Knee disorders

Question 1

What is the most common knee ligmanet to be injured?

Answer 1

MCL

Question 2

What is the function of MCL?

Answer 2

• valgus stabiliser

Question 3

How is MCL injured?

Answer 3

• external rotation forces applied to outside of knee

Question 4

MCL injury can be graded from 1-3. Describe each of them

Answer 4

• 1
  
  • Mild injury, minimal tear, integritiy intact
• 2
  
  • Moderate injury, incomplete tear, increased laxity
• 3
  
  • Severe injury, complete tear, gross laxity

Question 5

What are the clinical features of MCL injury?

Answer 5

• pop sensation
• swelling after few hours
• increased laxity on valgus stress test
• Tender along joint line
  *

Question 6

How do you differentiate between grade 2 & 3 MCL injury?

Answer 6

• 2
  
  • lax in 30 deg knee flexion
  • solid in full extension
• 3
  
  • lax in both positions

Question 7

What are the differentials for MCL tear?

Answer 7

• mesical injury
• ACL + MCL tear

Question 8

What is an unhappy triad?

Answer 8

Injury to MCL, ACL, medial meniscus

Question 9

What Ix would you roder for MCL tear?

Answer 9

• Imaging
  
  • Radiograph - to exclude fracture
  • MRI (gold standard)

Question 10

The Mx of MCL tear is different for each grade. Describe each of them

Answer 10

• 1 (RICE)
  
  • Rest
  • Ice
  • Compression
  • Elevation
  • Stregth training
  • aim to return to full exercise within 6 weeks
• 2
  
  • Analgesia
  • Knee brace
  • stregth training
  • aim to return full exercise within 10 weeks
• 3
  
  • Analgesia
  • Knee brace
  • Clutches
  • Surgery +-
  • stregth training
  • aim to return full exercise within 12 weeks

Question 11

What are the Cx of MCL tear?

Answer 11

• instability of joint
• saphenous nerve damage