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MSK > O: Adult Knee Disorders > Flashcards

O: Adult Knee Disorders Flashcards

1
Q

purpose of menisci?

A

fibrocartilages that stabilise round femoral condyles on flat tibial plateaux

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2
Q

aetiology of meniscal tear?

A

young: trauma, sports/squatting
older: spontaneous due to degeneration

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3
Q

mechanisms of injury for meniscal tears?

A

twisting on loaded knee, hyper-flexion of knee jt

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4
Q

what are the 4 meniscal tears?

A

longitudinal, bucket-handle, radial tear, parrot beak tear

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5
Q

s/s of a meniscal tear?

A

general pain, swelling, popping and giving way sensation, possible effusion

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6
Q

which tear poses a risk for acute locked knee syndrome?

A

bucket handle tear

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7
Q

ix of choice for meniscal tear?

A

MRI

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8
Q

mx for meniscal tears?

A

non-surgical: physio, knee strengthening

surgery: arthroscopic meniscal repair, arthroscopic meniscectomy

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9
Q

when is meniscal repair indicated?

A

in acute peripheral meniscal tear or in young

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10
Q

when is meniscectomy indicated?

A

irreplaceable tears, chronic pain, and mechanical symptoms e.g. clicking

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11
Q

why must an acute locked knee be immediately unlocked in theatre?

A

may cause fixed flexion deformity (FFD)

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12
Q

what are the 4 knee ligaments?

A

medial collateral ligament (MCL), LCL, Anterior cruciate ligament (ACL), PCL

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13
Q

MCL injury causes _____ instability

A

valgus

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14
Q

ACL & LCL causes ____ instability

A

rotatory

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15
Q

PCL injury causes _____ or ___

A

recurrent hyperextension or instability

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16
Q

cause of ACL tear?

A

sports- commonly football, rugby, skiing

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17
Q

causes of PCL?

A

direct blow to anterior tibia or hyperextension injury

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18
Q

cause of MCL?

A

high force from side

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19
Q

cause of LCL?

A

varus stress injury

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20
Q

s/s of ACL injury?

A

‘pop’, giving way on turning, deep knee pain, ahemoarthrosis common

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21
Q

PCL s/s?

A

popliteal knee pain, bruising

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22
Q

ix for ligamental damage?

A

MRI, exam & special tests

23
Q

what is a special test for ACL tear?

A

Lachman’s Test

24
Q

tx for MCL damage?

A

brace, early motion, physio, surgical tendon graft reconstruction

25
Q

ACL damage mx?

A

physio, surgery if physio not effective

26
Q

T/F: surgery for ACL improves pain

A

F: improves stability but not necessarily pain

27
Q

PCL mx?

A

conservative or surgical reconstruction

28
Q

which of the 4 ligament injuries always has surgical tendon graft mx as 1st line?

A

LCL injury

29
Q

what is a complication of ligament injury?

A

haemoarthrosis (bleeding into jt cavity), premature osteoarthritis, perineal nerve injury with LCL damage

30
Q

T/F: complete knee dislocations are impossible

A

F: may occur and high risk of NV injury, surgery is tx

31
Q

what is patellofemoral pain syndrome?

A

problem with the patellofemoral articulation resulting in anterior knee pain

32
Q

aetiology of patellofemoral pain syndrome

A

muscle imbalance, tightness of lateral tissues, bony malalignment, often synonymous with chondromalacia (softening of cartilage)

33
Q

s/s of patellofemoral pain syndrome?

A

anterior knee pain worse on going downhill, grinding or clicking at anterior knee, stiffness

34
Q

mx for patellofemoral pain syndrome

A

physio

35
Q

rupture of patellar and/or quadricep tendon is called…

A

extensor mechanism rupture

36
Q

what makes up the extensor mechanism?

A

tibial tuberosity, patella, patellar tendon, quadricep muscles, quadricep tendon

37
Q

T/F: <40yo usually have quadricep tendon rupture

A

F: <40 usually patellar tendon rupture, >40 quadricep tendon rupture

38
Q

aetiology of extensor mechanism rupture?

A

rapid quadricep contraction

39
Q

which abx predisposes to tendon rupture?

A

ciprofloxacin- quinolone

40
Q

signs on exam of extensor mechanism rupture?

A

unable to do straight leg test, palpable gap

41
Q

on MRI, how do you differentiate between patellar tendon and quadricep tendon rupture?

A

Patellar: high patella
Quadricep: low patella

42
Q

mx for extensor mechanism rupture?

A

surgery

43
Q

what is osteochondritis dissecans?

A

area of knee loses blood supply and cartilage/ bone may fragment off

44
Q

T/F: loose bodies often break off at lateral femoral condyle in osteochondritis dissecans

A

F: usually break off at lateral aspect of medial femoral condyle

45
Q

epi of osteochondritis dissecans?

A

M>F, 7-17yo

46
Q

aetiology of osteochondrtitis dissecans?

A

traumatic + hereditary factors

47
Q

ix for OD?

A

MRI

48
Q

mx for OD?

A

un-displaced: spontaneous resolution

displaced: if detached= pin surgery + cartilage regeneration therapy

49
Q

what is bone bruising?

A

common complication of previous trauma- micros coping fracture of trabecular bone with bleeding

50
Q

mx for bone bruising?

A

self-resolves in 3/12- 12/12

51
Q

why do loose bodies keep growing?

A

nutrition from synovial fluid

52
Q

s/s of loose bodies?

A

clicking/ locking, mobile lump

53
Q

mx for loose bodies?

A

arthroscopic removal

MSK (26 decks)

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