meniscal tears

Question 1

what are the 4 ligaments of the knee?

Answer 1

Anterior cruciate ligament
Posterior cruciate ligament
Lateral collateral ligament
Medial collateral ligament

Question 2

what symptoms would someone have with meniscal tear?

Answer 2

• pop sound or sensation with initial injury
• Pain
• Swelling
• Stiffness
• Restricted range of motion
• Locking of the knee
• Instability or the knee “giving way”

Question 3

what are the Ottawa knee rules?

Answer 3

The Ottawa knee rules can be used to determine whether a patient requires an x-ray of the knee after an acute knee injury to look for a fracture. do an xray if any of the following are present

Age 55 or above
Patella tenderness (with no tenderness elsewhere)
Fibular head tenderness
Cannot flex the knee to 90 degrees
Cannot weight bear (cannot take 4 steps – limping steps still count)

Question 4

what are the investigations of choice for a suspected meniscal tear

Answer 4

MRI scan is usually the first-line imaging investigation for establishing the diagnosis.

Arthroscopy can be used to visualise the meniscus within the joint and is the gold-standard investigation for diagnosing a meniscal tear. Arthroscopy can also be used to repair or remove damaged sections of the meniscus.

Question 5

what is conservative management of a meniscal tear?

Answer 5

R – Rest
I – Ice
C – Compression
E – Elevation

Question 6

what is medical management for a meniscal tear?

Answer 6

NSAIDs are usually used first-line for analgesia in MSK injuries.

Physiotherapy can be used for rehabilitation after the initial pain and swelling have settled.

Question 7

what is surgical management of a meniscal tear?

Answer 7

Surgery may be required. This involves arthroscopy (keyhole surgery) of the knee joint. The main options are:

Repair of the meniscus if possible
Resection of the affected portion of the meniscus (this often results in osteoarthritis)

Question 8

which special tests would you preform to assess an ACL injury?

Answer 8

• anterior drawer and Lachlan test
• anterior drawer involves sitting on foot and drawer test involves having a bent leg
• anterior drawer-> tibia will move a significant distance anteriorly

Question 9

which graft ligaments can be used to replace an ACL?

Answer 9

Hamstring tendon

Quadriceps tendon

Bone-patellar tendon-bone (taking part of the patella tendon as well as the bone it inserts into)