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MSK > Soft Tissue Knee injuries > Flashcards

Soft Tissue Knee injuries Flashcards

1
Q

If a patient reports an injury on twisting which ligament is likely to be affected?

A

ACL

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2
Q

If the injury was caused by a valgus force which ligament is likely to be affected?

A

MCL

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3
Q

If the injury was caused by a varus force which ligament is likely to be affected?

A

LCL

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4
Q

If an effusion is present what injury is likely?

A

Meniscal or cartilage

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5
Q

What is a haemarthrosis?

A

Blood in joint space caused by ACL injury or a fracture

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6
Q

What recurrent symptoms must you ask about?

A

Locking
Swelling
Clicking/catching
Patellar dislocation

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7
Q

At what angle of degrees do you do anterior drawer for?

A

90

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8
Q

At what angle of degrees is the Lachmans test done?

A

30

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9
Q

What kind of patients tend to get meniscal tears?

A

Sporting injury in young patients or spontaneous in >40

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10
Q

If a patient has an ACL injury what must you also keep in mind?

A

Half will have a meniscal tear

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11
Q

What are the 4 types of meniscal tear?

A

Longitudinal
Radial
Bucket handle
Parrot beak tear

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12
Q

Which type of meniscal tear will not heal?

A

Radial tears

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13
Q

Why do meniscal tears not heal well in general?

A

Only the peripheral third has a blood supply

High failure rate in arthroscopic repair

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14
Q

What would an acutely locked knee signify?

A

Displaced bucket handle meniscal tear

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15
Q

What needs to be kept in mind with a bucket handle tear?

A

It is potentially repairable and if the knee remains locked an FFD may develop

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16
Q

What would you do if you have a meniscal tear that hasn’t healed or wont heal?

A

Arthroscopic menisectomy

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17
Q

What can degenerate tears be a sign of?

A

OA

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18
Q

How are knee ligament injuries graded?

A

1- sprain. Tears some fibres but total structure intact
2- partial tear with some fascicles disrupted
3- complete tear

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19
Q

Usualyly an MCL tear will heal well.

When might it be complicated?

A

If combined with ACL or PCL rupture.

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20
Q

What is the rule of thirds of ACL rupture?

A

1/3 will compensate and function well
1/3 will avoid instability by avoiding activities
1/3 will have frequent instability

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21
Q

What percent of ACL ruptures need reconstruction?

A

40%

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22
Q

What reconstruction is available for repair of ACL?

A

Autograft from patellar tendon or hamstrings
Allograft from the achilles
Synthetic graft

23
Q

What is the rehab time for an ACL reconstruction?

A

3/12 to 12/12

24
Q

How does an LCL affect the patient?

A

Relatively uncommon
Can cause varus and hyperextension
High incidence of fibular nerve palsy

25
Q

What treatment is needed for an LCL?

A

Urgent (2-3 wk) repair then reconstruction

26
Q

When does a PCL injury occur?

A

Direct blow to anterior tibia

27
Q

What can occur with a knee dislocation?

A

Popliteal artery tear
Fibular nerve damage
Compartment syndrome

28
Q

Who is more likely to get a patellar dislocation?

A

Females, adolescents with ligamentous laxity

29
Q

How does a patellar dislocation occur?

A

Rapid turn or direct blow

30
Q

What can be clinically seen with an extensor mechanism rupture?

A

Palpable gap

Unable to straight leg raise

31
Q

What atraumatic cartilage defects exist?

A

Osteochondritis dissecans

OA

32
Q

Why will only cartilage injuries which are full thickness heal?

A

Blood vessels are only after the tidemark. If the tear is above the tidemark it will not heal.

33
Q

What kind of cartilage is present when healed?

A

Fibrocartilage.

Usual cartilige is hyaline

34
Q

What is osteochondritis dissecans?

A

Where an area of knee loses its blood supply.

Bone can fragment off

35
Q

What age group is osteochondritis most common in?

A

Adolescents

36
Q

What surgical treatment can be given for osteochondritis?

A

If detached then can remove.

If detaching then can pin in place

37
Q

What is cartilage regeneration?

A

Stem cells found within the bone and grown to produce new cartilage

38
Q

How long will a cartilage regeneration last?

A

Around 5 years

39
Q

What is the risk of multiple steroid injections with OA?

A

May accelerate the arthritic process

40
Q

When would an osteotomy be a good idea for control of OA?

A

If heavy manual worker and needs 10 years to retire.

41
Q

What is an osteotomy?

A

The arthritic bone is removed and replaced with another bit of bone

42
Q

Why wouldn’t a TKR be given in painful OA?

A

If young then will wear out the new joint too quickly and the second TKR is never as good.

43
Q

How long can a TKR last in older patients?

A

20 years

44
Q

What are common presentations to GP regarding knee?

A 
Anterior, localised pain
Stiffness
Swelling
Giving way
Deformity
Loss of function
45
Q

What must you always keep in mind regarding knee pain?

A

Could actually be pain from hip

46
Q

What is Osgood-Schlatter’s disease?

A

Inflammation of patellar ligament at tibial tuberosity.

Most common in adolesents

47
Q

What are the most common knee problems?

A

Ligament strain- most commonly medial collateral
Bursitis
OA

48
Q

What kind of cartilage tear are you thinking if you hear a pop and develop a haemoarthrosis?

A

ACL

49
Q

What is a chronic complaint with an ACL rupture?

A

Rotatory instability with giving way on turning

50
Q

When would a complete knee dislocation occur?

A

All 4 ligaments torn

51
Q

What is an extensor mechanism injury?

A

Rupture of patellar tendon or quadriceps tendon

52
Q

What are predisposing factors to an extensor mechanism injury?

A

Tendonitis
Chronic steroid (ab)use
DM
RA

53
Q

What direct does the patella dislocate?

A

Laterally

54
Q

A valgus misaligment predisposes to OA of which part of the knee?

A

Lateral since valgus misalignment puts a bigger stress on lateral bones

MSK (30 decks)

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