Meniscus Flashcards
What percent of body weight do the meniscus hold?
70%
In terms of vascularity what parts are highly vascularized, somewhat vascularized, and avascular
Highly: outer third
Somewhat: middle third
Inner: avascular
This meniscus is more circular and more mobile
Lateral meniscus
The lateral meniscus is more mobile for the - - - and is connected to what muscle that helps move it?
Screw home mechanism
Muscle: popliteus
This is an exception to the vascularity rule. This area does not heal well due to being separated from the joint capsule by the popliteus
Posterior lateral corner
This meniscus is smaller, C-shaped, and less mobile
Medial meniscus
This meniscus is injured more frequently
Medial
What three attachments does the medial meniscus have?
Joint capsule, MCL, semimembranosus
Semimembranosus attaches to the ___ligament and —-
MCL and medial meniscus
Lateral meniscus tears are most commonly seen in what age group?
Younger
What are risk factors for medial or lateral meniscus tears?
Cutting and pivoting sports
Increased age, delayed ACL reconstruction
What are the five risk factors for medial meniscus tears
Female sex
Older age
Higher BMI
Lower physical activity
Delayed ACL reconstruction
What is needed to dx a meniscus tear
Knee pain with a hx of twisting knee injury, hx of catching or locking, delayed onset of effusion, meniscal pathology composite score >3
What are the 5 items in the meniscal pathology composite score?
- Hx of catching or locking
- Pain with forced knee extension
- Pain with maximal passive knee flexion
- Joint line tenderness
- Pain or audible click with McMurrays test
Effusion due to a meniscal injury occurs when after injury?
6-24 hours after injury
Effusion 0-2 hours after injury is usually a _ injury but could also be _
Usually ACL but could also be osteochondral fx
ACL, PCL, MCL tears effusion usually shows up how many hours after injury?
0-12 hours
Younger patients do better with meniscectomy or meniscus repairs?
Meniscus repairs
Those who choose nonoperative meniscal option will have —- outcomes in strength and perceived knee function in short and intermediate time frame
Similar to better outcomes
After partial meniscectomy elite athletes or athletes <30 can return when? Older athletes return when?
<30 in two months or less, >30 in 3 months
What is the return to sport test after meniscal injury?
Single limb hop test
What is the stroke test?
When the knee is extended, use hand to move medial knee swelling to supra patellar pouch, then stroke downward on the distal lateral side looking for wave of fluid at medial side of knee
How is the stroke test graded?
0 if no wave
Trace if a little wave
1+ if large bulge with downstroke
2+ if bulge returns spontaneously without down stroke
3+ if fluid does not move upward
What is the tx for non operative meniscal tear?
Supervised Progressive ROM, progressive hip and knee strengthening exercises, neuromuscular training
For post op meniscus patients what is tx?
Early progressive active and passive knee motion, progressive knee and hip strength, Better functional outcomes being in a clinic, NMES, early progressive WB with no ROM restriction had same failure rate as TTWB for two weeks
