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MSKJaz > Knee > Flashcards

Knee Flashcards

1
Q

inflammation where the patellar tendon attaches to tibial tuberosity

A

Osgood Schlatter’s

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2
Q

___ distribute wt from ___ femoral condyles to tibial plateau

A

menisci

convex

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3
Q

compared to the lateral ones the medial plateau is more ___ and the medial meniscus is ___

A

concave

fixed (lateral is more mobile)

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4
Q

knee pivots on ___ compartment through flexion (tibial __ rotates) and extension (tibial __ rotates) => ___ meniscus under more shear stress

A

medial
internally
externally
medial

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5
Q

MCL resists ___ stress

rupture => __ instability

A

valgus x2

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6
Q

LCL resists ___ stress

A

varus

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7
Q

ACL resists ___ of the tibia and __ of the tibia in extension

A

anterior subluxation

internal rotation

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8
Q

PCL resists ___ of the tibia/ __ of femur and knee ___

rupture => __+___

A 
posterior subluxation of tibia
anterior subluxation of femur
knee hyperextension
=> recurrent hyperextension
instability descending stairs
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9
Q

posterolateral corner = +++ that resist ___ of tibia in flexion
rupture => + instability

A 
LCL
PCL
popliteus and other ligs
external rotation
varus and rotatory
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10
Q

in younger ptnts meniscal tears usually caused by __/__

A

sport / rising from squat

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11
Q

in elderly ptnts meniscal tears are usually caused by __

A

atraumatic degenerative tears

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12
Q

__% of ACL ruptures have a meniscal tear

A

50

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13
Q

menisci that is 10x more likely than the other to tear

A

medial

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14
Q

Ix for meniscal tears

A

MRI

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15
Q

___ in knee menisci have blood supply therefore __ tears wont heal

A

peripheral 1/3

radial

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16
Q

appearance of a normal knee menisci on MRI

A

uniformly black

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17
Q

acute locked knee =

A

displaced bucket handle meniscal tear

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18
Q

in a displaced bucket handle meniscal tear patient will have a ___ block to extension

A

15 degree springy

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19
Q

Rx of displaced bucket handle meniscal tear =

if not within a few wks =>

A

Sx - arthroscopic repair / partial menisectomy

fixed flexion deformity

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20
Q

Grd 1 ligament injury =

A

tear some fibres but macroscopically intact = a sprain

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21
Q

Grd 2 ligament injury =

A

partial tear - some fascicles disrupted

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22
Q

Grd 3 ligament injury =

A

complete tear

23
Q

Rx of MCL injury =

A

brace, early motion, physio

rarely needs Sx - advancement/reconstruction

24
Q

how is MCL injured ?

A

severe valgus stress

25
Q

how is ACL injured?

A

twisting

26
Q

__% of ACL rupture ptnts have reconstruction

A

40%

27
Q

Sx for ACL rupture if:

A 
to protect meniscal repair
to return to professional sport/ high demand job
young
multiligament reconstruction
DOESNT treat pain/prevent arthritis
28
Q

mechanism of LCL injury =

A

varus and hyperextension

29
Q

if LCL injury doesnt heal there is a high incidence of ___

A

common peroneal nerve injury

30
Q

usually LCL is injured along with __+__

A

PCL and ACL

31
Q

complete rupture of LCL needs __ in <=2-3wks and then later ___

A

repair

reconstruction

32
Q

mechanism of PCL injury =

A

direct blow to anterior tibia

hyperextension

33
Q

isolated PCL rupture is __ and doesnt need __

get ____ pain and bruising

A

rare
reconstruction
popliteal

34
Q

complications of knee dislocation =

A

popliteal artery injury
common peroneal nerve injury
compartment syndrome

35
Q

Rx of knee dislocation

A

emergency reduction
recheck neurovascular supply
perhaps externally fix temporarily and multiligament reconstruction

36
Q

mechanism of patellar dislocation

A

rapid turn/direct blow

37
Q

risk factors for patellar dislocation (5)

A

F, adolescents, ligament laxity, valgus knee, torsional abnormalities

38
Q

mechanism of extensor mechanism rupture =

A

fall on flexed knee with quads contracted => patellar/quad tendon rupture

39
Q

predisposing factors to extensor mechanism rupture =

A

previous tendonitis
steroids
renal failure
ciprofloxacin

40
Q

if in Extensor mechanism rupture there is no __ and a palpable __ => Sx repair

A

straight leg raise

gap

41
Q

dashboard injury to knee =

A

PCL rupture

42
Q

pain on joint line =

A

meniscal/chondral pathology

43
Q

___ cartilage covers bone in synovial joint

A

hyaline

44
Q

provides tensile strength to hyaline cartilage

A

collagen

45
Q

provide compressible strength to hyaline cartilage

as they are highly ___

A

proteoglycans

hydrophilic

46
Q

proteoglycans = ____ attaching __ branches with keratin sulfate and ____ chains

A

hyaluronic acid
protein
chondroitin sulfate

47
Q

hyaline cartilage:
only ___ thickness can heal
heals with ___ which has more friction and less wear resistance

A

full

fibrocartilage

48
Q

osteochondritis dissecans affects ____
age group=
most common site =

A

subchondral bone
adolescents
medial femoral condyle

49
Q

area of knee surface loses blood supply and cartilage +/- bone fragments off -

A

osteochondritis dissecans

50
Q

osteochondritis dissecans can heal spontaneouslybut is unlikely to heal after __

A

puberty

51
Q

Rx of osteochondritis dissecans

A

if detaching on MRI = pin in place
if detached = fix/remove
if severe may = cartilage regeneration / micro# - better for smaller defects (not if OA/ inflam arth/joint instability)

52
Q

cartilage regeneration is unsuccessful in ___ joint

A

patellofemoral

53
Q

Rx for varus knee with isolated early medial compartment OA

A

osteotomy - shifts load to lateral compartment

affedcts result of later TKR ; good for heavy manual workers

MSKJaz (28 decks)

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