orthopaedic problems knee Flashcards

1
Q

meniscal tear acute vs degenerative

A

acute - twisting, esp in deep flexion

degenerative - osteoarthritis

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2
Q

which meniscal is more likely to tear

A

medical meniscal tears more common - more fixed structure

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3
Q

presentation meniscal tear

A

pain
clicking
locking
intermittent swelling - several hours after

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4
Q

examination meniscal tear

A
wasting quadriceps
tender joint line at point of tear
mechanical block to movement
McMurrays test positive
fail deep squat
Thassaly's test positive
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5
Q

meniscal tear investigations

A

not always needed

x-ray - exclude arthritis + fractures

MRI

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6
Q

management meniscal tears

A

rest
NSAIDs
physiotherapy - hamstring + quadriceps strengthening

arthroscopy

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7
Q

management knee OA

A
weight loss
analgesia 
braces
walking aids
steroid injectinos 

knee replacement
uni-compartmental

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8
Q

ACL tear presentation

A

acute incident
heard pop/crack
swelling
deep pain

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9
Q

ACL tear on examination

A
effusion 
tender
anterior draw
lackman's test 
pivot shift
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10
Q

ACL tear investigations

A

x-ray

MRI

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11
Q

ACL tear treatment

A

focussed quadriceps programme

ACL recontruction

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12
Q

MCL

A

medial collateral ligament

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13
Q

MCL tear

A

most common ligament injury of knee

severe valgus stress

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14
Q

assoc injuries with MCL tear

A

ACL tear

meniscus

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15
Q

MCL tear presentation

A
heard pop/crack 
pain +++ (medial side) 
bruising medial knee
swelling 
tenderness
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16
Q

MCL tear on exam

A

medial swelling + bruising
tender medial joint line
pain full extension

17
Q

MCL tear investigatoin

A

x-ray

MRI

18
Q

MCL tear non-op management

A

majority

NSAIDs
rest
physio
brace

19
Q

MCL tear operative Rx

A

severe tears, failed non-op Rx

repair or reconstruction

20
Q

osteochondritis dissecans

A

pathological lesion affecting articular cartilage and subchondral bone

21
Q

causes osteochondritis dissecans

A

hereditary
traumatic
vascular (adult)

22
Q

where is osteochondritis dissecans most commonly at

A

knee

posterolatreal aspect medial femoral condyle

23
Q

presentation osteochondritis dissecans

A

activity related pain
recurrent effusions
mechanical symptoms - locking, block full movement

24
Q

osteochondritis dissecans on exam

A

effusion
tenderness
stiffness
block movement

25
Q

investigations osteochondritis dissecans

A

x-ray

MRI

26
Q

management osteochondritis dissecans

A

restrict weight bearing
Rom brace

arthroscopy
open fixation