Soft Tissue Injury

Question 1

What is the role of menisci in the knee?

Answer 1

Load distribution

Shock absorbtion

Question 2

Which of the 2 menisci is more mobile?

Answer 2

Lateral

Question 3

Which of the 2 menisci experiences a greater shear force?

Answer 3

Medial

- because it is fixed in place

Question 4

What is the role of the Medial Collateral Ligament (MCL)?

Answer 4

Resists valgus stress

Question 5

What is the role of the Lateral Collateral Ligament (LCL)?

Answer 5

Resists varus stress

Question 6

What are the 2 roles of the Anterior Cruciate Ligament (ACL)?

Answer 6

Prevents anterior translation
and internal rotation in extension
of tibia

Question 7

What are the 2 roles of the Posterior Cruciate Ligament (PCL)?

Answer 7

Prevents anterior subluxation of femur over tibia

and hyperextension of knee

Question 8

Which 2 of the 4 ligaments of the knee are highly vascularised?

Answer 8

Medial Collateral

Anterior Cruciate

Question 9

Which of the 2 vascularised ligaments of the knee have better chances of healing?

Answer 9

Medial Collateral

Question 10

What sort of problems may a person with injury to the posterolateral corner of the knee have?

Answer 10

Varus instability

Rotational instability

Question 11

What are the 3 most important ligaments in the posterior corner of the knee?

Answer 11

Lateral Collateral Ligament
Popliteus tendon
Popliteofibular ligament

Question 12

List 4 patterns of meniscal tears

Answer 12

Longitudinal
Radial
Bucket-handle
Parrot beak

Question 13

What proportion of ACL ruptures occur with meniscal tears?

Answer 13

50%

Question 14

Which compartment (medial or lateral) experiences meniscal tears more frequently? By how much?

Answer 14

Medial meniscal tears 10x more common than lateral

Question 15

What types of meniscal tears have greater healing potential?

Answer 15

Those along the peripheral 1/3

This has a good blood supply

Question 16

What are clinical findings of a patient with a bucket handle meniscal tear?

Answer 16

15 degree springy block to extension of knee (knee locks if meniscal flap is displaced)

Question 17

What is the consequence of not operating on a displaced bucket handle meniscal tear?

Answer 17

May develop fixed flexion deformity in the knee

Question 18

What can cause an acute meniscal tear?

Answer 18

Standing from squatting Sporting injury

Question 19

What imaging tools are used to investigate meniscal tears?

Answer 19

MRI

Question 20

How might an acute meniscal tear be treated?

Answer 20

Urgent surgery

- repair or menisectomy

Question 21

How might degenerate meniscal tears be treated?

Answer 21

Steroid injections

Question 22

Describe a Grade I knee ligament injury

Answer 22

Sprain

Some fibres torn but all macroscopic structures are intact

Question 23

Describe a Grade II knee ligament injury

Answer 23

Partial tear

Some fasicles disrupted

Question 24

Describe a Grade III knee ligament injury

Answer 24

Complete tear

Question 25

What 3 ways are MCL tears managed?

Answer 25

Bracing
Early movement
Physiotherapy

Question 26

Name 3 types of grafts that can be used to reconstruct an ACL after rupture

Answer 26

Autograft - hamstrings, patellar tendon
Allograft - Achilles from cadaver
Synthetic

Question 27

When may surgery be used to treat an ACL rupture?

Answer 27

Rotational instability not responding to physio

Patient an avid athlete