knee pathology

Question 1

MOA of ACL tear

Answer 1

rotation on a weight bearing leg

Question 2

presentation of a ACL injury

Answer 2

sudden pain and ‘pop’, rapid swelling, instability

Question 3

tests for ACL injury

Answer 3

anterior draw test and lachmans test (this is better)

Question 4

imaging for ACL

Answer 4

MRI to rule out concurrent injuries

Question 5

MX of ACL

Answer 5

1) RICE 2) physio, NSAID 3) surgery (preferred if younger patient + complete tear - do a tendon graft)

Question 6

MOA of PCL injury

Answer 6

fall onto hyper flexed knee

Question 7

is ACL or PCL stronger

Answer 7

PCL

Question 8

Mx of PCL

Answer 8

same as ACL

Question 9

MOA of a meniscal tear

Answer 9

rotational injury whilst flexed and weight bearing

Question 10

which side is more likely to get a meniscal tear

Answer 10

medial as attached to MCL

Question 11

O/E of meniscal tear

Answer 11

joint line tenderness, limited flexion and positive mcmurrays, swelling but doesn’t occur rapidly

Question 12

what does it indicate if the swelling is immediate or delayed in a knee injury

Answer 12

immediate = haemoarthrosis = ACL

Delayed = meniscal tear

Question 13

what deformity is common with knee OA

Answer 13

varus

Question 14

what are the two surgical options for knee OA

Answer 14

1) arthoroplasty (TKR)
2) osteotomy which just removes the part which is degenerating. May be used in younger patients

Question 15

abx needed in TKR

Answer 15

one dose if elective, three doses if traumatic

Question 16

firstline pain management for OA

Answer 16

always topical NSAID (not paracetamol)

Question 17

DVT prophylaxis in TKR

Answer 17

14 days LMWH and antimbolic stockings until discharge

Question 18

DVT prophylaxis in THR

Answer 18

28 days LMWH and antiembolic stockings until discharge