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MSK > Soft Tissue Knee Injuries > Flashcards

Soft Tissue Knee Injuries Flashcards

1
Q

Which meniscus is more flexible?

A

Lateral (the medial one is more fixed)

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2
Q

Purpose of menisci?

A

Distribute load from the convex femoral condyles to the relatively flat tibial articular surfaces

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3
Q

A valgus stress on the knee will damage…

A

MCL

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4
Q

A varus stress on the knee will damage…

A

LCL

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5
Q

What are the function(s) of the ACL?

A

1) Prevent anterior subluxation of tibia

2) Prevent internal rotation of tibia in knee extension

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6
Q

What are the function(s) of the PCL?

A

1) Prevent posterior subluxation of the tibia

2) Prevent knee hyperextension

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7
Q

Instability descending stairs and recurrent hyperextension suggest damage to which ligament?

A

PCL

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8
Q

Rotatory instability of the tibia suggests damage to which ligament?

A

ACL

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9
Q

In young patients, meniscal tears tend to be traumatic/atruamatic?

A

Traumatic

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10
Q

50% of ACL ruptures will also have what injury

A

Meniscal tear

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11
Q

What’s the imaging modality of choice for meniscal tears?

A

MRI

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12
Q

Most common area of meniscal tear

A

Medial

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13
Q

T/F: The meniscus generally has good healing potential.

A

False - only the peripheral 1/3rd of it has a blood supply. Radial tears will not heal at all.

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14
Q

Which surgery is useful in acute peripheral meniscal tears in young patients?

A

Arthroscopic repair

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15
Q

An arthroscopic menisectomy should be considered if what is present with meniscal tear?

A

Symptoms of locking or failed repair

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16
Q

An acute locked knee signifies what type of meniscal tear?

A

Bucket-handle tear

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17
Q

Degenerate tears are common in which group of patients?

A

> 50 (grey hair - meniscal tear)

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18
Q

Degenerate tears of the meniscus usually are the 1st indicator of which other disease

A

OA

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19
Q

What are the 3 grades of knee ligament injury?

A

Grade 1 = sprain
Grade 2 = partial tear
Grade 3 = complete tear

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20
Q

MCL tear treatment options

A

Brace, early motion and physio.

Most resolve very well without surgery.

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21
Q

T/F: ACL repairs are more common than reconstruction.

A

False - repairs usually don’t work, reconstruction is the mainstay

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22
Q

What tendons can be used in an ACL reconstruction?

A 
Patellar or semitendinosus tendon. 
Achilles tendon (less similar).
23
Q

What is the “rule of 1/3rds” in reference to ACL?

A

1/3rd do well, 1/3rd can avoid instability, 1/3rd get frequent instability

(younger patients more likely to have poorer outcomes)

24
Q

What % of ACL injuries have to have surgery?

A

40%

25
Q

What is the main indication for surgery in ACL rupture?

A

Rotatory instability not responding to therapy.

26
Q

ACL reconstruction means how long in rehab?

A

3 months to 1 year

27
Q

LCL injury commonly gives damage to which nerve?

A

Common fibular nerve

28
Q

LCL tends to heal well by itself, T/F?

A

False - doesn’t heal well and often leads to varus and rotatory instability if not corrected

29
Q

A direct blow to the anterior tibia OR a hyperextension injury is likely to damage which structure?

A

PCL

30
Q

How is complete knee dislocation treated?

A

ORIF (emergency due to risk of compartment syndrome and common fibular nerve injury)

31
Q

Risk factors for patellar dislocation (4)

A

1) Female sex
2) Adolescent age
3) Ligamentous laxity
4) Valgus knee

32
Q

A fall onto the flexed knee with quadriceps contracted is likely to cause which type of injury

A

Extensor mechanism rupture

33
Q

What are the risk factors for extensor mechanism rupture?

A

Tendonitis, steroids, chronic renal failure, fluroquinolones (ciprofloxacin)

34
Q

Extensor mechanism rupture can be managed conservatively, T/F?

A

False - needs surgery to correct

35
Q

Which ligament damage: valgus force?

A

MCL

36
Q

Which ligament damage: twisting?

A

ACL or meniscal injury

37
Q

Which ligament damage: varus?

A

LCL

38
Q

Dashboard or hyperextension injury will damage which ligament?

A

PCL

39
Q

Getting up from squatting will damage which structure?

A

Meniscus

40
Q

Spot diagnosis: football injury, twist and pop, haemarthrosis, generalised knee pain, pain settles after a few days but rotatory instability present.

A

ACL rupture

41
Q

Spot diagnosis: getting up from squatting, sudden sharp pain in medial joint line, effusion, recurrent medial pain & locking?

A

Meniscal tear (bucket handle-possible)

42
Q

Which cartilage covers the surface of the bones in synovial joints?

A

Hyaline cartilage

43
Q

T/F: Partial articular cartilage injuries will heal quickly.

A

False - only full thickness injuries tend to heal.

44
Q

What is the underyling pathology of osteochondritis dessecans?

A

An area of the surface of the knee loses it blood supply and cartilage (plus bone sometimes) can fragment off.

45
Q

Treatment of choice for osteochondritis dessecans?

A

Pinning if detaching

46
Q

Will osteochondritis dessecans continue to progress to further injury?

A

Sometimes - can also heal or resolve spontaneously.

47
Q

All cartilage regeneration techniques will heal with what

A

Fibrocartillage

48
Q

Most common cartilage regeneration technique

A

Drilling

49
Q

Contraindications to cartillage regeneration

A

Radiographic signs of OA, inflammatory arthritis, joint instability.

50
Q

What’s a surgical treatment option for early knee OA?

A

Osteotomy - only if varus knee with pure medial OA.

51
Q

Knee replacements should be given as early as possible in OA, T/F?

A

False - wait for end-stage arthritis.

52
Q

What has a better success rate: partial or total knee replacement?

A

TKR

53
Q

How long should a TKR usually last?

A

15-20 years

54
Q

T/F: ACL reconstruction surgery involves drilling into the femur.

A

True

MSK (21 decks)

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