meniscus - exam 3 Flashcards
2nd MOST common knee injury?
meniscal tear
True or False:
Medial < Lateral Meniscus
Posterior < Anterior Horn
False:
>
>
RF of meniscus tear:
acute:
chronic:
acute- all WB sports
Chronic/Degenerative:
greater the age, especially > 60 yrs. of age
male > female
worked related kneeling/squatting/stair climbing
Meniscus: structures involved :
attachment:
nearly circular wedged-shaped fibrocartilage discs on the tibial plateau
attached to the tibia via horizontal coronary ligaments
Meniscus Functions:
–outer
–inner
stability>shock absorption
deepen the joint surface for stability
–Outer 1/3
80% type I collagen
<1% of other types
–Inner 1/3
60% type II collagen
40% type I collagen
Medial meniscus characteristics: (3)
more “O” shaped
torn more frequently
attachment to MCL
Lateral meniscus characteristics: (2)
more “C” shaped
greater mobility without ligamentous attachment
There are various portions of the meniscus that can tear. T or F?
True
Symptoms of Meniscal Injury?
-______P!, refer _________
-Onset?
-ROM/WB?
Joint P! with possible referral into shin
Onset: if acute, trauma reported likely with WB sport
if chronic, gradual and unknown, typically in. an older individual w/o a prior injury
limited and P!ful motion
WBing limitation with possible catching or locking
Signs of Meniscal Injury:
Observation:
possible swelling
potential asymmetrical and antalgic gait
Signs of Meniscal Injury:
-ROM:
-Resisted Testing:
-Stress Tests:
limited and P!ful motions
potentially weak and P!full (severity dependent)
possibly P!full w/compression
What are the meniscus special tests:
McMurrays
Ege’s
Thesallys’s (lateral ONLY)
Apley’s
Which of the following special tests is being described:
pt. in supine palpate menisci at end range flx
–IR then EXT _________menisci
–ER then EXT for _______menisci
–checking for ________________
McMurray’s
Lateral
Medial
audible or palapble clicking/thud: NOT P!**
Which of the following special tests is being described:
in B stance w/feet 1-1 1/2 ft. apart
Full hip IR and squat for _______menisci
Full hip ER and squat for ________menisci
–checking for ___________
Ege’s
lateral
medial
P! or click
Which of the following special tests is being described:
in U stance twist 3x in each direction testing ________ menisci ONLY
@5º flx
@30º flx
–checking for ________________
Thesally’s
Lateral
locking, catching or P!
Which of the following special tests is being described:
pt. in prone flx knee to 90º (stabilize femur)
-apply distx then IR/ER : (+) test Indicates ____________
-apply comp then IR/ER (+) test indicates _________
Apleys
ligamentous injury
meniscal injury
Signs of Meniscal Injury:
- m. activity/MMT:
- palpation
inhibited quads
joint line tenderness has minimal to no support
PT Rx for meniscal injury:
POLICED
assistive device to minimize/avoid limping
JM - meniscal integrity
what are the purposes of MET for a meniscal injury?
meniscal integrity and stabilization
NMES - moderate support for strength
what does the research say about surgery for degenerative tears in the meniscus?
strong recommendation AGAINST even in the presence of age related joint changes
what is a partial meniscectomy?
- post op aspects?
removal of tear
- no immobilization
- earlier WBing
- return to play in 2-6 weeks
what is a meniscal repair?
- post op aspects?
sutured
primarily with tears in outer 1/3
immobilization and/or limited ROM initially
TTWB 4-6 weeks
return to play in 12 weeks - takes this long to become densely healed which you need before running, jumping, etc
what is a bakers cyst?
excessive swelling in popliteal space, often due to articular changes i.e., age related joint changes
fluid filled cysts can be due to:
persistent inflammation
subsequent weakening of capsule
baker’s cysts are asymptomatic until:
significant effusion
How do Baker’s cysts differentiate from meniscus tears?
palpable popliteal protrusion just medial to medial gastroc head
No p! With compression like meniscal tear
Signs of Baker’s cyst:
- ROM:
- Resisted:
limited and painful with flx/ext
flexion painful
PT Rx for Baker’s cyst:
- precaution:
like degenerative meniscal tear (reduce swelling)
- forceful activity
prognosis for Baker’s cyst:
- complication
difficult to manage in active individuals
complication: rupture may occur and mimic gastroc tear
MD Rx for baker’s cyst:
aspiration and/or surgical repair
