Soft tissue and knee injuries

Question 1

examples of soft tissue knee problems

Answer 1

meniscal tears
ligament tears; acc,mcl,lcl
multiligament injuries and knee dislocation
osteochondral defects
patellofemoral disorders
bone bruising
loose bodies

Question 2

where does your mensicus lie

Answer 2

between tibia and femur

Question 3

role of meniscus

Answer 3

a cushion to keep the bones of the knee joint from grinding against one other and causing damage

Question 4

which meniscus is more mobile

Answer 4

lateral meniscus

Question 5

investigation if meniscal tear suspected

Answer 5

MRI

Question 6

main causes of meniscal tear

Answer 6

sporting injury or getting up from squatting position

Question 7

which types of meniscal tears wont heal

Answer 7

radial tears

Question 8

which part of meniscus has blood supply

Answer 8

peripheral 1/3rd

Question 9

what does an acute locked knee signify

Answer 9

displaed bucket handle meniscal tear
urgent surgery required

Question 10

what surgery is required if mensical tear unrepairable

Answer 10

partial meniscectomy
removes part of dodgy meniscus

Question 11

can meniscal tears be spontaneous

Answer 11

yes due to old age the meniscus weakens

Question 12

which stress does MCL resist

Answer 12

valgus

Question 13

which stress does LCL resist

Answer 13

varus

Question 14

valgus stress

Answer 14

inwards knee

Question 15

varus stress

Answer 15

outwards knee

Question 16

gradings of knee ligament injuries

Answer 16

Grade 1 – sprain – tear some fibres but macroscopic structure intact
Grade 2 – partial tear - some fascicles disrupted
Grade 3 – complete tear

Question 17

rupture to where might cause instability descending stairs

Answer 17

PCL

Question 18

MCL injury overview

Answer 18

usually heals well even if complete tear
Pain can take a few to several months to settle
- Great blood supply
- Get knee moving early, lot of physio

- Surgery If on going instability   very good at healing itself, often don’t need to perform surgery

Question 19

ACL rupture overview

Answer 19

• More common in females
  
  • Sports injury, sharp turn, landing ; netball, skiing from rotating
  • When ruptures gives an audible pop
  • When ruptures bleeding into knee occurs
    Risk of arthritis, surgery doesn’t protect against

Question 20

which test for ACL tear

Answer 20

anterior drawer test

Question 21

LCL injury overview

Answer 21

require surgery
- Doesn’t heal and causes varus and rotatory instability
often occurs in combo with all/pcl injury

Question 22

PCL rupture overview

Answer 22

direct blow to anterior tibia
popliteal knee pain and bruising

Question 23

is a knee dislocation an emergency

Answer 23

yes it requires prompt reduction
high risk of vascular injury, nerve injury and comprtment synrome
gets put in external fixator

Question 24

patellar dislocation overview

Answer 24

• Rapid turn
  
  • Increased in females due to angle of muscles, more ligamentous laxitae
    First line treatment; physiotherapy

Question 25

what is patellofemoral pain syndrome

Answer 25

adult growing pains may be due to muscle imbalance, flat feet

Question 26

extensor mechanism rupture overview

Answer 26

• Surgical emergency
  
  • Straight leg raise for examination
  • If miss and present after 4 weeks not good
    RF; steroids as weakens tendons , previous tendonitis, ciprofloxacin as can cause tendinopathies
    US/MRI if in doubt

Question 27

what causes high patella on xray

Answer 27

patellar tendon rupture

Question 28

what causes a low patella on xray

Answer 28

quads tendon rupture

Question 29

what is osteochondritis dissecans

Answer 29

when a piece of bone and the attached cartilage break down and become loose
can heal or resolve spontaneously

Question 30

what is bone bruising

Answer 30

when something damages the bone and causes bleeding in or around it
will settle over time

Question 31

bone marrow oedema

Answer 31

when fluid builds up inside your bone marrow

Question 32

what is a loose body

Answer 32

a fragment of cartilage or bone detaches causing a loose body in the joint
can grow over time getting nutritiion from synovial fluid and may cause painful locking/ catching

Question 33

what is commonly misdiagnosed as a loose body

Answer 33

a fabella
acessory ossicle

Question 34

Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking

Answer 34

meniscal tear

Question 35

Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability

Answer 35

ACL rupture