Cortex - Adult orthopaedics pelvis and lower limb 3 (soft tissue injuries to the knee) Flashcards Preview

MSK week 4 > Cortex - Adult orthopaedics pelvis and lower limb 3 (soft tissue injuries to the knee) > Flashcards

Flashcards in Cortex - Adult orthopaedics pelvis and lower limb 3 (soft tissue injuries to the knee) Deck (18):
1

What is the extensor mechanism of the knee comprised of ?

Constitutes of the tibial tuberosity, the patellar tendon, the patellar, the quadriceps tendon and the quadriceps muscles.

A image thumb
2

Describe the mechanism of how patellar tendon or quadriceps tendon ruptures occur?

With rapid contractile force:

e.g. after lifting a heavy weight, after a fall

Or spontaneously in a severely degenerate tendon

3

What is the difference in who patellar tendon ruptures and quadricep ruptures tend to occur in ?

patellar tendon ruptures tend to occur in people <40 

quadriceps tendon ruptures tend to occur in >40 

4

What are some of the predisposing factors to patellor or quadricep tendon ruptures ?

History of tendonitis

  • Chronic steroid use or abuse (body builders)
  • Diabetes
  • RA
  • Chronic renal failure.
  • Quinolone antibiotics (eg ciprofloxacin) can predispose to tendonitis/ruptures 

5

Should steroid injections be avoided in people with tendonitis of the extensor mechanism of the knee ?

Yes! it comes with a high risk of tendon rupture 

6

What test in your examination of acute knee injury would assess if the extensor mechanism of the knee is intact or if there is injury to it ?

SLR (straight leg raise)

7

What is the results of the SLR when a patient has A disruption of the quadriceps tendon, patella, or patellar tendon e.g. talking about ruptures of the tendons 

The patient may not be able to perform SLR

8

If a patient has a partial tear of a tendon in the extensor mechanism of the knee what may the results of the SLR be ?

May have some extensor mechanism function (so may be able to perform it) but have reduced power e.g. when putting pressure on the SLR they may not be able to keep it up 

9

What is the treatment of tendon ruptures/ substantiale tears involving the extensor mechanism of the knee ?

Surgical with tendon to tendon repair or reattachment of the tendon to the patella

10

What are the signs of patellar and quariceps tendon ruputres ?

Inability to straight leg raise or weight bear.

A palpable gap in the patellar or quadriceps tendon (although this may be difficult to detect owing to swelling).

Change in height of the patella. (quadriceps tendon rupture patellar displaced inferiorly) (patellar tendon rupture, patellar displaced superiorly)

11

What is patellofemoral dysfunction ?

It is described as an ill-defined ach producing anterior knee pain (this is a result of (mechanical and biochemical changes to the patellofemoral joint)

12

What are the common signs/symptoms of patellofemoral dysfunction ?

  • Anterior knee pain - worse going downhill
  • Griniding or clicking sensation at the front of the knee
  • Stiffness after prolonged sitting causing “pseudolocking”

13

What is the treatment of patellofemoral dysfunction?

  • 1st line - Physio to strengthen the muscles 
  • Adjunct - NSAID's
  • Adjunct - Patellar taping may help

14

How does patellar dislocation commonly occur ?

By a direct blow or sudden twist of the knee 

15

What may be torn when the patellar dislocates ?

The patellofemoral ligament 

16

When the patellar dislocates what way does it usually displace ?

Laterally 

17

What type of swelling occurs following a patellar dislocation (same idea as what type of swelling occurs following an ACL rupture)

A lipo‐haemarthrosis occurs

18

What is the treatment of patellar dislocation ?

  • The patella usually reduces when leg is straightened or spontaneously, rarley needs manipulated back in 
  • After this physio is done to help strengthen the muscles