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orthopedics 2 > knee > Flashcards

knee Flashcards

0
Q

ACL tibial insertion?

A

between intercondylar eminences

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1
Q

ACL femoral attachment?

A

posteroMEDIAL ASPECT of LATERAL CONDYLE

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2
Q

TWO BUNDLES of ACL? (clue: named based on tibial insertion)

A

anteromedial and posterolateral bundles

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3
Q

ACL bundle tight in FLEXION, ANTERIOR restraint, tested with lachman/ANTERIOR drawer?

A

ANTEROMEDIAL bundle

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4
Q

ACL bundle tight in EXTENSION, a ROTATORY restraint, tested with pivot shift?

A

POSTEROLATERAL bundle

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5
Q

blood supply of cruciate ligaments?

A

middle geniculate artery, fat pad

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6
Q

PCL femoral attachment?

A

anteroLATERAL ASPECT of MEDIAL CONDYLE

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7
Q

PCL tibial insertion?

A

tibial sulcus BELOW ARTICULAR SURFACE

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8
Q

TWO BUNDLES of PCL?

A

anterolateral and posteromedial

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9
Q

MCL biomechanics?

A

anterior fibers tight @ <90degrees

posterior fibers tight @ 180degrees

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10
Q

most anterior structure on proximal fibula?

A

LCL

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11
Q

LCL biomechanics?

A

tight in extension, lax in flexion

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12
Q

posteroMEDIAL corner function?

A

ROTARY stability

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13
Q

posteroLATERAL corner function?

A

primary stabilizer of EXTERNAL TIBIAL ROTATION

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14
Q

vascularized parts of menisci?

A

peripheral 20-30% MEDIAL meniscus

peripheral 10-25% LATERAL meniscus

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15
Q

blood supply of menisci?

A

medial and lateral genicular arteries

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16
Q

shapes of menisci?

A

medial:C-shaped, lateral:circular

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17
Q

function of menisci?

A

1) deepen articular surfaces
2) stability
3) lubrication
4) nutrition

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18
Q

attachment between menisci?

A

transverse (intermeniscal) ligament

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19
Q

peripheral attachment of menisci?

A

coronary ligaments

20
Q

MORE MOBILE meniscus?

A

LATERAL meniscus (fewer attachments - 2x more mobile)

21
Q

more commonly torn meniscus?

A

MEDIAL meniscus ~3x more

22
Q

more commonly torn meniscus WITH ACL tear?

A

LATERAL meniscus

23
Q

meniscal tears with highest healing potential?

A

tears in PERIPHERAL 3RD of meniscus

27
Q

“screw home mechanism”?

A

medial tibial plateau rotates externally in full extension

28
Q

function of medial patellofemoral ligament?

A

> 50% restraint to lateral subluxation

29
Q

stronger graft: patellar tendon vs quadrupled hamstring?

A

quadrupled hamstring BUT dependent on graft fixation

30
Q

history of pain after SITTING/CLIMBING?

A

PATELLOFEMORAL injury

31
Q

history of LOCKING/SQUATTING pain?

A

MENISCAL tear

32
Q

history of NONCONTACT injury with ‘POPPING’?

A

ACL tear or patellar dislocation

33
Q

history of ACUTE SWELLING?

A

ACL or meniscal tear

34
Q

history of hyperextension, varus angulation, tibial external rotation?

A

POSTEROLATERAL CORNER injury

35
Q

SIGNIFICANT DIFFERENCE of knee laxity?

A

> 3MM between left and right knees

36
Q

MOST SENSITIVE imaging view for EARLY ARTHROSIS?

A

WEIGHT-BEARING 45-degree POSTEROANTERIOR view

37
Q

significance of joint line tenderness?

A

meniscal tear

38
Q

components of Q-angle?

A

ASIS-patella-tibial tubercle

39
Q

indication of partial meniscectomy?

A

complex, degenerative, central/radial tears

40
Q

indication of meniscal repair?

A

peripheral longitudinal tears, young patients

41
Q

gold standard of meniscal repair?

A

vertical mattress sutures

42
Q

associated with chronic ACL deficiency?

A

higher incidence of complex meniscal tears

43
Q

graft of choice for early return to sports activity?

A

bone-patella-tendon-bone autograft (faster incorporation)

44
Q

disadvantage of BPTB autograft?

A

higher incidence of arthritis 5-7yrs after reconstruction

45
Q

why is primary ACL repair NOT recommended?

A

myofibroblasts coat end of ACL stumps, making healing impossible

46
Q

STANDARD IMAGING for evaluation and grading of PCL injuries?

A

STRESS RADIOGRAPHS

MRI only confirmatory

47
Q

rehab focus for ACL/PCL injuries?

A

ACL:hamstrings, PCL:quadriceps

48
Q

J sign?

A

lateral deviation of patella in extension

49
Q

most sensitive test for ACL injury?

A

LACHMAN (pull tibia @ 30deg flexion)

50
Q

how arthrocentesis/intraarticular knee injection is done?

A

extended knee, lateral entry point @ mid-upper patella

orthopedics 2 (5 decks)

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