the ACL assessed?

A

assessing anterior translation of tibia

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6
Q

How is PCL assessed?

A

assessing posterior translation of tibia

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7
Q

What does the MCL do?

A

resists valgus force

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8
Q

What does the LCL do?

A

resists varus force

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9
Q

What may predispose early OA of the knee?

A

previous meniscal tears

ligament injurines and malalignment

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10
Q

What side of OA does genu varum lead to?

A

medial OA

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11
Q

What side of OA does genu valgum lead to?

A

lateral OA

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12
Q

What should you consider in a patient with substantial knee pain and disability where conservative management is no longer effective?

A

knee replacement

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13
Q

Is there more of a chance of dislocation in knee or hip replacements?

A

hip

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14
Q

In which, knee or hip replacements is there a higher chance of unexplained pain?

A

knee

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15
Q

Which type of injuries classically occur with twisting force on loaded knee?

A

meniscal injuries

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16
Q

Describe presentation of meniscal injury.

A

localized pain
effusion develops by following day
catching sensation or locking - difficulty straightening knee

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17
Q

When do ACL ruptures tend to occur?

A

with higher rotational force, turning upper body laterally on planted foot
Normally during high impact sports

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18
Q

Describe what symptoms occur in an ACL injury.

A

pop is usually heard/felt
patient develops haemarthrosis and swelling within an hour
deep pain

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19
Q

What may patients complain of in ACL later?

A

rotatory instability

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20
Q

What happens to the tibia in ACL rupture?

A

excessive internal rotation

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21
Q

What may cause a valgus stress injury?

A

rugby tackle from side

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22
Q

What will a valgus stress injury usually tear?

A

MCL, but if higher force, may also damage ACL

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23
Q

A direct blow to the anterior tibia with the knee flexed eg in a motorcycle crash may rupture what?

A

PCL

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24
Q

What will a varus stress injury rupture?

25
What percentage of ACL ruptures also have a meniscal tear?
25%
26
What may clinical examination of a meniscal tear reveal?
effusion joint line tenderness pain on tibial rotation
27
A locked knee with a displaced bucket handle meniscal tear will have what degree block to full extension
15'
28
What type of meniscal tear is more common and why?
medial because medial meniscus is more fixed so force from pivoting movements is centred here
29
What may large longitudinal tears result in?
bucket handle tear
30
What happens in a bucket handle tear?
large meniscal fragment can flip out of its normal position and displace anteriorly and knee locks
31
Why does the knee lock in a bucket handle tear?
due to mechanical obstruction from trapped meniscal fragment
32
When do degenerate meniscal tears tend to occur?
as meniscus weakens with age
33
Why does the meniscus have limited healing potential?
only has arterial blood supply in outer third
34
What type of meniscal tears should be considered for meniscal repair?
fresh, longitudinal tears, involving outer 1/3 of meniscus in younger patient
35
What should be performed in patients with meniscal tear in whom pain or mechanical symptoms do not improve in around 3 months?
arthroscopic partial menisectomy
36
What is the principal complaint in an ACL injury?
rotatory instability, giving way on turning
37
What does clinical examination reveal in ACL?
knee swelling with excessive anterior translation of tiba on anterior drawer test and Lachman
38
Who are good candidates for ACL reconstruction and what does it involve?
those who want to go back to sports | involves tendon graft and intense rehabilitation
39
Do MCL tears tend to heal well?
Yes
40
How are acute MCL tears usually treated?
hinged knee brace
41
How can chronic MCL instability be treated?
MCL tightening or reconstruction with tendon graft
42
What is a complete knee dislocation?
rupture of all four of the knee ligaments
43
What may reperfusion in complete knee dislocation result in?
compartment syndrome, especially after prolonged ischaemia
44
When does an extensor mechanism rupture e.g. of patellar tendon or quadriceps tendon tend to occur?
with rapid contractile force eg after lifting heavy weight
45
What should the assessment of ANY acute knee injury include?
straight leg raise test to determine if extensor mechanism is intact
46
Which out of patellar tendon ruptures and quadriceps tendon ruptures occur in under 40s?
patellar tendon ruptures
47
Who may be likely to get an extensor mechanism rupture?
body builders
48
What antibiotics can cause tendonitis and risk tendon ruptures?
quinolones e.g. ciprofloxacin
49
Should steroid injections for tendonitis of the extensor mechanism of the knee be given?
no - high risk of tendon rupture
50
What may X rays reveal regarding the patella in extensor mechanism ruptures?
high patella in patella tendon rupture or low lying in quads rupture
51
What may determine the extent of the extensor mechanism injury in obese patient?
ultrasound
52
What does patellofemoral dysfunction describe?
disorders of patellofemoral articulation resulting in anterior knee pain
53
In whom is patellofemoral dysfunction more common?
females, particularly in teens
54
What do patients complain of in patellofemoral dysfunction?
anterior knee pain, worse going downhill, grinding/clicking sensation at front of knee stiffness after prolonged sitting causing "pseudolocking" - stiffens in flexed position
55
When do you see true locking?
bucket handle tear
56
Which way does the patella almost always dislocate?
laterally
57
What is seen on X ray in patellar dislocation?
lipo haemarthrosis
58
Does risk of patellar instability increase or decrease with age?
decrease

MSK Pathology (17 decks)

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