Meniscal Injuries

Question 1

Pathogenesis of meniscal injuries?

Answer 1

Twisting force on a loaded knee (squatting)

Question 2

What is the pathogeneis of true knee locking?

Answer 2

Meniscus may flip over & stuck in joint line

Question 3

Patterns of meniscal injuries?

Answer 3

• Longitudinal tear
• Radial tears
• Oblique tears
• Horizontal tears

Question 4

Aetiology of meniscal tears?

Answer 4

• Young sports related injury
• 255 of ACL ruptures also have a meniscal tear
• Medial is more common

Question 5

Symptoms of meniscal tear?

Answer 5

• Pain
• Effusion develops the following day
• Pain and mechanical symptoms
• Knee feel about to give way if loose fragment is caught in the knee when walking
• True knee locking
• Pseudo locking
• If torn meniscus: no “locking”

Question 6

Examples of pain and mechanical symptoms?

Answer 6

Catching sensation
Locking
Difficulty straightening the knee with a 15 degree or so block to full extension

Question 7

Signs of mechanical symptoms?

Answer 7

• Effusion
• Joint line tenderness
• Pain on tibial rotation
• Localizing to affected compartment (Steinmann’s test)
• Locked knee with displaced bucket handle meniscal tear
• Degenerate tears are Steinmann’s test negative & likely to be associated with OA s

Question 8

Investigation for meniscal injuries?

Answer 8

MRI: Confirm to clinical suspicion

Question 9

Treatment of meniscal injuries?

Answer 9

-Reasonably fresh tears involving outer 1/3: meniscal repair