Knee Conditions Flashcards
who usually presents with a patellar dislocation
teenage females
what can cause patellar dislocation
direct blow
sudden quadriceps contraction with a flexing knee
which way does a patella dislocate
ALWAYS laterally
give some risk factors for patellar dislocation
hypermobility
increased Q angle
high riding patella
clinical signs of patellar dislocation
pain medially, effusion
positive patellar apprehension test
XR of patellar dislocation
lipo-haemarthrosis
management of patellar dislocation
reduction with knee extension
physiotherapy
complication of patellar dislocation
osteochondral fracture
lateral collateral ligament injury + peroneal nerve injury
complete knee dislocation that has spontaneously reduced
clinical presentation of complete knee dislocation
pain and instability of the knee
immediate management of complete knee dislocation
emergency reduction under sedation
when might you require surgical reduction of a complete knee dislocation
if medial femoral condyle button-holed through the medial capsule
definitive management of complete knee dislocation
sequential ligamentous repair
clinical signs of a patellar fracture
- Palpable patellar defect
- Significant hemarthrosis
- Unable to preform straight leg raise
conservative management of patellar fracture
knee immobilisation in extension
operative management of patellar fracture
ORIF
what is a bakers cyst
ganglion cyst in the popliteal fossa
what do bakers cyst usually arise in conjunction to
OA of the knee
clinical presentation of bakers cyst
general fullness in the popliteal fossa
soft and non-tender
painful rupture
clinical presentation of patellofemoral dysfunction
anterior knee pain, worse going downhill
grinding/clicking sensation
how do you investigate bone bruising
MRI
what do most tibial plateau fractures affect
lateral condyle
what is used to classify tibial plateau fractures
schatzer classification
complication of a bumper injury
damage to the common fibular nerve
name a high risk complication of tibial plateau fracture
compartment syndrome
what are loose bodies in a joint
small fragments of cartilage or bone that can move freely around in joint fluid
what can cause loose bodies to form
trauma, osteochondritis dissecans, joint degeneration
clinical presentation of a loose body in the joint
History of mobile lump or sharp occasional pain and locking/catching suggestive of loose body
what can commonly be misdiagnosed as a loose body of the knee
fabella
what is a fabella
an accessory ossicle in the lateral head of gastrocnemius
management of loose bodies
arthroscopic removal
mechanism of injury in a young patient with a meniscal tear
twisting force sporting injury
mechanism of injury in an older patient with a meniscal tear
atraumatic spontaneous degenerate tears
what is the most common type of meniscal tear
medial
what can meniscal tears be associated with
ACL ruptures
clinical presentation of a meniscal tear
pain localised to the joint line (lateral or medial)
catching or locking sensation
acute locked knee
displaced bucket handle meniscal tear
clinical sign of meniscal tear
positive meniscal provocation test
inflammatory effusion
investigation of meniscal tear
MRI
management of meniscal tear in younger patient
arthroscopic meniscal repair
management of degenerative meniscal tears
RICE
analgesia
physio
mechanism of action of a knee ligament injury
rotational movement of the knee joint
how can we classify knee ligament injuries
Grade 1: sprain
grade 2: partial tear
grade 3: complete tear
complication of MCL tear
valgus instability
complication of ACL rupture
rotatory instability
complication of a PCL rupture
recurrent hyperextension or instability descending stairs
mechanism of a MCL injury
valgus stress with possible external rotation
clinical presentation of MCL injury
knee swelling with ecchymosis + pain
medial joint line tenderness
medial joint laxity and pain on valgus stress
management of an acute MCL tear
hinged knee brace
management of a chronic MCL instability
MCL tightening
what is the most common injured knee ligament
ACL
mechanism of ACL injury
twisting sports injury
who is more likely to present with ACL injury
females
clinical presentation of ACL injury
audible pop followed by deep knee pain and swelling within the hour
excessive anterior translation of the tibia on anterior drawer test
investigation of ACL injury
joint aspiration shows hemarthrosis
MRI to confirm
complication of ACL injury
arthritis
when is ACL reconstruction indicated
rotatory instability not responding to physio
when does an LCL injury commonly occur
in combination with other ligament injuries
mechanism of injury of LCL injury
varus stress and hyperextension
clinical presentation of LCL injury
knee swelling + ecchymosis, pain, deformity
lateral joint line tenderness
lateral joint laxity
management of LCL injury
complete rupture needs urgent repair
complications of LCL injury
common fibular nerve palsy
early OA of the knee
mechanism of injury of a PCL injury
a direct blow to the anterior tibia
clinical presentation of PCL injury
popliteal knee pain and bruising
positive posterior drawer test and sag sign
who usually presents with an extensor mechanism rupture
middle age population who play running or jumping sports
clinical sign of extensor mechanism rupture
unable to do a straight leg raise
