Soft tissue and knee injuries Flashcards
examples of soft tissue knee problems
meniscal tears
ligament tears; acc,mcl,lcl
multiligament injuries and knee dislocation
osteochondral defects
patellofemoral disorders
bone bruising
loose bodies
where does your mensicus lie
between tibia and femur
role of meniscus
a cushion to keep the bones of the knee joint from grinding against one other and causing damage
which meniscus is more mobile
lateral meniscus
investigation if meniscal tear suspected
MRI
main causes of meniscal tear
sporting injury or getting up from squatting position
which types of meniscal tears wont heal
radial tears
which part of meniscus has blood supply
peripheral 1/3rd
what does an acute locked knee signify
displaed bucket handle meniscal tear
urgent surgery required
what surgery is required if mensical tear unrepairable
partial meniscectomy
removes part of dodgy meniscus
can meniscal tears be spontaneous
yes due to old age the meniscus weakens
which stress does MCL resist
valgus
which stress does LCL resist
varus
valgus stress
inwards knee
varus stress
outwards knee
gradings of knee ligament injuries
Grade 1 – sprain – tear some fibres but macroscopic structure intact
Grade 2 – partial tear - some fascicles disrupted
Grade 3 – complete tear
rupture to where might cause instability descending stairs
PCL
MCL injury overview
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
ACL rupture overview
- 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
which test for ACL tear
anterior drawer test
LCL injury overview
require surgery
- Doesn’t heal and causes varus and rotatory instability
often occurs in combo with all/pcl injury
PCL rupture overview
direct blow to anterior tibia
popliteal knee pain and bruising
is a knee dislocation an emergency
yes it requires prompt reduction
high risk of vascular injury, nerve injury and comprtment synrome
gets put in external fixator
patellar dislocation overview
- Rapid turn
- Increased in females due to angle of muscles, more ligamentous laxitae
First line treatment; physiotherapy
- Increased in females due to angle of muscles, more ligamentous laxitae
what is patellofemoral pain syndrome
adult growing pains may be due to muscle imbalance, flat feet
extensor mechanism rupture overview
- 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
what causes high patella on xray
patellar tendon rupture
what causes a low patella on xray
quads tendon rupture
what is osteochondritis dissecans
when a piece of bone and the attached cartilage break down and become loose
can heal or resolve spontaneously
what is bone bruising
when something damages the bone and causes bleeding in or around it
will settle over time
bone marrow oedema
when fluid builds up inside your bone marrow
what is a loose body
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
what is commonly misdiagnosed as a loose body
a fabella
acessory ossicle
Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking
meniscal tear
Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability
ACL rupture
