Knee Pathology - Ligament Injuries Flashcards
Aetiology; .
Ligamentous injuries occur when a force greater than the ? ? of the ligament occurs, e.g. ? injuries or ?.
? are more susceptible, but ? more commonly injured.
The most common injury is ??? tear, with ??? tear the second most
common.
tensile strength sporting trauma women men ACL MCL
Aetiology
In practice it is common for ? ligaments to be involved (e.g. ? will rupture the ACL first, but as the degree of ? increases the PCL may also be injured).
The collateral ligaments are tight in ? and loose in ?, thus injury is most common when the knee is ?, with the MCL more susceptible to injury as it blends with the ?, decreasing ?.
multiple hyperextension extension extension flexion extended capsule flexibility
History;
It is key in the history to elicit the full ? (position of the knee and
direction of any ? applied).
Swelling in the first hour indicates ? rupture (in contrast to ? tear).
Patients may describe a ‘?’ at the time of injury.
Patients cannot ? ? after the injury, and the knee will feel very ?.
mechanism force complete meniscal pop weight bear unstable
Examination;
On examination, there will not be a ‘firm’ ? ? when testing the ligament, rather a ‘soft’ ? ? as the surrounding ? ? stop the force.
Partial tears do not give increased ?, but instead there is ? when
testing.
? test is significantly more sensitive than the ? ? test
for ACL pathology.
end point end point soft tissues mobility pain lachmans anterior drawer
Investigations;
X Ray (?/ ?/ ?): to show any ?, exclude ?, and
show any ?.
?: will pick up 90% of ligament injuries.
Diagnostic ?: occasionally used if ? shows an ? ACL however the patient clinically has ACL ?
AP/lateral/skyline displacements oa #'s mri arthroscopy mri intact dysfunction
Management;
Conservative;
o ?/partial tears will ? heal with ? as the intact fibres ?the torn ones.
o ? will complicate this process if the joint is ?, so ?movement with a ? is encouraged.
sprains spontaneously physio splint adhesions rested active brace
Management;
Conservative;
o Prolonged ? and patient ? about activity limitations may be used in ? patients or those with low functional
? following ACL rupture.
0 Conservative management is almost always the option of choice in ? ligament pathology, unless part of ?-? injuries.
physio education older demands collateral multi-level
Surgical;
0 ACL: ? tendon ? repair, with the ? or ? used as the donor tendon. The donor tendon lies between two ? ? that anchor it is position in a ‘bone ?’.
arthroscopic graft semimembranosus hamstring bone screws tunnel
Surgical
0 PCL: less is known about ? management, with bony ? the most common indication, and should be screwed in place ?.
o Collateral ligaments: if being fixed surgically, should be performed within ? ? of the injury.
optimal
avulsion
early
two weeks
