Soft Tissue Disorders of the Knee

Question 1

knee dislocation

Answer 1

grossly unstable knee that has disruption of both cruciate ligaments and at least one collateral ligament complex

Question 2

big risk in knee dislocation

Answer 2

Neurovascular injury to popliteal artery and/or peroneal nerve - do CTA or arteriogram

Question 3

patellofemoral syndrome

Answer 3

commonly seen in adolescent females

chondromalacia

pain or crepitation in knee at PF joint w/ effusion and positive patellar compression test

non-operative – just do quad strengthening exercises

Question 4

which does the patella dislocate? how to reduce?

Answer 4

reduce laterally

apply gentle medial pressure w/ knee extended

Question 5

patellar tendinitis

Answer 5

“jumper’s knee”

pain at inferior pole of patella

conservative tx

Question 6

osteochondritis dissecans

Answer 6

separation of an avascular fragment of bone and cartilage from underlying normal bone

seen in adolescents

usually medial femoral condyle

tx: symptomatically, or remove/reattach loose fragments, maybe autologous chondrocyte implantagtion

Question 7

osgood-schlatter’s disease

Answer 7

pain at tibial tubercle secondary to patellar tendon traction

adolescents

radiographic changes of fragmentation at tibial tubercle

tx: rest and activity modification, occasional surgical excision as adult

Question 8

sinding-larsen-johansson disease

Answer 8

“reversed” osgood-schlatter’s - pain and fragmentation at inferior pole of patella

Question 9

bipartite patella

Answer 9

incidental finding- not a fracture

50% bilateral

no tx