Soft Tissue Injury Flashcards
What is the role of menisci in the knee?
Load distribution
Shock absorbtion
Which of the 2 menisci is more mobile?
Lateral
Which of the 2 menisci experiences a greater shear force?
Medial
- because it is fixed in place
What is the role of the Medial Collateral Ligament (MCL)?
Resists valgus stress
What is the role of the Lateral Collateral Ligament (LCL)?
Resists varus stress
What are the 2 roles of the Anterior Cruciate Ligament (ACL)?
Prevents anterior translation
and internal rotation in extension
of tibia
What are the 2 roles of the Posterior Cruciate Ligament (PCL)?
Prevents anterior subluxation of femur over tibia
and hyperextension of knee
Which 2 of the 4 ligaments of the knee are highly vascularised?
Medial Collateral
Anterior Cruciate
Which of the 2 vascularised ligaments of the knee have better chances of healing?
Medial Collateral
What sort of problems may a person with injury to the posterolateral corner of the knee have?
Varus instability
Rotational instability
What are the 3 most important ligaments in the posterior corner of the knee?
Lateral Collateral Ligament
Popliteus tendon
Popliteofibular ligament
List 4 patterns of meniscal tears
Longitudinal
Radial
Bucket-handle
Parrot beak
What proportion of ACL ruptures occur with meniscal tears?
50%
Which compartment (medial or lateral) experiences meniscal tears more frequently? By how much?
Medial meniscal tears 10x more common than lateral
What types of meniscal tears have greater healing potential?
Those along the peripheral 1/3
This has a good blood supply
What are clinical findings of a patient with a bucket handle meniscal tear?
15 degree springy block to extension of knee (knee locks if meniscal flap is displaced)
What is the consequence of not operating on a displaced bucket handle meniscal tear?
May develop fixed flexion deformity in the knee
What can cause an acute meniscal tear?
Standing from squatting Sporting injury
What imaging tools are used to investigate meniscal tears?
MRI
How might an acute meniscal tear be treated?
Urgent surgery
- repair or menisectomy
How might degenerate meniscal tears be treated?
Steroid injections
Describe a Grade I knee ligament injury
Sprain
Some fibres torn but all macroscopic structures are intact
Describe a Grade II knee ligament injury
Partial tear
Some fasicles disrupted
Describe a Grade III knee ligament injury
Complete tear
What 3 ways are MCL tears managed?
Bracing
Early movement
Physiotherapy
Name 3 types of grafts that can be used to reconstruct an ACL after rupture
Autograft - hamstrings, patellar tendon
Allograft - Achilles from cadaver
Synthetic
When may surgery be used to treat an ACL rupture?
Rotational instability not responding to physio
Patient an avid athlete
