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MSK > Soft Tissue Knee Injuries > Flashcards

Soft Tissue Knee Injuries Flashcards

1
Q

What is the purpose of the menisci?

A

to distribute load from convex femoral condyles to relatively flat tibial articular surfaces

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2
Q

What are the differences between the lateral and medial menisci?

A

medial is fixed whislt the lateral meniscus is more mobile; medial is under a greater amount of shear pressure

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3
Q

Why does the knee pivot on the medial meniscus through flexion and extension?

A

due to shpae and soft tissues the tibia interally rotates on flexion and externally rotates on extension

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4
Q

What type of stress does the MCL resist?

A

valgus stress

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5
Q

what type of stress does the LCL resist?

A

varus stress

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6
Q

What does the ACL resist?

A

anterior subluxation of the tibia and internal rotation of the tibia in extension

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7
Q

What does the PCL resist?

A

posterior subluxation of the tibia and hyperextension of the knee

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8
Q

Why does the MCL heal well?

A

has a very good blood supply

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9
Q

What type of instability does an MACL rupture lead to?

A

valgus instability

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10
Q

What type of instability does an ACL rupture lead to?

A

rotatory instability

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11
Q

What type of instability does a PCL rupture lead to?

A

recurrent hyperextension or instability descending stairs

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12
Q

What causes a meniscal tear in younger patients?

A

a sporting injury or getting up from squatting positions

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13
Q

What can cause a medinscal tear in older patients?

A

atraumatic spontaneous degenrate tears

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14
Q

How are meniscal tears investigated?

A

MRI

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15
Q

Which meniscus is more likely to be torn?

A

medial 10x as common

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16
Q

Why is there limited healing potential with meniscal tears?

A

only the peripheral third has a blood supply

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17
Q

When should a menisectomy be considered?

A

mechanical symptoms- painful catching or locking or irreparable tear os failed meniscal repair

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18
Q

How should the menisci appear on MRI?

A

like a black boe-tie; any white in the bows indicates a tear

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19
Q

What does an acute locked knee signify?

A

a significant displaed bucket handle meniscal tear

20
Q

What would happen if the knee remains locked for an extended period of time

A

Patient may develop fixed flexion defomrity

21
Q

What is the link between a degenerative meniscal tear and OA?

A

probably represents the first stage of OA

22
Q

What are hte grades in a knee ligament injury?

A

grade 1- sprain-tear some fibres but macroscopic structure intact; grade 2- partial tear; grade 3- complete tear

23
Q

What are the treatments for an MCL injury?

A

brace; early motion; physi

24
Q

How are ACL treated?

A

repair doesnt work- reconstruction only- autograft using patellar tendon or hamstrings;PT

25
Q

What is the rule of thirds in ACL rupture

A

a third can compensate and are able to funcion well; a third can avoid instability by avoiding certain activites and a third do not compensate and have frequent instability

26
Q

What is the role of ACL reconstruction?

A

to fix rotary instaibilty not responding to physio- does not treat pain or prevent arthritis

27
Q

How is the LCL injured?

A

by varus and hyperextension

28
Q

What nerve is commonly damaged in an LCL tinjury?

A

the common fibular nerve

29
Q

What is the problem with an LCL injury?

A

it doesnt heal

30
Q

What causes a PCL rupture?

A

a direct blow to anterior tibia or hyperextension injury

31
Q

What are the symptoms of PCL ruptre?

A

popliteal knee pain and bruising

32
Q

What type of instability results with PCL rupture?

A

recurrent hyperextension or feeling unstable when going downstairs

33
Q

What are the common complications associated with knee disloactions?

A

popliteal artery injury (tear; intima tear and thrombosis); nerve injury- common fibular nerve; compartment syndrom

34
Q

What is the managment fro a knee dislaction?

A

emergency reduction and recheck of neurovascular status; multi-ligament reconstruction

35
Q

What causes a patellar dislocation?

A

rapid turn or direct blow

36
Q

Who gets patellar dislocation?

A

females; adolescents; ligamentous laxity; valgus knee

37
Q

How many patients with patellar disolcation get recurrent dislocation?

A

10%

38
Q

What type of trauma causes an extensor mechanism rupture?

A

a fall onto flexed knee with quads contraction

39
Q

What predisposes to an extensor mechanism rupture?

A

previous tendonitis; steroids; chronic renal failure; ciprofloxacin

40
Q

What is seen on exam with an extensor mechanism rupture?

A

unable to straight leg raise; palpable gap

41
Q

What is the treatment for an extensor mechanism rupture?

A

surgical repair

42
Q

Haemarthrosis is seen with what injuries?

A

ACL rupture or fracture

43
Q

What causes pain on the joint line?

A

meniscal/chondral pain

44
Q

What is the most likely cause of this presentation? twist, pop, haemarthosis; generalised pain; pain settles after a few days; rotary instability

A

ACL rupture

45
Q

what is the most likely cause of this presentation?- getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain and catching +/- locking

A

meniscal tear

MSK (39 decks)

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