Knee ligaments tear

Question 1

What is an ACL tear

Answer 1

Tear of the anterior cruciate ligament of the knee
mechanism often a sudden decelleration/stop/change of direction with a fixed foot (football, basket ball etc)
non-contact

can either partial or total tear
F>M

Question 2

What are the sx of acl tear

Answer 2

Sx-
Sudden ppainful POP/crack
feeling unstable
giving way

significant swell within a few hours
difficulty walking

signs- lateral knee and joint line tender
Lachman test positive/anterior drawer positive

assox with meniscal tear, tibial plateau injury and bakers cyst

Question 3

ix and management of ACL tear

Answer 3

xray- widened notch
USS
MRI

mx-
surgical repair of the tear if pt is young and active
non operative if old and sedentary

then rehab with physio

Question 4

What is a PCL tear

Answer 4

rupture of the posterior knee ligament-mechanism of injury often direct blow to tibia- dash board/contact injiry

sports injury/trauma- dashboard

Question 5

Sx of PCL tear

Answer 5

acute-vague and minimal, if alone
chronnic- pain on kneeling/squat/walking long distance

Often painless/relatively asymptomatic
can be posterior pain or pain on kneeling

signs-
mild effusion and reduced ROM
Posterior drawer test
posterior lachmans positive
varus leg

Question 6

Ix and management of PCL tear

Answer 6

USS cheap and effective
xrray- widened notch
MRI

Mx-
conservative if acute isolated minimal tear (if tibia stable)
immobilize for 2-3w, patial to full weight bear 2w and physio

srugical - graft of tendon from patellar tendon
if acute- high tibial instability
chronic-mostly reccomended