Week 2 -acute Meniscal Injuries

Question 1

What type of stress typically causes these types of injuries at the knee?

Answer 1

Sheer stresses

Question 2

What position will the lower limbs typically be in to cause an acute meniscal injury at the knee

Answer 2

Knee in flexion and compression with femoral rotation. Twisting with a planted foot

Question 3

Which meniscus at the knee is more prone to injury and why?

Answer 3

Medial meniscus (circular) Is a lot less mobile than a lateral (c-shaped) so therefore is more prone to injury

Question 4

What are three signs and symptoms of acute meniscal injuries at the knee?

Answer 4

One. Joint swelling (effusion)
Two. Popping or clicking within joint
Three. Locking (unlocking manoeuvre)

Question 5

What kind of clinical examinations can you perform for testing for an acute meniscal injury at the knee?

Answer 5

One. Palpation along the joint line - both medial and lateral, paint present will often suggest injury
Two. McMurray’s test. Put the knee into flexion and apply pressure to force the tibia into the knee joint to try and catch on the meniscus - like a pepper grinder

Question 6

What’s another reason that the medial meniscus is less mobile?

Answer 6

Is it also attached to the medial collateral ligament

Question 7

What are the different types of tears of the meniscus

Answer 7

1. Radial tear (small)
2. Radial tear (large)
3. Flap tear (parrot beak tear)
4. Complex or degenerative tear
5. Longitudinal tear (short)
6. Longitudinal tear (long)
7. Longitudinal tear (displaced bucket handle)

Question 8

What happens when you get displacement of injured meniscus fragments.

Answer 8

Can prevent full extension, can cause locking, can be painful (irritation of the synovium - pain not from meniscus itself)

Question 9

What are the 3 considerations to meniscal surgery?

Answer 9

1. Vascularity (meniscus broken into thirds relating to vascularity, red zone contains many blood vessels, red and white zone contains some, white zone has very little, meaning healing is poor and slow
2. Age (degenerative status)
3. Osteoarthritis (try to reduce the change or affects of oa later in life, improve prognosis)

Question 10

Where are the three zones of the meniscus?

Answer 10

The outermost zone is the red zone - most vascularised, the middle zone is the red and white zone, and the innermost zone is the white zone - least vascularised

Question 11

What are the types of arthroscopic surgeries to repair a meniscal injury?

Answer 11

1. Suture repair - in the lateral third - good blood vessels allows for better healing
2. Partial meniscectomy - “nibble” out the torn parts, smooth out edges