Knee Injuries Flashcards
How might contact/non-contact activites show up in knee injuries?
- majority of knee injuries are non-contact mechanisms
- contact injuries have some non-preventable “unlucky” events
Which is more common in knee injuries: hyperflexion or extension?
hyperextension
How does hyperextension/flexion impact the knee ligaments?
*unclear from slides - hyperextension prob affects most except pcl, hyperflexion would cause pcl injury
hyperextension might cause PCL injury
- hyperflexion might affect menisci
What happens with valgus collapse?
- MCL can pop first, ACL is next
How does the trunk affect knee injuries?
- trunk is part of the story! Knees don’t only just collapse in a direction on their own. This is why core work is very important
How might foot and ankle positioning/disrupted function affect knee injury risk?
- ppl who land flat footet/without a toe to heel drop can affect the knee
- when we land from a jump, ankle is supposed to absorb some of that impact
- if you cut the ankle from the picture, knee is next in line
- if we are retraining someone after an ACL injury, we would focus on ways to strengthen so this doesn’t happen again
How can information given on sense of collapse or rupture like hearing a “sound” helps us identify injury?
- often patient will tell you if they felt something shift or if a noise was made
- quick changes in direction can give chance of failure
- sometimes “gave out and buckled” is used, could indicate torn meniscus too
If the swelling had a slow build, what does this tell us about the injury?
- Synovial fluid slowly builds up which can take up to 24 hours = slow build probably means joint effusion
- we have synovial fluid in joint for fluid movement but in injury this fluid is overproduced.
If swelling occurs within an hour, what does this mean?
this is swelling from a bleed = we have damaged something that has blood supply
What does weight bearing status tell us about knee injuries
not much, weight bearing is too variable to be meaningful
OK ON SURFACE DOES NOT MEAN OK
Is there a colour indication of bleed-related swelling?
no - unless you damage the capsule the bleeding is on the inside
can you damage the MCL with no joint effusion?
yes
What might localized swelling mean?
- might mean damage of that specific structure
What may happen to the knee appearance with joint effusion?
lose contour of the knee
Deformities should be watched out for: how might this present in a patella?
patellas will typically dislocate laterally (sometimes snaps back in when quads contract)
REVIEW: what are the lateral knee structures?
- LCL between femur and fibula
- meniscus sandwiched in between
- Lateral patellofemoral ligament connects patella
REVIEW: what are the medial knee structures
- MCL between femur and tibia (wider than LCL)
- medial meniscus sandwiched
- medial patellofemoral ligament (usually damaged more often in patellar dislocation since lateral dislocation is more common)
REVIEW: what does the ACL limit?
- anterior translation of tibia
- twisting tibia in any direction will put stress on ACL (happens when ppl plant foot and pivot)
more extension = more stress on ACL
REVIEW: what does the PCL limit?
- posterior translation of tibia
- more flexion = more stress on PCL
Are ACL injuries the majority?
no, we just hear more about them
What is the incidence of ACL injuries between females/males
1/29 female athletes
1/50 male athletes
- lots of factors involved (neural etc.)
- relative risk this happens to women is 1.5 men’s risk (50% higher)
How does family history affect ACL injury statistically?
- ppl who have parent/sibling with ACL injury have 2.53x more risk than someone who is not related to anyone who tore ACL
Do all ACL injuries need surgery?
- if you have a minor ACL injuri you can still play a lot of the time, depends on neuromuscular status before and degree of rupture
- if you’re an athlete and need ot do all sorts of pivorting you will probably get surgery
- you could get lucky and have some minor tearing and some healing over time if you take it easy
What is the primary source of chronic knee pain?
patella
What 2 conditions are included under the title of “anterior knee pain?”
- patellar tendinopathy
- patellofemoral pain syndrome
What might aggravate patellar injuries/anterior knee pain?
- any activity that requires person to actively extend their knee or absorb impact
- some things are more aggravating than others (ex. stair running)