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Orthopedic Surgery Ultimate > Sport Related Injuries > Flashcards

Sport Related Injuries Flashcards

1
Q

Prevention: General Principles

5

A
  1. Stretch prior to activity: shouldn’t hurt
  2. Warm up prior to activity: break a sweat
  3. Make sure you’re in good enough shape to participate
  4. Ease back into activity
  5. Don’t play through the pain
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2
Q

What are the kinds of injuries that can happen to the shoulder?
3

A

Overuse: fatigued tendons and muscles

Subacute: fatigued tendons and muscles that now slowly begin to tear/wear out: pain is increasing

Acute: Fell, threw too hard, swung to hard, now your shoulder hurts

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3
Q

Describe overuse injuries? 1

Subacute? 2

Acute? 4

A

Overuse:
1. fatigued tendons and muscles

Subacute:

  1. fatigued tendons and muscles that now slowly begin to tear/wear out:
  2. pain is increasing

Acute:

  1. Fell,
  2. threw too hard,
  3. swung to hard,
  4. now your shoulder hurts
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4
Q

Overuse Injuries of the shoulder are? 2

A
  1. Tendonitis

2. Tendonopathy: sick tendon

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5
Q

Describe tendonitis? 3

Tendinopathy? 2

A

Tendonitis:

  1. irritation/inflammation of a tendon
  2. Pain down the side of the shoulder with overhead and behind the back activity
  3. Nighttime pain

Tendonopathy: “sick” tendon

  1. Similar pain complaints
  2. Pain may have been evident for a longer period of time
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6
Q

Sports injury shoulder tx? 5

A

Treatment

  1. Make sure that’s all it is: xrays and MRI
  2. Non-steroidal anti-inflammatories
  3. Ice
  4. Physical Therapy
  5. Corticosteroid injection
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7
Q

Describe subacute injury of the shoulder.

  1. Progression of what?
  2. Describe the pain?
A
  1. Progression of an overuse injury

2. Had occasional pain before, now it hurts worse and more frequently

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8
Q

Subacute shoulder injury

  1. Dx? 2
  2. Tx if unremarkable? 4
A
    • Xrays for the bones
    • MRI for the soft tissues
  2. If unremarkable
    - Non-steroidal anti-inflammatories
    - Ice
    - Physical Therapy
    - +/- Corticosteroid injection
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9
Q

Acute shoulder injury dx? 2

tx?

A
  1. Xray and MRI

2. Treatment depends on the findings

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10
Q

Shoulder:
In general the work up for overuse, subacute, and acute shoulder pain is the same
1. What are a must?

  1. MRI Indications? 3

Know what you are dealing with before treating it

A
  1. Radiographs
    • Drop arm sign,
    • external rotation lag sign,
    • dislocation
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11
Q

Concerning injuries: Shoulder injuries that you should be more worried about? 2

A
  1. Pain does not improve with conservative management
  2. Positive findings on xray
  3. Positive findings on MRI (found something wrong)
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12
Q

Concerning injuries: Shoulder

  1. Positive findings on xray? 2
  2. Positive findings on MRI (found something wrong)? 3
A
  1. Fracture
  2. Arthritis
  3. Rotator cuff tear
  4. Labral tear
  5. Biceps tendon tear
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13
Q

Shoulder

Whats next if conservative tx doesn’t work? 3

A
  1. Shoulder arthroscopy
  2. “Clean up the shoulder”
  3. Repair torn tendons
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14
Q 
Recovery
Worst case scenario is cuff repair
1. Healing phase is how long?
2. When does it start?
3. Time in full time sling and part time sling?
4. Rehab?
5. Strengthening?
6. Typically takes how long?
A
  1. 6 weeks: Healing phase
  2. Typically start therapy at 3 weeks
  3. Full time sling 3 weeks/part time 3 weeks
  4. 6 weeks: Rehab
  5. 6 weeks: Strengthening
  6. Typically 3-4 months…start resuming previous activities…SLOWLY
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15
Q
  1. What kind of joint is the knee?

2. There are 3 seperate compartments: What are they?

A
  1. A diarthroidal joint: a hinge joint
  2. 3 separate comparments
    - Patellofemoral
    - Medial
    - Lateral
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16
Q

Two main types of cartilage in the knee? Describe them?

