Meniscal Tears Flashcards
What are the functions of the menisci on the knee
Shock absorbers
Increasing the articular surface
What is the medial meniscus attached to
Medial collateral ligament - important in the unhappy triad injury
What is the most common cause for meniscal tears
Trauma related - twisting of the knee whilst flexed
Degenerative disease
What is the most common type of meniscal tear
Longitudinal - sometimes Called the bucket handle tear
what are the different types of tears
Vertical
Longitudinal ( bucket handle )
Transverse ( parrot-beak )
Degenerative
What are the clincal feature of meniscal tears
Tearing sensation
Intense sudden onset pain
Slow swelling
In bucket handle type - may be locked in flexion
Joint line tenderness
What are the tests that you can carry out to test for meniscal tears
McMurrays test
Apleys grind test
What are the differential diagnosis
fracture, cruciate ligament tear, collateral ligament tear, and osteochondritis dissecans.
what are the investigations that you need to Carry out
First line - X rays - to exclude fracture
MRI scan is the gold standard however to confirm meniscal tear + type of tear present
What is the management of small Meniscal tears
RICE
Most small tears will swell up but subside in the next couple of days
What is the management of a tear that is large/ remaining symptomatic
arthroscopic surgery
When is arthroscopic surgery indicated
If the tear is in the outer third of meniscus - rich vascular supply
If the tear is in the inner third
What are the complications of meniscal tears
OA
If surgery then:
Risk of DVT
Risk of damage to the saphenous nerve and vein
Risk of damage to peroneal nerve and popliteal vessels
