Week 5 Task Sheet - Soft Tissue Injuries of the Knee

Question 1

What is are the meniscus made up of?

Answer 1

fibrocartilage

Question 2

What is the attachment of the medial meniscus? (5)

Answer 2

• to the capsule
• to the MCL laterally
• to the intercondylar eminence of the tibia via the horns
• to the transverse ligament anteriorly
• to the oblique popliteal ligament posteriorly

Question 3

What are the attachments of the lateral meniscus? (5)

Answer 3

• to the capsule
• to the intercondylar eminence of the tibia via the horns
• to the transverse ligament anteriorly
• to the tendon of popliteus posteriorly
• contributes to the PCL

Question 4

What are the characteristic differences between the medial meniscus and lateral meniscus?

Answer 4

• The lateral meniscus is more mobile and smaller
• The lateral meniscus is uniform width and forms 4/5ths of a circle
• the medial meniscus is broader posteriorly and less mobile

Question 5

What are the 5 functions of the menisci?

Answer 5

• increase congruency between the tibia and femur (deepens articulation)
• weight-bearing
• shock absorption
• aids lubrication
• helps to lock the knee into extension (screw home)

Question 6

How do the menisci contribute to knee movement?

Answer 6

• push forwards on the femoral condyles during extension - increasing the contact area
• drawn backwards on the femoral condyles during flexion
• during LR - medial meniscus pulled anteriorly, lateral meniscus pulled posteriorly with some axial rotation
• during MR - lateral meniscus pulled anteriorly, medial meniscus pulled posteriorly with some axial rotation

Question 7

What is the MOI for meniscal injuries?

Answer 7

Foot planted, knee slightly flexed, excessive rotation of the trunk

Question 8

What are examples of vertical meniscal tears?

Answer 8

Longitudinal (tear of the length of the meniscus
bucket handle (hole in the meniscus)

Question 9

What are examples of horizontal meniscal tears?

Answer 9

radial tears (incomplete or complete)
flap tears (partial cleavage)

Question 10

What are complex meniscal tears?

Answer 10

Combined horizontal and vertical tears - usually degenerative origin

Question 11

What are the zones of vascularisation?

Answer 11

white-white zone
red-white zone
red-red zone

Question 12

What is the potential for healing in the red-red zone?

Answer 12

Highest due to being close to the periphery and so having good blood supply - tears here are more painful but are able to heal

Question 13

What is the potential for healing in the red-white zone?

Answer 13

reduced but still possible

Question 14

What will happen to the knee joint if the meniscus is removed?

Answer 14

Secondary knee osteoarthritis - due to the lack of ‘shock absorption’ by the meniscus having a knock-on effect and damaging the articular hyaline cartilage underneath

Question 15

What is an effusion?

Answer 15

increased synovial fluid within the joint due to inflammation of the synovial membrane

Question 16

What is an extension lack?

Answer 16

reduced knee extension due to a mechanical prevention - e.g. meniscal tear or loose body
aROM=pROM

Question 17

What is a quadriceps lag?

Answer 17

When aROM is reduced due to pain inhibition of quads - pROM is normal

Question 18

What factors impact prognosis following meniscal tears? (5)

Answer 18

Age of patient 
The location of the tear in the mensicus
If there is previous signs of degeneration
If the tear is extensive/complex
Commitment to physiotherapy