Knee injuries

Question 1

anatomy of the knee

Answer 1

anterior cruciate ligament attaches at the anterior intercondylar area on the tibia - ACL originates from the lateral aspect of the intercondylar notch

posterior cruciate ligament attahces at the posterior intercondylar area on the tibia- PCL originates from the medical aspect of the intercondular notch

Question 2

what is the role of the ACL and PCL?

Answer 2

ACL stops the tibia sliding forward in relation to the femur

PCL stops the tibia sliding backwards in relation to the femur

Question 3

ACL damage presentation

Answer 3

twisting injury of the knee (skiing)

pain
swelling
pop sound / sensation

instabilty of the knee joint and the tibia will move anteriorly below the femur

Question 4

ACL and the anterior draw test

Answer 4

ACL normally works to stop the tibia sliding forward in relation to the femur

the anterior drawer test assesses for ACL damage

The patient is supine with the hip flexed to 45 degrees and the knee flexed to 90 degrees, with the foot flat on the couch. The examiner sits on the patient’s toes to stabilise the foot. The examiner holds the leg just below the knee and pulls the proximal tibia anteriorly, sliding it forward from the femur at the knee. In a normal knee, there will be slightly anterior movement of the proximal tibia but a definite end-point to movement, as the ACL holds the joint securely. With ACL damage, the tibia can move an excessive distance anteriorly, and the examiner will not be able to feel a clear end-point to the movement

Question 5

investigations for ACL

Answer 5

imaging: MRI
athroscopy