Knee injuries Flashcards
What are the types of cause of patellar fractures?
Direct blow and undisplaced fractures
Avulsion fractures
What is the presentation of patellar fracture?
Joint deformity/shortening Swelling Bruising Severe pain on movement Limited extension
What investigations are doenfor patellar fractures?
XR
CT if complex
What is the management of patellar fractures?
Casting in straight leg position
Surgery if severe or complex
What is the presentation of a patellar dislocation?
Pain, tenderness Deformity, swelling Inability to move joint or weight bear HAemarthrosis Often associated injuries
What investigations are done for patellar dislocation?
Skyline XR
MRI for associated soft tissue injury if suspected
What is the management of patellar dislocation?
Reduction- extension and lateral pressure
Immobilisation
Physio
What ae the complications of patellar dislocation?
20% recurrence
Associated soft tissue injury
What is the presentation of an ACL tear?
Forward momentum on fixed flexion +/- rotation
Often audible pop
Quick pain and swelling
Unstable feeling knee but often able to weight bear
Anterior draw test +
What are the investigations done for ACL tear?
XR- rule out avulsion injury
MRI
What is the management of ACL injuries?
Rest, ice, brace, analgesia
Intense physio
Surgical reconstruction
What is the presentation of a PCL tear?
Hypertexteion injury or anterior force to tibia Posterior draw + Posterior sag + Pain Able to weight bear
What is the investigation of a PCL tear?
AP and lateral XR
Kneeling PCL stress test
What is the presentation of a meniscal injury?
Twisting movement on loaded fixed knee Painful "squelch" Slow to swell Painful ti weight bear, gives way Locked knee
What investigations are done for meniscal tear?
XR
Consider MRI
What is the management of meniscal tear?
Surgical and post op physio
What are the surgical options for meniscal tear?
Meniscal repair- if clean and clear
Partial meniscectomy if complex or degenerative
What is the presentation of a collateral ligament injury?
Feel a "carck" Sharp pain Little to no swelling Bruising to one side Usually able to walk
How is collateral ligament injury diagnosed?
History and exam
What is the management of collateral ligament injuries?
Supportive and physio
Rarely surgical
What is the unhappy triad?
ACL
MCL
Meniscus
Commonly seen following lateral blow to knee
What is OSgood-Schlatter disease?
Tibial apophysitis in sporty preteens and teenagers
What is the presentation of Osgood Schletter disease?
Pain, tenderness and swelling over tibial tubercle
What is the diagnosis and management of OSgood Schlatter’s?
Clinical diagnosis
Activity modification
Rest, ice and stretching
Who is patellar tendinitis seen in?
Active, esp jumping sports
Overweight
What is the presentation of patellar tendinitis?
Chronic anterior knee pain- worse after running , better at rest
Tenderness below patella
Swelling
What is the management of patellar tendinitis?
Rest
Physio
What is patellofemoral pain syndrome?
Knee pain resulting from mechanical and biochemical changes to patellofemoral joint
Multifactorial
What is the presentation of patellofemoral pain syndrome?
Ill defined ache
Worsened by hills/stairs, squatting, prolonged sitting
What is the management of patellofemoral pain syndrome?
Activity modification
Correction of specific factors- physio, bracing
