Soft tissue injury and knee pain

Question 1

Functional roles of the meniscus

Answer 1

• Load-bearing
• Shock absorption
• Joint stability
• Joint lubrication
• Only outer 1/3rd has vascular supply

Question 2

Damage to menisci

Answer 2

• Test using McMurray’s test (listen for popping/clicking sounds)
• Tears are very painful, heal poorly
• Long term arthritis will develop w/o a meniscus
• ALWAYS want to repair meniscus (esp in young pts), b/c great risk for arthritis w/o one

Question 3

ACL injury

Answer 3

• Test via Lachman’s test (15-30 degrees) or anterior drawer (90 degrees) test
• Can be repaired non-operatively (brace + rehab) or operatively
• Candidates for ACL operations: young pts, those who have high demand, twisting, stopping, turning activities
• Can use 3 different grafts (all work the same): bone-tendon-bone, hamstring tendon, allograft
• Recovery: 9-12 mo

Question 4

Shoulder injury

Answer 4

• Non-operative rehab: for those under 20 and over 40
• High chance at dislocation again
• Most dislocations are anteriorly
• Operative: reconstruction of anterior capsule/ligament complex
• For pts over 40, thing of possible rotator cuff tears w/ dislocation

Question 5

Rotator cuff tears

Answer 5

• Age related, associated w/ older (>50) pts
• Pain especially at night during sleep
• Usually need operations

Question 6

Knee ligament tears

Answer 6

• ACL: use lachman’s or anterior drawer test
• PCL: use posterior drawer test
• MCL (most commonly strained ligament): use valgus tets
• LCL: use varus test