Knee Disorders

Question 1

define Osgood-Schlatters Disease

Answer 1

an apophysitis (inflammation or stress injury) of the tibial tuberosity that causes anterior knee pain in adolescence

Question 2

cause of Osgood-Schlatters Disease

Answer 2

repetitive strain of patellar tendon at its insertion on the ossification centre of the tibial tuberosity

Question 3

clinical features of Osgood-Schlatters Disease

Answer 3

unilateral gradual anterior knee pain that relieves on rest and worsens on knee extension
swelling below the knee

Question 4

examination findings in Osgood-Schlatters Disease

Answer 4

tenderness and swelling of tibial tuberosity
pain on knee extension against resistance
pain on hyperflexion on knee in prone position

Question 5

investigations of Osgood-Schlatters Disease

Answer 5

XR
US
MRI

Question 6

conservative management of Osgood-Schlatters Disease

Answer 6

analgesia
reduction in activity based on pain
refer to physiotherapy

Question 7

indications for surgery in Osgood-Schlatters Disease

Answer 7

presence of ossicle under distal patellar tendon

recurrent symptoms in adulthood

Question 8

define meniscal tears

Answer 8

injury (often twisting or pivoting) or trauma to the meniscus of the knee causing tearing

Question 9

risk factors of meniscal tears

Answer 9

acute trauma
degenerative changes
repetitive stress
PMH of cruciate ligament injury

Question 10

clinical features of meniscal tears

Answer 10

knee pain
sensation of ‘buckling’, ‘locking’ or ‘catching
swelling
⬇️ ROM of joint

Question 11

investigations for meniscal tears

Answer 11

MRI

plain XR

Question 12

management of meniscal tears

Answer 12

PRICER: 
protect from further injury
rest (crutches for 24-48hrs)
ice
compression
elevation 
rehabilitation (physio)

Question 13

indications for surgical intervention in meniscal tears

Answer 13

locking of the knee

symptoms persisting after 6-8wks of physio

Question 14

surgical management of meniscal tears

Answer 14

partial meniscectomy

Question 15

define anterior cruciate ligament (ACL) injuries

Answer 15

a tearing of the ACL often due to sudden deceleration/change of direction that causes a valgus twisting injury

forceful hyperextension

Question 16

clinical features of ACL injuries

Answer 16

sudden painful ‘popping’ sensation
rapid swelling
inability to resume activity
lateral knee and joint line tenderness

Question 17

examination findings in ACL injuries

Answer 17

+ve anterior drawer test

+ve lachman test

Question 18

investigations in ACL injuries

Answer 18

MRI

XR (only if impact occurred)

Question 19

management of ACL injuries (low demand)

Answer 19

PRICER

Question 20

management of ACL injuries (high demand)

Answer 20

ACL reconstruction

Question 21

define medial collateral ligament (MCL) injury

Answer 21

a traumatic knee injury often occurring as a result of a sudden valgus force to the lateral aspect of the knee

Question 22

clinical features of MCL injuries

Answer 22

medial joint line pain
‘pop’ at time of injury
difficulty moving due to pain and instability of the joint

Question 23

examination findings in MCL injuries

Answer 23

+ve valgus stress test

Question 24

management of MCL injuries

Answer 24

PRICER

surgical repair