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MSK wk 4 > soft tissue knee injuries > Flashcards

soft tissue knee injuries Flashcards

1
Q

What do menisci do?

A

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

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2
Q

Lateral an medial menisci are fixed T/F

A

F

Medial meniscus is fixed while lateral meniscus Is more mobile

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3
Q

MCL resists valgus stress T/F

A

T (its rupture may lead to values instability)

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4
Q

LCL resists valgus stress T/F

A

F- it resists varus stress

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5
Q

ACL resists anterior _____ of the tibia and _____ rotation of the tibia in extension

A

subluxation
internal
(its rupture may lead to rotatory instability)

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6
Q

PCL resists _____ subluxation of the tibia i.e. anterior subluxation of the femur and hyperextension of the knee

A

posterior

its rupture may lead to various and rotatory instability

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7
Q

who are meniscal tears usually found in?

A

usually sporting injuries in younger patients or getting up from squatting position in younger patients
(can get atraumatic spontaneous degenerative tears in older patients -over 40)

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8
Q

What should you investigate a meniscal tear with?

A

MRI

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9
Q

Lateral meniscal tear is 10 times more common than medial T/F

A

F- medial meniscal tears approx 10 times more common than lateral meniscal tears

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10
Q

Meniscal tears heal very well T/F

A

F
only peripheral 1/3 has a blood supply
radial tears won’t heal

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11
Q

When should arthroscopic repair be considered?

A 
In acute peripheral tears in younger patients 
Mechanical symptoms (painful catching or locking) for irreparable tears or failed meniscal repair
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12
Q

What does acute locked knee signify

A

displaced bucket handle meniscal tear

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13
Q

What is the management for acute locked knee?

A

urgent surgery required - may be repairable by arthroscopic repair
If knee remains locked- may develop FFD
If irreparable needs partial meniscectomy to unlock knee and prevent further damage

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14
Q

Degenerate meniscal tears are common T/F

A

T- 20% over 50s , many asymptomatic (injection may help)

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15
Q

What is the grading for knee ligament injuries

A

grade 1- sprain-tear some fibres but macroscopic structure intact

Grade 2-Partial tear-some fascicles disrupted

Grade 3-complete tear

some ligaments heal more than others and some stabilise over time

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16
Q

What is the treatment for MCL injury

A

brace, early motion and physio
Pain can take several months to settle
rarely requires surgery

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17
Q

What is the main stabiliser against IR of tibia

A

ACL

18
Q

The best way to treat ACL rupture is repair T/F

A

F
ACL repair does not work- reconstruction only
autograft-patellar tendon or hamstrings
allograft-achilles

19
Q

What is the ACL rupture rule of thirds?

A

1/3 compensate and are able to function well
1/3 can avoid instability by avoiding certain activities
1/3 do not compensate and have frequent instability or can’t get back to high impact sport

20
Q

What is the role of surgery in ACL rupture

A

when the rotatory instability is not responding to physio

21
Q

LCL injury is relatively uncommon. Where is it found?

A

varus and hyperextension

22
Q

What is the management of complete rupture of the LCL ligament

A

need urgent repair if early (within 2-3 wks)

later–> reconstruction (hamstring or other tendon)

23
Q

What causes a PCL rupture?

A

Direct blow to anterior tibia, or hyperextension injury

there will be popliteal knee pain and bruising

24
Q

In 90% of cases PCL rupture is isolated T/F

A

F- isolated PCL rupture rare

25
Q

A knee dislocation is a serious high energy injury. What are the high incidence complications?

A

Popliteal artery injury (tear, intimal tera and thrombosis)
nerve injury-common perineal nerve
compartment syndrome

26
Q

What is the treatment for a knee dislocation?

A

Emergency reduction

re check neuromuscular status

27
Q

What may cause a patellar dislocation

A

Rapid turn or direct blow

28
Q

Patellar dislocation is more common in…

A 
females
adolescents
ligamentous laxity
valgus knee
torsional abnormalities
29
Q

What is the risk of recurrent dislocation in patellar dislocation?

A

10%

30
Q

What is the management for patellar dislocation?

A

Some may benefit from surgical stabilisation-bony or soft tissue procedures

31
Q

what is the likely soft tissue knee injury as a result of falling onto a flexed knee with quads contraction?

A

Extensor mechanism rupture

32
Q

What are the RF for extensor mechanism rupture

A

previous tendonitis
steroids
chronic renal failure,ciprofloxacin

33
Q

What does an extensor mechanism rupture practically look like?

A

Unable to straight leg raise

palpable gap

34
Q

Getting from squatting - what is the most likely injury?

A

meniscal tear

35
Q

Hypeextension- what is the most likely injury?

A

PCL

36
Q

Varus- what is the most likely injury?

A

LCL

37
Q

Valgus- what is the most likely injury?

A

MCL

38
Q

Twisting- what is the most likely injury?

A

ACL or meniscal injury

39
Q

Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability. What is the most likely diagnosis?

A

ACL rupture

40
Q

Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking. What is the most likely diagnosis?

A

Meniscal tear

MSK wk 4 (11 decks)

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