Knee Problems Flashcards
How does a meniscal injury occur in the knee?
Twisting movement on a loaded fixed knee
Presentation of a meniscal knee injury
Painful squelch (feeling of something letting go)
Slow swelling (quicker in the young)
Painful to weight bear
“locked knee” - cannot straighten it
How does an ACL tear occur?
forward momentum, leg fixed +/- rotation
Presentation of an ACL tear
“pop”
quick swelling (almost immediately)
often able to weight bear
Presentation of a collateral tear
Lateralised pain Feel of "crack" sharp pain no or minimal effusion often able to weight bear
What to look for on an exam of knee problems
scars
bruising
swelling
joint line irregularity
What should you feel for in an exam of the knee problems
effusion crepitus heat tenderness tissue lumps or defects
what movements should be examined in a knee problem?
passive and active straight leg raise ROM ligament testing dynamic testing
What do X rays show in knee problems?
fracture loose bodies ligament avulsion osteochondral defect degenerative joint disease lipohaemarthrosis
What do USS show in knee problems?
tendon rupture
some meniscal tears
swelling
cysts
Who gets meniscal injuries?
young, sporty people
Reasons for ACL surgery
prevention of further injury
back to work
back to sport
prevention of OA
Treatment of ACL tear
Full ACL rehabilitation
ACL reconstruction
osteochondral injury examples
debridement reattachment of fragment removal of loose bodies microfracture chrondoplasty ACI
Indications for knee surgery
failure of conservative treatment demands of work demands of sport problems with daily activities prevention of further joint injury prevention of falls
non surgical management of knee problems
physio
analgesia
swelling reduction
ROM restoration
Treatment of meniscal injury
partial menisectomy
meniscal repair
meniscal transplantation
When is the unhappy triad seen?
Following a lateral blow to the knee
What is the unhappy triad?
ACL
MCL
Meniscus
Which ligament is isolated injury uncommon?
Lateral collateral ligament
What nerve is associated with a positive Trendelenburg sign?
Superior gluteal nerve
What tests may be positive if the anterior cruciate ligament is damaged?
Anterior draw test
Lachman test
Symptoms of locking and giving way are indicative of what?
Meniscal injury
What is the most common cause of lateral knee pain in runners?
Iliotibial band syndrome
How many runners get iliotibial band syndrome?
1 in 10
Investigation for meniscal tears
MRI
What is fouchers sign?
In bakers cyst - the increase in tension of the bakers cyst on extension of the knee
