Knee Injuries Flashcards
what are some common causes of meniscal tears?
sporting injury
getting up from squatting
degenerate
what do 50% of ACL tears have associated?
meniscal tears
how does a meniscal tear present?
pain
tenderness at the joint line
inflammatory effusion
what investigations should be done for a suspected meniscal tear?
MRI
which type of meniscal tear is more common?
medial
what are the four patterns of meniscal tear?
longitudinal
bucket handle
radial
parrot beak
what should be considered for acute traumatic peripheral meniscal tears in young patients?
arthroscopic meniscal repair
what should be considered for irreparable meniscal tears with symptoms?
arthroscopic meniscectomy
what does an acute locked knee suggest?
a displaced bucket handle meniscal tear
what is needed for an acute locked knee?
urgent surgery
what is seen on MRI in acute locked knee?
two things that look like a PCL
what does the MCL resist?
valgus stress
what does the LCL resist?
varus stress
what type of instability can MCL rupture lead to?
valgus instability
what does the ACL resist?
anterior subluxation of the tibia
internal rotation of the tibia
what type of instability can ACL rupture lead to?
rotatory instability
what does the PCL resist?
posterior subluxation of the tibia
hyperextension of the knee
what can PCL rupture lead to?
recurrent hyperextension
inability to descend stairs
what forms the posterolateral corner?
PCL
LCL
popliteus
smaller ligaments
what does the posterolateral corner resist?
external rotation of the tibia
what are the three grades of knee ligament injuries?
grade 1
grade 2
grade 3
describe a grade 1 knee ligament injury
sprain
tear some fibres
describe a grade 2 knee ligament injury
partial tear
describe a grade 3 knee ligament injury
complete tear
which is more likely to heal - an MCL or LCL injury?
MCL
how is an MCL injury managed?
brace
early motion
physiotherapy
what surgery may be done for MCL injury?
reconstruction with a tendon graft
what usually causes an ACL injury?
sports
what is the classic history of an ACL injury?
pop
hemarthrosis
giving way on turning
what can allow ACL injuries to stabilise?
time
physio
how is an ACL injury diagnosed?
history
MRI
what clinical tests can be done for an ACL injury?
lachman’s test
anterior drawer test
what causes an LCL injury?
varus
hyperextension
what is there a high incidence of in LCL injury?
common peroneal nerve palsy
what is an LCL injury often found in combination with?
PCL or ACL injury
what is the management of a complete LCL rupture?
urgent repair with 2-3 weeks
what is the later or second line management for an LCL injury?
reconstruction with another tendon
what causes a PCL rupture?
direct blow to the anterior tibia
hyperextension injury
how does a PCL rupture present?
popliteal knee pain
bruising
what do PCL rupture often occur alongside?
other knee injuries
what are three possible complications of a knee dislocation?
popliteal artery injury
common peroneal nerve injury
compartment syndrome
what is the initial management of a knee dislocation?
emergency reduction
check neurovascular status
how is knee dislocation managed?
knee reconstruction
what causes patellar dislocation?
rapid turn
direct blow
what are three risk factors for patellar dislocation?
female
ligamentous laxity
valgus knee
what is the surgical management for patellar dislocation?
MPFL reconstruction
what is MPFL?
median patello femoral ligament
what direction does a patellar dislocation occur in?
laterally always
what are two other names for patellofemoral pain syndrome?
idiopathic adolescent anterior knee pain
chondromalacia patellae
what do the majority of patients with patellofemoral pain syndrome get?
physio
what causes an extensor mechanism rupture?
falling onto a flexed knee when the quads are contracted
what are some risk factors for extensor mechanism rupture?
previous tendonitis
steroids
chronic renal failure
ciprofloxacin
what is seen on examination of extensor mechanism rupture?
unable to do a straight leg raise
palpable gap
what investigations may be done to support a diagnosis of extensor mechanism rupture?
USS or MRI
how is extensor mechanism rupture managed?
urgent surgical repair
what is osteochondritis dissecans?
when an area of the surface of the knee loses its blood supply and cartilage/bone fragments off
when is osteochondritis dissecans most common?
adolescence
how long can bone bruising take to settle?
three months
can be up to a year in some cases
