Soft Tissue Knee Injuries Flashcards
is meniscus vascular or avascular?
only blood supply outer third, so largely avascular
where are nerves in meniscus?
peripheral attachment
how is meniscus usually injured?
usually sporting or getting up from squatting position in younger patients
what meniscal damage do middle aged patients tend to get?
atraumatic degenerative tears
how do meniscal tears typically present?
pain and tenderness localised to joint line (can have inflammatory involvement)
how do you investigate meniscal tears?
MRI
how much more common are medial meniscal tears to lateral meniscal tears?
9-10 times
what is the healing potential of meniscal tears?
limited. only peripheral 1/3 has blood supply, radial tears don’t heal. pain from the injury might settle
what treatment method for acute traumatic peripheral meniscal tears in younger patients?
arthroscopic meniscal repair
what treatment method for people with irreparable tears with recurrent pain, effusion or mechanical symptoms?
arthroscopic meniscectomy
what tear usually signifies acute locked knee syndrome
displaced bucket handle meniscal tear
what is a locked knee
inability to fully extend knee
what happens if the knee remains locked
patient may develop fixed flexion contracture
what happens in degenerate tears of the meniscus
meniscus weakens over time and can tear spontaneously
what do degenerate tears tend to signify
first stage of OA (loss of shock absorbers lead to increased pressure)
what does the pain usually originate from in degenerate tears
bone marrow oedema and synovitis
what can help degenerative tears
injection of corticosteroids or antiinflammatories
why is arthroscopic meniscectomy ineffective for degenerative tears
ineffective for pain, only for unstable tears with mechanical symptoms
what ligament tears heal very well
MCL due to high vascularisation
what can be used to treat MCL tears
brace, physio, early motion (rarely surgery)
what does ACL rupture usually come from
sports injuries
what is characteristic of ACL tear
‘pop’, swelling within hour and giving way on turning
treatment for ACL tears
time and physio
how good is survival rate
1/3 compensate well, 1/3 avoid instability by behaviour avoidance and 1/3 don’t compensate and have frequent instability
