K N E E

Question 1

describe causes of anterior cruciate ligament injury

Answer 1

twisting motion or hyperextension

Question 2

what are the signs and symptoms anterior cruciate ligament injury

Answer 2

• patient feels something break or give way
• joint swells
• positive anterior draw test
• Lachman’s test
• effusion may be present

Question 3

describe management of anterior cruciate ligament injury

Answer 3

• conservative with aspiration of haemarthrosis
• analgesia
• physiotherapy

Question 4

what is the rule of thirds in regards to anterior cruciate ligament injury

Answer 4

1/3 improve with this regimen, 1/3 manage with decreased function, 1/3 require arthroscopic repair for higher level of function e.g. sports or for severe instability

Question 5

describe causes. mechanism of injury of posterior cruciate ligament injury

Answer 5

• occurs when knee is flexed, tibia if forced backwards

- posterior draw sign is positive

Question 6

management of posterior cruciate ligament injury

Answer 6

same as anterior cruciate ligament injury

Question 7

what is medial collateral ligament injury associated with

Answer 7

unhappy triad

anterior cruciate ligament and media meniscus injury

Question 8

management of medial collateral injury

Answer 8

immobilisation with cast for 6 weeks or surgical reconstruction to restore stability

Question 9

describe meniscal injury and which meniscus is mostly involved

Answer 9

common tears

medial meniscus

Question 10

epidemiology of medial meniscus

Answer 10

fit young males

Question 11

describe mechanism of meniscal injury

Answer 11

1. traumatic - common in those who regularly kneel, turn, crouch
2. degenerative - asymptomatic

Question 12

clinical features of meniscal injury

Answer 12

• pain, delayed swelling, joint locking, tearing sensation
• joint line tenderness
• positive McMurray’s test
• sx may settle but episodes may recur

Question 13

lx for meniscal injury

Answer 13

XR, MRI and arthroscopy can confirm nature and location of injury

Question 14

management of meniscal injury

Answer 14

conservative management initially, arthroscopic surgery if larger tear.

arthroscopic meniscectomy

Question 15

MOI of patella fracture

Answer 15

direct trauma to the knee. Occasionally secondary to excess contraction of the quadriceps muscle.

Question 16

features of patellar fracture

Answer 16

pain and swollen knee joint.

Question 17

patella fracture lx

Answer 17

xr

Question 18

management of patellar fracture

Answer 18

reduction, surgical management if significant displacement (e.g. ORIF)