Knee soft tissue injuries Flashcards

1
Q

what part of knee will increased weight affect the most

A

patella femoral joint

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2
Q

what causes pseudo locking

A

lack of synovial fluid after a prolonged sitting

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3
Q

who are ACL tears more common in

A

women

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4
Q

what can predispose to a extensor mechanism rupture

A

previous tendonitis
steroids
chronic renal failure (ciprofloxacin)

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5
Q

what are the signs of an extensor mechanism rupture

A

unable to straight leg raise,

palpable gap

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6
Q

what is the treatment for an extensor mechanism rupture

A

requires surgical repair

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7
Q

does the meniscus have innervation

A

peripheral 1/3rd does

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8
Q

what tears of the meniscus can be ignored

A

radial

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9
Q

how many ACL tears have meniscal tears too

A

50%

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10
Q

will radial meniscal tears heal

A

no

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11
Q

what can you consider in acute peripheral menisci tears

A

arthroscopic repair

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12
Q

when is a menisectomy done

A

mechanical symptoms, irreparable tears, failed meniscal repairs

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13
Q

what is a degenerative tear often the first stage of

A

OA

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14
Q

what does the ACL resist

A

anterior subluxation of the tibia and internal rotation of the tibia in extension

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15
Q

what does the PCL resist

A

posterior subluxation of the tibia and hyperextension of the knee

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16
Q

what might ACL rupture lead to

A

rotator instability

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17
Q

what might PCL rupture lead to

A

recurrent hyperextension or instability descending stairs

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18
Q

what rupture causes haemoarthrosis

A

ACL

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19
Q

what is bone bruising

A

bleeding inside the bone

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20
Q

what is the treatment for an MCL rupture

A

usually heals well, brace, early motion, physio, pain takes several months to heal, rarerly surgery

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21
Q

what is the main stabiliser against internal rotation of the tibia

A

ACL

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22
Q

does ACL surgical repair work

A

no- has to be reconstruction (autograft- hamstring or patellar tendon) (allograft- achilles)

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23
Q

what can stabilise ACL deficient knees

A

physio. if not responding to physio consider surgery

24
Q

does the LCL heal

A

no

25
Q

what artery can be affected in a knee dislocation

A

popliteal

26
Q

what is affected in a twisting injury

A

ACL/ meniscal

27
Q

what fall causes an extensor mechanism rupture

A

fall onto flexed knee with quads contraction

28
Q

what injuries can cause an extensor mechanism rupture

A

rectus femoris tear
quadriceps tendon or patellar tendon rupture
patellar fracture

29
Q

what are the roles of the menisci

A

distribute load,

make medial plateau more concave

30
Q

which menisci is more likely to tear

A

medial as more fixed than lateral, also under more shear stress

31
Q

what do 50% of ACL ruptures have

A

meniscal tear

32
Q

will radial tears heal

A

no

33
Q

how many arthroscopic repairs of acute peripheral menisci tears fail

A

40%

34
Q

what does an acutely locked knee signify

A

displaced bucket handle meniscal tear

35
Q

what is the treatment for a meniscal tear causing locked knee

A

urgent surgery, arthroscopic repair/ menisectomy

36
Q

what does the MCL resist

A

valgus stress

37
Q

what does the LCL resist

A

varus stress

38
Q

what might a MCL rupture lead to

A

valgus instability

39
Q

what is the rule of thirds of ACL ruptures

A

1/3rd compensate and can function well
1/3rd avoid instability by avoiding certain activities
1/3rd do not compensate, have frequent instabilities/ cant get back into high impact sport

40
Q

how many ACL ruptures end up having reconstruction

A

40%

41
Q

when is surgery used in ACL tears

A

when rotator instability not responding to physio
professional sport/ high demand job
adolescent or young adult- keen on sport

42
Q

what does ACL reconstruction not help

A

pain and prevention of arthritis

43
Q

what causes an LCL injury

A

varus and hyperextension

44
Q

what nerve can be affected in a LCL injury

A

common peroneal nerve

45
Q

what is the treatment for a complete LCL rupture

A

urgent repair (within 2-3 weeks)

46
Q

what causes a PCL injury

A

direct blow to anterior tibia/ hyperextension

47
Q

what is often involved in a knee dislocation

A

often high energy injuries;

  • popliteal artery injury (tear, intimal tear and thrombosis)
  • nerve injury (common peroneal nerve)
  • compartment syndrome
48
Q

what is the treatment for a knee dislocation

A
emergency reduction
recheck neurovascular status 
- poss vascular surgery 
maybe temporary stabilisation 
maybe multiligament reconstruction
49
Q

what causes a patella dislocation

A

rapid turn or direct blow

50
Q

why gets patella dislocations

A

females more, adolescents, ligamentous laxity, valgus knee, torsional abnormalities

51
Q

twisting injuries think

A

ACL or meniscal

52
Q

getting up from squatting injury

A

meniscal

53
Q

haemarthrosis think

A

ACL or fracture

54
Q

effusion think

A

meniscal or chondral injury

55
Q

pain in joint line think

A

meniscal/ chondral

56
Q

Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability =?

A

ACL rupture

57
Q

Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking = ?

A

meniscal tear