Knee Conditions

Question 1

who usually presents with a patellar dislocation

Answer 1

teenage females

Question 2

what can cause patellar dislocation

Answer 2

direct blow
sudden quadriceps contraction with a flexing knee

Question 3

which way does a patella dislocate

Answer 3

ALWAYS laterally

Question 4

give some risk factors for patellar dislocation

Answer 4

hypermobility
increased Q angle
high riding patella

Question 5

clinical signs of patellar dislocation

Answer 5

pain medially, effusion
positive patellar apprehension test

Question 6

XR of patellar dislocation

Answer 6

lipo-haemarthrosis

Question 7

management of patellar dislocation

Answer 7

reduction with knee extension
physiotherapy

Question 8

complication of patellar dislocation

Answer 8

osteochondral fracture

Question 9

lateral collateral ligament injury + peroneal nerve injury

Answer 9

complete knee dislocation that has spontaneously reduced

Question 10

clinical presentation of complete knee dislocation

Answer 10

pain and instability of the knee

Question 11

immediate management of complete knee dislocation

Answer 11

emergency reduction under sedation

Question 12

when might you require surgical reduction of a complete knee dislocation

Answer 12

if medial femoral condyle button-holed through the medial capsule

Question 13

definitive management of complete knee dislocation

Answer 13

sequential ligamentous repair

Question 14

clinical signs of a patellar fracture

Answer 14

• Palpable patellar defect
• Significant hemarthrosis
• Unable to preform straight leg raise

Question 15

conservative management of patellar fracture

Answer 15

knee immobilisation in extension

Question 16

operative management of patellar fracture

Answer 16

ORIF

Question 17

what is a bakers cyst

Answer 17

ganglion cyst in the popliteal fossa

Question 18

what do bakers cyst usually arise in conjunction to

Answer 18

OA of the knee

Question 19

clinical presentation of bakers cyst

Answer 19

general fullness in the popliteal fossa
soft and non-tender
painful rupture

Question 20

clinical presentation of patellofemoral dysfunction

Answer 20

anterior knee pain, worse going downhill
grinding/clicking sensation

Question 21

how do you investigate bone bruising

Answer 21

MRI

Question 22

what do most tibial plateau fractures affect

Answer 22

lateral condyle

Question 23

what is used to classify tibial plateau fractures

Answer 23

schatzer classification

Question 24

complication of a bumper injury

Answer 24

damage to the common fibular nerve

Question 25

name a high risk complication of tibial plateau fracture

Answer 25

compartment syndrome

Question 26

what are loose bodies in a joint

Answer 26

small fragments of cartilage or bone that can move freely around in joint fluid

Question 27

what can cause loose bodies to form

Answer 27

trauma, osteochondritis dissecans, joint degeneration

Question 28

clinical presentation of a loose body in the joint

Answer 28

History of mobile lump or sharp occasional pain and locking/catching suggestive of loose body

Question 29

what can commonly be misdiagnosed as a loose body of the knee

Answer 29

fabella

Question 30

what is a fabella

Answer 30

an accessory ossicle in the lateral head of gastrocnemius

Question 31

management of loose bodies

Answer 31

arthroscopic removal

Question 32

mechanism of injury in a young patient with a meniscal tear

Answer 32

twisting force sporting injury

Question 33

mechanism of injury in an older patient with a meniscal tear

Answer 33

atraumatic spontaneous degenerate tears

Question 34

what is the most common type of meniscal tear

Answer 34

medial

Question 35

what can meniscal tears be associated with

Answer 35

ACL ruptures

Question 36

clinical presentation of a meniscal tear

Answer 36

pain localised to the joint line (lateral or medial) catching or locking sensation

Question 37

acute locked knee

Answer 37

displaced bucket handle meniscal tear

Question 38

clinical sign of meniscal tear

Answer 38

positive meniscal provocation test inflammatory effusion

Question 39

investigation of meniscal tear

Answer 39

MRI

Question 40

management of meniscal tear in younger patient

Answer 40

arthroscopic meniscal repair

Question 41

management of degenerative meniscal tears

Answer 41

RICE analgesia physio

Question 42

mechanism of action of a knee ligament injury

Answer 42

rotational movement of the knee joint

Question 43

how can we classify knee ligament injuries

Answer 43

Grade 1: sprain grade 2: partial tear grade 3: complete tear

Question 44

complication of MCL tear

Answer 44

valgus instability

Question 45

complication of ACL rupture

Answer 45

rotatory instability

Question 46

complication of a PCL rupture

Answer 46

recurrent hyperextension or instability descending stairs

Question 47

mechanism of a MCL injury

Answer 47

valgus stress with possible external rotation

Question 48

clinical presentation of MCL injury

Answer 48

knee swelling with ecchymosis + pain medial joint line tenderness medial joint laxity and pain on valgus stress

Question 49

management of an acute MCL tear

Answer 49

hinged knee brace

Question 50

management of a chronic MCL instability

Answer 50

MCL tightening

Question 51

what is the most common injured knee ligament

Answer 51

ACL

Question 52

mechanism of ACL injury

Answer 52

twisting sports injury

Question 53

who is more likely to present with ACL injury

Answer 53

females

Question 54

clinical presentation of ACL injury

Answer 54

audible pop followed by deep knee pain and swelling within the hour excessive anterior translation of the tibia on anterior drawer test

Question 55

investigation of ACL injury

Answer 55

joint aspiration shows hemarthrosis MRI to confirm

Question 56

complication of ACL injury

Answer 56

arthritis

Question 57

when is ACL reconstruction indicated

Answer 57

rotatory instability not responding to physio

Question 58

when does an LCL injury commonly occur

Answer 58

in combination with other ligament injuries

Question 59

mechanism of injury of LCL injury

Answer 59

varus stress and hyperextension

Question 60

clinical presentation of LCL injury

Answer 60

knee swelling + ecchymosis, pain, deformity lateral joint line tenderness lateral joint laxity

Question 61

management of LCL injury

Answer 61

complete rupture needs urgent repair

Question 62

complications of LCL injury

Answer 62

common fibular nerve palsy early OA of the knee

Question 63

mechanism of injury of a PCL injury

Answer 63

a direct blow to the anterior tibia

Question 64

clinical presentation of PCL injury

Answer 64

popliteal knee pain and bruising positive posterior drawer test and sag sign

Question 65

who usually presents with an extensor mechanism rupture

Answer 65

middle age population who play running or jumping sports

Question 66

clinical sign of extensor mechanism rupture

Answer 66

unable to do a straight leg raise