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MSK > Orthopaedic knee problems > Flashcards

Orthopaedic knee problems Flashcards

1
Q

What bones surround the knee joint?

A

Distal end of femur - epicondyles
Tibia
Patella

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2
Q

What are the extensor muscles of the knee?

A

Quadriceps

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3
Q

What are the flexor muscles of the knee?

A

Hamstrings

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4
Q

What are the ligaments supporting the knee joint?

A

Anterior cruciate ligamnet
Posterior cruciate ligament
Medial collateral ligament
Lateral collateral ligament

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5
Q

What are the meniscii?

A

C shaped cartilage within the knee joint, which helps to absorb force and increase stability

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6
Q

What are the 2 meniscii?

A

Medial meniscus

Lateral meniscus

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7
Q

What causes meniscal tear?

A

Twisting in deep flexion

Osteoarthritis

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8
Q

Is it more common for the medial or lateral meniscus to tear?

A

Medial

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9
Q

How does meniscal tear present?

A

Pain
Clicking
Locking
Intermittent swelling

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10
Q

What can be seen on examination of meniscal tear?

A 
LOOK - effusion
FEEL - tender joint line at point of tear
MOVE - mechanical block to movement
McMurrays test positive
Fail deep squat
Thassalys test positive
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11
Q

What investigations can be done for meniscal tear?

A

X-ray to detect arthritis or fracture

MRI - see soft tissue but high false positive rate

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12
Q

What is prognosis for meniscal tear?

A

Poor due to poor blood supply

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13
Q

What are non-operative treatment options for meniscal tear?

A

Rest
NSAIDs
Physio - hamstring and quadriceps strengthening

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14
Q

What are operative treatment options for meniscal tear?

A

Arthroscopy

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15
Q

What is the course of the anterior cruciate ligament?

A

From between the tibial eminences to the lateral wall of intercondylar notch of femur

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16
Q

What is the blood supply of the ACL?

A

Middle geniculate artery

17
Q

What is the function of the ACL?

A

Primary restraint to anterior translation of the tibia relative to femur
Secondary restraint to tibial rotation and varus/valgus stress

18
Q

What is the most common cause of acl tear?

A

Non-contact pivot injury

19
Q

How does acl tear present?

A

Heard a pop or crack
Immediate swelling
Unable to continue playing sport
Deep pain

20
Q

What can be found on examination of ACL tear?

A

LOOK - effusion
MOVE - anterior draw positive
Lachmann’s test
Pivot shift

21
Q

What investigations can be done for ACL tear?

A

X-ray

MRI - ACL and meniscii

22
Q

How is ACL tear treated?

A

Non-operative - Focused quadricep programme

Operative - ACL reconstruction

23
Q

What is the role of the superficial medial collateral ligament?

A

Primary restraint to valgus stress

24
Q

What is the role of the deep medial collateral ligament?

A

Contributes in full knee extension

25
Q

What causes MCL tear?

A

Severe valgus stress - contact related

26
Q

How does MCL tear present?

A 
Heard a pop or crack
Pain++ on medial side of knee
Unable to continue playing sport
Bruising on medial knee
Localised swelling
27
Q

What will be found on examination of MCL tear?

A

LOOK - medial swelling, bruising
FEEL - tender medial joint line and femoral insertion of MCL
MOVE - painful in full extension, opening on valgus stress

28
Q

What investigations can be done for MCL tear?

A

X-ray - may be normal, calcification at femoral insertion

MRI helps assess location and severity

29
Q

What are non-operative treatments for MCL tear?

A

Rest/NSAIDs
Physiotherapy
Brace for comfort

30
Q

What are indications for surgery in MCL tear?

A

Severe tears

Failed non-operative management

31
Q

What are operative treatments for MCL tear?

A

Repair - avulsions

Reconstruction - damaged tissue

32
Q

What is osteochondritis dissecans?

A

Pathological lesions affecting articular cartilage and subchondral bone causing cracks to appear

33
Q

What are causes of osteochondritis dissecans?

A

Hereditary
Traumatic
Vascular

34
Q

How does osteochondritis dissecans present?

A

Activity related pain - poorly localised
Recurrent effusions
Mechanical symptoms - locking and block to full movement

35
Q

What is found on examination of osteochondritis dissecans?

A

LOOK - effusion
FEEL - localised tenderness
MOVE - stiffness, block to movement, wilsons test

36
Q

What investigations can be done into osteochondritis dissecans?

A

X-ray

MRI

37
Q

What are treatment options for osteochondritis dissecans?

A

Non-operative - restricted weight bearing and range of movement brace
Operative - Arthroscopy, open fixation

MSK (30 decks)

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