Soft Tissue Knee Injuries Flashcards
Mr G Foubister
what could cause an extensor mechanism rupture? (4)
Rectus femoris tear
Quadriceps tendon rupture
Patellar fracture
Patellar tendon rupture
an extensor mechanism injury normally occurs by falling onto a ______ knee with the ___________ contracted
flexed knee with quadriceps contracted
people with extensor mechanism rupture are unable to ________ ___ _____.
straight leg raise
what is the main purpose of menisci?
weight distribution
the medial/lateral plateau is slightly more concave
medial
the medial/lateral meniscus is more mobile
lateral
the medial/lateral meniscus is under great amount of shear stress
medial
name the 3 types of meniscal tears
longitudinal
bucket handle
radial
parrot beak
how do most meniscal tears occur?
sporting injury in younger patients
getting up from squatting position in younger patients
__% of ACL ruptures have meniscal tears
50
how do you investigate meniscal tears?
MRI
______ meniscal tears are much more common (x10 more) that _______ meniscal tears
medial more common than lateral
what type of meniscal tears don’t heal?
radial
only peripheral 1/3 of menisci has blood supply
true or false?
true
when should you consider arthroscopic menisectomy?
mechanical symptoms
painful catching or locking
Acute locked knee signifies displaced ______ ______ meniscal tear and requires urgent _______
bucket handle - urgent surgery
MCL resists ______ stress
valgus
LCL resists _____ stress
varus
ACL resists anterior subluxation of the _____ and ________ rotation of the tibia in extension
anterior subluxation of the tibia and internal rotation of the tibia in extension
PCL resists _________ subluxation of the _____ i.e. anterior ___________ of the _____ and hyperextension of the ____
posterior subluxation of the tibia i.e. anterior subluxation of the femur and hyperextension of the knee
MCL rupture may lead to ______ instability
valgus
ACL rupture may lead to ________ instability
rotatory
PCL rupture may lead to recurrent ______________ or instability when __________ stairs
hyperextension
descending stairs
MCL usually heals well
true or false?
true
___ is the main stabiliser against IR of tibia
ACL
ACL repair does not work - reconstruction only
true or false?
true
ACL:
autograft -
allograft -
autograft - hamstring or patellar tendon
allograft - achilles
ACL - rule of _______
thirds
ACL rupture surgery is considered when rotary instability is not responding to ______
physio
LCL injury is relatively ________
uncommon
what does the knee look like in LCL rupture?
varus and hyperextension
does LCL heal?
no
LCL injury often occurs in combination with PCL and ACL injury
true or false?
true
rupture of LCL needs urgent ______ if early but ______________ later
repair then reconstruction
direct blow to the anterior tibia such as on a motorbike results in rupture of what?
PCL
knee dislocation is a serious high energy injury with high incidence complications such as… (3)
popliteal artery injury
nerve injury - common perineal nerve
compartment syndrome
mechanism of injury:
valgus - twisting - varus - hyperextension - getting up from squatting -
valgus - MCL twisting - ACL or meniscal varus - LCL hyperextension - PCL getting up from squatting - meniscal
Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability =
ACL rupture
Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking =
Meniscal tear
Q: What do you call white people running down a hill?
A: An avalanche.
Q: What do you call Mexicans running down a hill?
A: A mudslide.
Q: What do you call black people running down a hill?
A; ?
A jail break
