meniscal injuries Flashcards
Pathogenesis of meniscal injuries?
Twisting force on a loaded knee (squatting)
What is the pathogeneis of true knee locking?
Meniscus may flip over & stuck in joint line
Patterns of meniscal injuries?
-Longitudinal tear -Radial tears-Oblique tears -Horizontal tears
Aetiology of meniscal tears?
- Young sports related injury
- 25% of ACL ruptures also have a meniscal tear
- Medial is more common
Symptoms of meniscal tear?
- 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”
Examples of pain and mechanical symptoms?
Catching sensation Locking Difficulty straightening the knee with a 15 degree or so block to full extension
Signs of mechanical symptoms?
-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
Investigation for meniscal injuries?
MRI: Confirm to clinical suspicion
Treatment of meniscal injuries?
-Reasonably fresh tears involving outer 1/3: meniscal repair