A
  1. Articular cartilage: a thin lining of resilient connective tissue that serves as padding and an ultra low friction surface
  2. Meniscal cartilage: serve to deepen the contact of the femur on the tibia, provide stability, distribute force
17
Q
  1. Joint reaction force in the knee is about __ times body weight when walking
  2. This is absorbed by the what? 2
A
  1. 3
    • menisci
    • articular cartilage
18
Q

4 main ligaments in the knee?

A
  1. Anterior Cruciate Ligament (ACL)
  2. Posterior Cruciate Ligament (PCL)
  3. Medial Collateral Ligament (MCL)
  4. Lateral Collateral Ligament (LCL)
19
Q

The Knee
Problems of the knee?
5

A
  1. Tendonitis
  2. Meniscal tears
  3. Ligament injuries
  4. Cartilage injuries
  5. Arthritis
20
Q

Mechanism of injury of a meniscus tear?

4

A
  1. Twisting
  2. Turning
  3. Deep knee bends
  4. Pivoting
21
Q

Meniscal Tear Symptoms? 5

A
  1. Focal pain, typically intermittent
  2. Swelling
  3. Nightime pain
  4. Pain with activity
  5. Catching/locking
22
Q

Meniscal Tears
Tx options?
3

A
  1. Physical Therapy
  2. Injections
  3. Arthroscopic surgery
23
Q

Arthroscopic surgery

  1. What is it?
  2. Better by when?
A
  1. remove/fix the tear

2. 80-90% better by 6-8 weeks

24
Q 
Ligament injuries
ACL
1. Fix in who?
2. Age restriction?
3. CI in who?

PCL

  1. Fix when?
  2. CI?

MCL

  1. Tx?
  2. Weight bearing?

LCL

  1. Tx?
  2. Fix if what?
A

ACL

  1. Fix in active, physical individual
  2. NO real age restriction
  3. Contraindicated if significant arthritis

PCL

  1. Fix when symptomatic
  2. Contraindicated if significant arthritis

MCL

  1. Brace for six weeks
  2. Weight bearing as tolerated

LCL

  1. Brace
  2. Fix if part of a complex of lateral injuries
25
Q

Cartilage injury

  1. When do we generally find out the level of severity?
  2. Variety of treatments dependent on the severity? 2
A
  1. Typically unclear of severity until the time of arthroscopy
  2. Variety of treatments dependent on the severity
    - “smooth down”
    - Microfracture
26
Q
  1. When would we do a cartilage transplant?
  2. An attempt to prevent what?
  3. Not useful in who?
A
  1. Treatment for smaller, focal cartilage defects
  2. An attempt to prevent the progression to osteoarthritis
  3. Not useful in degenerative arthritis
27
Q

Knee injuries
Meniscus tear with mild/mod arthritis
1. How common?

  1. Meniscus tear is the __________ problem
  2. Treatment based on what?
  3. If symptoms are improving?
  4. If not or worsening, then consider?
A
  1. Rather common
  2. “mechanical”
  3. 6 weeks of observation
  4. monitor
  5. viscosupplemenation
28
Q
  1. What is Viscosupplementation?
  2. Maximum benefits can be seen up to when from the last injection?
  3. In general, the beneficial effects last for what time period?
  4. CI?
A
  1. It is a solution of hyaluronan.
    - Hyaluronan is the lubricant and shock absorber in joints.
  2. 12 weeks
  3. 6 months to a year
  4. No contraindication to a repeat injection series
29
Q
  1. Osteoarthritis reduces the body’s ability to produce what?
  2. Without it, the patient experiences what?
A
  1. hyaluronan.

2. the pain of OA as the joint wears out.

30
Q

Lateral and Medial Epicondylitis

Treatment consists of ?
5

A
  1. Rest: take some time off!
  2. Ice
  3. Compression
  4. Elevation
  5. Anti-inflammatories
31
Q

Lateral and Medial Epicondylitis

For recalcitrant cases? 2

A
  1. Consider corticosteroid injection
  2. Platelet rich plasma injection

Most of the time these go away. Some require surgery

32
Q
  1. What is Platelet Rich Plasma?
  2. Extracted from?
  3. Delivered and works how?
A
  1. High concentration of functionally viable platelets and their associated growth factors
  2. Extracted from a small amount of patients blood: 9-18cc
  3. Delivered arthroscopically/open and placed directly into the tear site to stimulate a reparative healing response for soft tissue and bone repair
33
Q

Applications for PDGF
1. Direct liquid form injections of concentrated platelets for what?

  1. Clot form applications with extended growth factor release for what?
A
  1. the various tendonitis problems

2. cuff repairs, etc…

Orthopedic Surgery Ultimate (88 decks)

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