Meniscal Tears Flashcards
What are the menisci?
They are crescentile plates of fibrocartilage on the articular surface of the proximal tibia
What is the function of the menisci?
They function to stabilise the knee joint, distribute friction between the femur and tibia and to act as a form of shock absorption
What is the anatomical location of the medial meniscus?
It is located between the medial condyle of the femur and the medial condyle of the tibia
Is the medial meniscus attached to the tibial collateral ligament?
Yes
What is the anatomical location of the lateral meniscus?
It is located between the lateral condyle of the femur and the lateral condyle of the tibia
Is the lateral meniscus attached to the fibular collateral ligament?
No
What meniscus is most commonly injured? Why?
Medial Meniscus
This is due to the fact its attached to the tibial collateral ligament
What are the four clinical features of meniscal tears?
Knee Pain
Knee Swelling
Knee Instability
Knee Locking
What three investigations are used to diagnose meniscal tears?
McMurrays Test
Thessaly’s Test
MRI Scans
How is the McMurrays test conducted - in order to examine the medial meniscus?
It involves the patient lying supine and the examiner passively flexing the knee as far as possible
The examiner then holds the patient knee with their thumb over the medial aspect and fingers over the lateral aspect of the joint lines
The examiner’s other hand is used to hold the patient’s foot
The examiner creates valgus stress on the knee joint by applying outward pressure to the knee joint, whilst fixating and externally rotating the foot – and at the same time slowly extending the knee joint
How is the McMurrays test conducted - in order to examine the lateral meniscus?
It involves the patient lying supine and the examiner passively flexing the knee as far as possible
The examiner then holds the patient knee with their thumb over the medial aspect and fingers over the lateral aspect of the joint lines
The examiner’s other hand is used to hold the patient’s foot
The examiner creates varus stress on the knee joint by applying inward pressure to the knee joint, whilst fixating and internally rotating the foot – and at the same time slowly extending the knee
What is a positive McMurrays test?
A painful sensation or clicking sound during this manoeuvre
How is the Thessaly’s test conducted?
It involves asking the patient to stand on one leg – with support of the examiner
The patient then flexes the knee to 5 degrees and laterally rotates the knee joint three times
The test is then repeated at 20 degrees flexion
What is a positive Thessaly’s test?
There is knee pain or knee locking sensation during this manoeuvre
What is the gold standard investigation used to diagnose meniscal tears?
MRI Scans
