11. Knee Problems Flashcards

1
Q

What are the common Knee Problems?

A
  1. Fracture
  2. Acute on Chronic Degenerative Joint Disease
  3. Meniscal Injury
  4. Ligament Injury
  5. Tendon Injury
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2
Q

What should special focus be placed on, in the History of a Knee Problem?

A
  1. Environment (Sport / Recreation vs Workplace)
  2. Activity (Sport tackle vs jumping)
  3. Energy (How fast and How heavy)
  4. Systemic Symptoms
  5. Chronology (Quick vs Slow, Previous Injury)
  6. Hear / Feel a Pop/Crack
  7. Swelling (Early (Haemarthrosis) vs Late)
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3
Q

What causes a Meniscal Injury?

A

Twisting Movement on a Loaded, Fixed Knee

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4
Q

What are the Features of a Meniscal Injury?

A
  1. Painful “Squelch”
  2. Slow Swelling
  3. Painful to Weight Bear
  4. “Locked” Knee
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5
Q

What causes an Anterior Cruciate Ligament Tear?

A
  1. Forward Momentum

2. Leg Fixed +/- Rotated

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6
Q

What are the Features of an Anterior Cruciate Ligament Tear?

A
  1. “Pop”
  2. Quick Swelling
  3. Often able to Weight Bear
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7
Q

What are the Features of a Collateral Tear?

A
  1. Lateralised Pain
  2. Feel of “Crack” - Sharp Pain
  3. No / Minimal Effusion
  4. Bruising to one side
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8
Q

What are the Principles of a Knee Musculoskeletal Examination?

A
  1. Look
  2. Feel
  3. Move
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9
Q

What are you Looking for in a Knee Musculoskeletal Examination?

A
  1. Scars / Bruising / Swelling

2. Joint Line Irregularity

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10
Q

What are you Feeling for in a Knee Musculoskeletal Examination?

A
  1. Effusion
  2. Crepitus
  3. Heat
  4. Tenderness
  5. Tissue Lumps / Defects
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11
Q

What are you looking for in Movement during a Knee Musculoskeletal Examination?

A
  1. Passive and Active
  2. Straight Leg Raise
  3. Range of Movement
  4. Ligament Testing
  5. Dynamic Testing
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12
Q

What Rradiological Investigations can be done on the Knee?

A
  1. X-Ray
  2. Ultrasound
  3. MRI
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13
Q

What is seen on an X-Ray of a Knee Joint?

A
  1. Fracture
  2. Loose Bodies
  3. Ligament Avulsion
  4. Osteochondral Defect
  5. Degenerative Joint Disease
  6. Lipohaemarthrosis
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14
Q

What is seen on an Ultrasound of a Knee Joint?

A
  1. Tendon Rupture
  2. Some Meniscal Tears
  3. Swelling
  4. Cysts
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15
Q

What is an MRI of a Knee Joint used for?

A

Clinical Confirmation

Note - This is not good for Degenerative Joint Disease or Mobile Pathology

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16
Q

What are the Indications that Surgery may be needed?

A
  1. Failure of Conservative Treatment
  2. Demands of Work / Sport
  3. Problems with Daily Activities
  4. Prevention of Further Joint Injuries / Falls
17
Q

What forms of Non-Surgical Management are there?

A
  1. Physiotherapy

2. Analgesia

18
Q

What can Non-Surgical Management lead to?

A
  1. Restoration of Function
  2. Swelling Reduction
  3. Range of Motion
  4. Normal Movement
19
Q

What surgeries are available for Meniscal Injuries?

A
  1. Meniscal Repair
  2. Partial Meniscectomy
  3. Meniscal Transplantation
20
Q

Who is most likely to get Surgical Repair of a Meniscal Injury?

A
  1. Young
  2. Sporty
  3. Fresh Tears - up to 3 months
  4. Healthy Meniscus (Red/Red or Red/White)
21
Q

What are the Repair Techniques for a Meniscal Injury?

A
  1. Open Technique
  2. Outside - In
  3. Inside - Out
  4. All Inside
    Note - This has a 90% success rate
22
Q

What Procedures are there for Anterior Cruciate Ligament tears?

A
  1. Full ACL Rehabilitation

2. ACL Reconstruction Surgery

23
Q

What would the reasons be for having ACL Reconstruction Surgery?

A
  1. Prevention of further injury
  2. To get back to work / sport
  3. Prevention of Osteoarthritis
24
Q

What are the treatment options for Osteochondral Injuries?

A
  1. Debridement
  2. Reattachment of Fragment
  3. Removal of Loose Bodies
  4. Microfracture Chondroplasty
  5. ACI