October 30, 2015 - MSK Tissue Response

Question 1

Vascularity in ACL

Answer 1

Has almost no vascularity.

Therefore, has almost no healing potential.

Question 2

Tendinitis

Answer 2

Inflammation of the tendon

Need a biopsy to officially diagnose tendonitis

Question 3

Tendinopathy

Answer 3

A “diseased” tendon

Question 4

Fascia

Answer 4

Widespread connective tissue. There is superficial fascia that is under the skin, as well as deep fascia that is dense connective tissue.

These are involved in compartment syndromes.

Question 5

Patellofemoral Pain Syndrome

Answer 5

Most common “knee pain” presentation

Exact cause unknown

Question 6

Acute Soft Tissue Injuries

Answer 6

These may damage arteries. If this is not detected, the extremity may become ischemic and may need amputation.

You NEED to do an anchiobrachail index on these patients. This is when you take the blood pressure above and below the site of injury. If it is less than 0.8, then they have an arterial injury and they may potentially need to go to amputation.

Question 7

Muscle Contusion Hematoma

Answer 7

Basically a big bruise or crushing injury of the muscle tissue with bleeding may lead to a hematoma formation. This is usually from a direct blow, and the quadriceps are very common.

BEWARE NSAID history. This can cause uncontrolled bleeding.

Question 8

Myositis Ossificans

Answer 8

Ossification that occurs in muscle tissue after moderate or severe contusion-hematoma.

Clinically, this presents as increasing pain and reduced ROM following a muscle contusion. Most often in the quadriceps or biceps.

Be aware of this, and check for it after 2-3 weeks.

Question 9

ACL Tear

Answer 9

Assess with VERPS

Can be contact or non-contact (more likely)

With contact, a player is usually hit in the anterior of their knee

With non-contact, it is often placing legs outside of shoulder-width

Question 10

VERPS

Answer 10

Used to assess ACL tears

V - valgus force

ER - external rotation

P - pop

S - swelling (immediate)

Reassess in 7-10 days

Question 11

Treatment for ACL Tears

Answer 11

Non-surgical can include physiotherapy, bracing, and activity modification.

Surgical can include re-attachment. This is to restore stability as the primary goal as well as function. Pain comes secondary.

Question 12

MCL Tear

Answer 12

Most common mechanism of injury is a blow to the lateral knee with a valgus force, but may also be injured by non-contact and/or rotational forces. This can be falling on a flexed knee which drives the tibia posterior on the femur.

Most often treated non-operatively

Question 13

Treatment for MCL Tears

Answer 13

Usually treated non-operatively.