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Musculoskeletal > Knee > Flashcards

Knee Flashcards

1
Q

which of the menisci is fixed?

A

medial meniscus

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2
Q

what do menisci do?

A

distribute load from convex femoral condyles to relatively flat tibial articular surfaces

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3
Q

which plateau is slightly more concave?

A

medial

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4
Q

what does the MCL resist?

A

valgus stress

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5
Q

what does the LCL resist?

A

varus stress

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6
Q

what does the ACL resist?

A

anterior subluxation of the tibia /femur

hyperextension of the knee

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7
Q

what can an MCL rupture lead to?

A

valgus instability

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8
Q

what can an ACL rupture lead to?

A

rotatory instability

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9
Q

what can an PCL rupture lead to?

A

recurrent hyperextension or instability descending stairs

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10
Q

what can an posterolateral corner rupture lead to?

A

varus & rotatory instability

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11
Q

which kinds of patients usually have meniscal tears?

A

sporting injury in younger patients or getting up from squatting in younger patients

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12
Q

which patients can you see an atraumatic meniscal tear in?

A

spontaneous degenerate tears in older patients (40+)

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13
Q

what associated injury to 50% of ACL ruptures have?

A

meniscal tears

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14
Q

how would you investigate a meniscal tear?

A

MRI

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15
Q

which side is more commonly torn in meniscal tears?

A

medial

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16
Q

how would you repair a meniscal tear?

A

arthroscopic repair

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17
Q

how you repair a meniscal tear with mechanical symptoms (pain/catching), irreparable tears or failed meniscal repair?

A

arthroscopic menisectomy

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18
Q

what does acute locked knee signify?

A

displaced bucket handle meniscal tear

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19
Q

what is required with a displaced bucket handle meniscal tear?

A

urgent surgery (arthroscopic repair/partial meniscectomy)

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20
Q

what can develop if a knee remains locked?

A

FFD

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21
Q

what does a degenerate meniscal tear probably signify?

A

1st stage of OA

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22
Q

what’s a grade 1 knee ligament injury?

A

sprain

tear some fibres but macroscopically still intact

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23
Q

what’s a grade 2 knee ligament injury?

A

partial tear

some fascicles disrupted

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24
Q

what’s a grade 3 knee ligament injury?

A

complete tear

25
Q

describe what the healing like with an MCL injury?

A

usually heals well even if completely torn unless combined with ACL/PCL rupture

26
Q

how would you treat an MCL injury?

A

brace
early motion
physiotherapy

27
Q

how does ACL rupture usually come about?

A

sports injury - football, rugby, skiing

28
Q

how do you treat ACL rupture?

A

reconstruction

  • autograft
  • allograft
  • synthetic graft
29
Q

how does an LCL injury usually come about?

A

varus stress & hyperextension

30
Q

describe the healing of an LCL injury?

A

doesn’t heal & can cause various & rotatory instability

31
Q

what nerve damage can occur in LCL injury?

A

peroneal nerve palsy

32
Q

what does an LCL injury often occur in combination with?

A

PCL/ACL injury

33
Q

when would urgent repair be required in an LCL injury?

A

if complete rupture occurs

34
Q

how does a PCL rupture usually occur?

A

direct blow to anterior tibia (dashboard/motorbike) or hyperextension injury

35
Q

what will be seen clinically with PCL rupture?

A

popliteal knee pain & bruising

36
Q

what complications can occur with knee dislocation?

A

popliteal artery injury
nerve injury
compartment syndrome

37
Q

what’s required fro knee dislocation to occur?

A

serious high energy injury

38
Q

how does patellar dislocation occur?

A

rapid turn or direct blow

39
Q

in which patient groups is patellar dislocation more likely?

A 
females 
adolescents 
ligamentous laxity 
valgus knee 
torsional abnormalities
40
Q

what can patellar dislocation cause?

A

chondral or osteochondral injury

41
Q

how can extensor mechanism rupture occur?

A

all onto flexed knee with quads contracted

42
Q

what will you usually find in the history of a patient with extensor mechanism rupture?

A

previous tendonitis
steroids
chronic renal failure -> ciprofloxacin

43
Q

what will be found clinically in extensor mechanism rupture?

A

unable to straight leg raise

palpable gap

44
Q

how is extensor mechanism rupture treated?

A

requires surgical repair

45
Q

haemarthrosis

A

knee fills up with blood, comes up within an hour, causes generalised pain across the knee

46
Q

effusion

A

comes up the following day

47
Q

what does a haemarthrosis suggest?

A

ACL, fracture or very peripheral meniscal tear

48
Q

what does an effusion suggest?

A

meniscal or chondral injury

49
Q

what does pain along the joint line mean?

A

meniscal or chondral injury or a generalised haemarthrosis

50
Q

what does hyaline cartilage do within a knee?

A

decreases friction & distributes load

51
Q

which type of articular cartilage injury can heal?

A

only full thickness injuries can heal

52
Q

how does hyaline cartilage heal?

A

with fibrocartilage which has greater friction & is less wear resistant

53
Q

what atraumatic articular cartilage defects can occur?

A

osteochondritis dissecans
ostoearthritis
inflammatory arthritis

54
Q

osteochondritis dissecans

A

an area of the surface of the knee loses its blood supply & cartilage +/- bone can fragment off

55
Q

when is osteochondritis discerns most common?

A

in adolescence

56
Q

what are the options of techniques for cartilage regeneration?

A

drilling/microfracture
osteochondral autograft/allograft
mosaicplasty
MACI

57
Q

MACI

A

membrane induced autologous chondrocyte implantation

58
Q

which compartment does load go through in varus knees?

A

medial compartment

59
Q

which compartment does load go through in valgus knees?

A

lateral compartment

Musculoskeletal (22 decks)

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