Knee Pathology - Meniscal Tears Flashcards
Aetiology
Classically occur when there is a ? strain on a ?, weight-bearing knee (hence common in ?).
Relatively little force is required in ? adults (due to ?), and degenerative tears are seen in knee ??.
twisting flexed footballers older fibrosis OA
Aetiology
The ? meniscus is most commonly affected as it is less ?, and ? meniscus tears are associated with ??? tears.
The meniscus is mainly ?(apart from the ? 25%) so will not repair ? after a tear, or heal after ? repair.
medial mobile medial ACL avascular lateral spont surgical
Presentation
Symptoms are initial ?, which can be ?, and variable amounts of ?, hours later.
Swelling subsides with ?, but may recur after further trivial injury.
On examination, acutely there is often an ? and fixed ? deformity, with ? joint line tenderness.
pain intermittent swelling rest effusion flexion medial
Presentation
The ? tag of meniscus can act as a mechanical ? if it finds its way into the ? notch, causing symptoms;
- o ? of the knee (blocked ? giving fixed flexion).
- o Spontaneous ‘? ?’ of the knee.
loose irritant intercondylar locking extension giving way
Investigations
X-Ray (?, ? and ? essential): will be normal but important to exclude ?/??.
?: mainstay of imaging, picks up over 90% of tears.
AP Lateral SKyline #/OA MRI
Management;
? repair is indicated in many patients, especially if ?/ active.
If not repaired, small ? tears may propagate to cause a secondary ?.
Tears in the ? zone are amenable to repair.
If in the ? zone (more common), then a partial ? is the treatment of choice, to prevent ongoing ? symptoms.
arthroscopic young avascular arthritis vasc avascular meniscectomy mechanical
Management;
? meniscectomy is avoided due to a high risk of secondary ?
In ? tears secondary to OA, it is appropriate to treat
conservatively as response to ? is often poor;
- 0 OA is already causing symptoms, so treat ? until bad enough for a ? ?.
total OA degenerative debridement conservatively joint replacement
