Knee Injuries Flashcards
How does a patella dislocation normally present?
Flexed knee with lateral deformity
How do you treat patella dislocation?
- Reduce with firm medial pressure while extending
- X ray
- Immobilisation in cast
- Quad strengthening rehab
What is recurrent patellar subluxation?
- Developmental abnormality - tight lateral retinaculum
- Knee may give way
- Medial pain
- More common in girls and with valgus knees
- If patella dislocation happens once, more likely to happen again
What is the typical MOI of a patella fracture?
Dashboard injury or fall on flexed knee
How do you treat a non displaced patella fracture with intact extensor mechanism?
Conservative management
How do you treat a displaced patella fracture?
Operative fixation
Which collateral ligament is most commonly injured?
Medial collateral ligament
What is the MOI of a medial collateral ligament injury?
Blow to lateral aspect of knee while foot is fixed (football)
What are signs of a medial collateral ligament injury?
Effusion and tender
How do you treat a medial collateral ligament injury?
- Rest and firm support
- Rarely surgery
How do you treat a lateral collateral ligament injury?
- Rare and more extensive
- May need surgery if unstable
What is the MOI of an anterior cruciate ligament tear?
Twisting injury with foot fixed (football)
What are the signs of ACL tear?
- Effusion
- Haemarthrosis (70% - bc ligaments are v vascular)
- Positive anterior draw sign
How do you treat an ACL tear?
- 3 week rest
- Physio
- Ligament reconstruction if young and unstable
What is the MOI of a PCL tear?
- Car crashes
- Twice as strong as ACL so rarely damaged
- Rare menisci involvement
How do you diagnose PCL tear?
Positive posterior draw test
How do you treat PCL tear?
- Conservative
- Reconstruction less preferred
What is the most common reason for knee arthroscopy?
Meniscal (semilunar) cartilage tear
How does a meniscal tear present?
- Limited extension
- Patient can only tiptoe (locked knee)
What is the MOI of a medial meniscal tear?
Follows twist to flexed knee
What is the MOI of a lateral meniscal tear?
Adduction + internal rotation
How do you diagnose ACL tear?
Positive draw sign
What are the two key signs of a meniscal tear?
- Tender joint line
- Positive McMurray’s test
How do you treat a meniscal tear?
- Conservative if small asymptomatic tear
- Arthroscopy
- Surgery - aims to preserve meniscus
