Meniscus

Question 1

What percent of body weight do the meniscus hold?

Answer 1

70%

Question 2

In terms of vascularity what parts are highly vascularized, somewhat vascularized, and avascular

Answer 2

Highly: outer third
Somewhat: middle third
Inner: avascular

Question 3

This meniscus is more circular and more mobile

Answer 3

Lateral meniscus

Question 4

The lateral meniscus is more mobile for the - - - and is connected to what muscle that helps move it?

Answer 4

Screw home mechanism
Muscle: popliteus

Question 5

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

Answer 5

Posterior lateral corner

Question 6

This meniscus is smaller, C-shaped, and less mobile

Answer 6

Medial meniscus

Question 7

This meniscus is injured more frequently

Answer 7

Medial

Question 8

What three attachments does the medial meniscus have?

Answer 8

Joint capsule, MCL, semimembranosus

Question 9

Semimembranosus attaches to the ___ligament and —-

Answer 9

MCL and medial meniscus

Question 10

Lateral meniscus tears are most commonly seen in what age group?

Answer 10

Younger

Question 11

What are risk factors for medial or lateral meniscus tears?

Answer 11

Cutting and pivoting sports
Increased age, delayed ACL reconstruction

Question 12

What are the five risk factors for medial meniscus tears

Answer 12

Female sex
Older age
Higher BMI
Lower physical activity
Delayed ACL reconstruction

Question 13

What is needed to dx a meniscus tear

Answer 13

Knee pain with a hx of twisting knee injury, hx of catching or locking, delayed onset of effusion, meniscal pathology composite score >3

Question 14

What are the 5 items in the meniscal pathology composite score?

Answer 14

1. Hx of catching or locking
2. Pain with forced knee extension
3. Pain with maximal passive knee flexion
4. Joint line tenderness
5. Pain or audible click with McMurrays test

Question 15

Effusion due to a meniscal injury occurs when after injury?

Answer 15

6-24 hours after injury

Question 16

Effusion 0-2 hours after injury is usually a _ injury but could also be _

Answer 16

Usually ACL but could also be osteochondral fx

Question 17

ACL, PCL, MCL tears effusion usually shows up how many hours after injury?

Answer 17

0-12 hours

Question 18

Younger patients do better with meniscectomy or meniscus repairs?

Answer 18

Meniscus repairs

Question 19

Those who choose nonoperative meniscal option will have —- outcomes in strength and perceived knee function in short and intermediate time frame

Answer 19

Similar to better outcomes

Question 20

After partial meniscectomy elite athletes or athletes <30 can return when? Older athletes return when?

Answer 20

<30 in two months or less, >30 in 3 months

Question 21

What is the return to sport test after meniscal injury?

Answer 21

Single limb hop test

Question 22

What is the stroke test?

Answer 22

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

Question 23

How is the stroke test graded?

Answer 23

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

Question 24

What is the tx for non operative meniscal tear?

Answer 24

Supervised Progressive ROM, progressive hip and knee strengthening exercises, neuromuscular training

Question 25

For post op meniscus patients what is tx?

Answer 25

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