Ortho Knee Flashcards
MCL: what kind of stress with rotation?
vaLgus
LCL: what kind of stress with rotation?
vaRus
Tx for grade I & II MCL & LCL collateral ligament injuries
sprains & incomplete tears:
conservative: NSAIDS, PT
Grade III MCL & LCL collateral ligament injuries
complete tear: surgical repair
MC knee ligament injury
ACL
MOI ACL
noncontact pivoting injury (deceleration, hyperextension, internal rotation)
Presentation for ACL
pop & swelling –> hemarthrosis
inability to bear wt
does not actively extend knee
What is the most specific and sensitive test for ACL?
lachman’s test: 30 degree flexion of affected knee, push thigh downa nd inferior knee up
Segond Fx
avulsion of lateral tibial condyle w/ vaRus stress to the knee seen in ACL injury
Tx ACL
therapy vs surgical
O’Donoghues triad
- ACL injury
- medial collateral ligament
- medial meniscus
MC associated with dashboard injuries
(ant. force to proximal tibia with knees flexed)
PCL injuries
presentation for PCL injury
anterior bruising
PE for PCL
pivot shift test, post drawer test
Cause of meniscal tears
degenerative: squatting, twisting, compression or trauma w/femur rotation on tibia
MC meniscal tear
Medial
Presentation for Meniscal tear
locking, popping, “giving way”, effusion after activities
Best test for meniscal tear
McMurray’s sign: pop or click when tibia is externally and internally rotated
Apley test
meniscal tear: joint line tenderness
Tx for meniscal tear
NSAIDS, partial wt bearing until ortho f/up
MOI patellar fx
direct blow
presentation for patellar fx
pain swelling deformity
dx for patellar fx
X ray: sunrise view
nondisplaced patellar fx tx
knee immobilizer, leg cast x 6 weeks
displaced patellar fx
surgery
MOI for patellar/quadriceps tendon ruptures
forceful quadriceps contraction –> fall on a flexed knee walking up/down stairs
patellar and quadriceps tendon rupture MC in what population
males w/ hx of systemic disease (DM, gout, obesity, renal dz)
Presentation for patellar/quadriceps tendon ruptures
sharp proximal knee pain w/ambulation, inability to extend knee/straight leg raise
patella baja
quadriceps: defect above knee