The knee- problems

Question 1

Femoral shaft injuries causes

Answer 1

In healthy adults and children are usually the result of a high velocity trauma
In young children may be a sign of abuse
In the elderly may be due to osteoporosis

Question 2

Signs of femoral shaft fractures

Answer 2

Tense swollen thigh,
Blood loss in closed femoral shaft fracture 1-1.5 litres.
Rarely there may be complications with nearby neuromuscular bundles

Question 3

Causes of distal femoral fractures

Answer 3

Young patients- high energy sporting injury

Elderly patients- osteoporosis a fall from standing

Question 4

Complications of distal femoral fractures

Answer 4

The popliteal artery and need to asses neurovascular state of limb

Question 5

Tibial plateau fractures types

Answer 5

Can be unicondylar or bicondykar.

Most rare unicondylar lateral tibial condyle

Question 6

Causes of tibial plateau fractures

Answer 6

Virus or vagus load- abnormal medial or lateral flexion load. These fractures will be associated with meniscal tears

Question 7

Meniscal injuries

Answer 7

Most common type of knee injury.
Occur due to a sudden twisting motion of the knee
.symptoms- intermittent localised pain, knee clicking or catching or locking. Swelling may occur. There may be restricted movement of the joint

Question 8

Collateral ligament injury causes

Answer 8

Sporting injury- like football- a blow to one side of the knee

Question 9

varus deformation

Answer 9

Medial angulation of distal segment

Question 10

Valgus deformation

Answer 10

Lateral angulation of the distal segment

Question 11

Which collayteral ligament is damaged more often?

Answer 11

Medial collateral ligament

Question 12

What is the unhappy triad?

Answer 12

Anterior cruciate ligament, medial collateral ligament and medial meniscus damage.
Often caused by strong force to lateral aspect of the knee.

Question 13

Causes of anterior cruciate ligament damage

Answer 13

Quick deceleration, hyperextension or rotational injury.

Question 14

Causes of posterior cruciate ligament

Answer 14

When knee is flexed a lot of pressure is applied to the upper tibia, or a fall in football on a flexed knee

Question 15

How can anterior and posterior cruciate ligament injuries be detected?

Answer 15

Anterior and posterior drawer tests

ACL can also be detected by Lachmans test

Question 16

How many bursae are there in the knee?

Answer 16

11

Question 17

Housemaids knee

Answer 17

Prepatella bursitis- prepatella bursa has a thin synovial lining, does not communicate with joint space.
Normally presents as knee pain and swelling

Question 18

Clergyman’s knee

Answer 18

Infrapatella bursitis caused by repeated micro trauma caused by activities involving kneeling.

Question 19

Suprapatella bursitis

Answer 19

Knee effusion- causes swellling in suprapatella bursa, it is normally a sign of significant pathology in the knee joint.

Question 20

Osgood Schlatters Disease

Answer 20

Inflammation of patellar ligament - occurs in teenagers who do running and jumping sports it is bilateral in 20-30% of cases.

Question 21

Osteoarthritis of the knee symptoms

Answer 21

Knee pain- caused by bending kneeling or squatting
Stiffness- worse after prolonged rest e.g. sleeping
Swelling
Some patients felell that their knee is giving away
Crepitus
Effusion may develop

Question 22

Septic arthritis of the knee

Answer 22

Invasion of joint space by microorganisms.
knee is most common joint affected by osteoarthritis
The most common pathogen is staph aureus