Flashcards in Knee Deck (59):
which of the menisci is fixed?
what do menisci do?
distribute load from convex femoral condyles to relatively flat tibial articular surfaces
which plateau is slightly more concave?
what does the MCL resist?
what does the LCL resist?
what does the ACL resist?
anterior subluxation of the tibia /femur
hyperextension of the knee
what can an MCL rupture lead to?
what can an ACL rupture lead to?
what can an PCL rupture lead to?
recurrent hyperextension or instability descending stairs
what can an posterolateral corner rupture lead to?
varus & rotatory instability
which kinds of patients usually have meniscal tears?
sporting injury in younger patients or getting up from squatting in younger patients
which patients can you see an atraumatic meniscal tear in?
spontaneous degenerate tears in older patients (40+)
what associated injury to 50% of ACL ruptures have?
how would you investigate a meniscal tear?
which side is more commonly torn in meniscal tears?
how would you repair a meniscal tear?
how you repair a meniscal tear with mechanical symptoms (pain/catching), irreparable tears or failed meniscal repair?
what does acute locked knee signify?
displaced bucket handle meniscal tear
what is required with a displaced bucket handle meniscal tear?
urgent surgery (arthroscopic repair/partial meniscectomy)
what can develop if a knee remains locked?
what does a degenerate meniscal tear probably signify?
1st stage of OA
what's a grade 1 knee ligament injury?
tear some fibres but macroscopically still intact
what's a grade 2 knee ligament injury?
some fascicles disrupted
what's a grade 3 knee ligament injury?
describe what the healing like with an MCL injury?
usually heals well even if completely torn unless combined with ACL/PCL rupture
how would you treat an MCL injury?
how does ACL rupture usually come about?
sports injury - football, rugby, skiing
how do you treat ACL rupture?
- synthetic graft
how does an LCL injury usually come about?
varus stress & hyperextension
describe the healing of an LCL injury?
doesn't heal & can cause various & rotatory instability
what nerve damage can occur in LCL injury?
peroneal nerve palsy
what does an LCL injury often occur in combination with?
when would urgent repair be required in an LCL injury?
if complete rupture occurs
how does a PCL rupture usually occur?
direct blow to anterior tibia (dashboard/motorbike) or hyperextension injury
what will be seen clinically with PCL rupture?
popliteal knee pain & bruising
what complications can occur with knee dislocation?
popliteal artery injury
what's required fro knee dislocation to occur?
serious high energy injury
how does patellar dislocation occur?
rapid turn or direct blow
in which patient groups is patellar dislocation more likely?
what can patellar dislocation cause?
chondral or osteochondral injury
how can extensor mechanism rupture occur?
all onto flexed knee with quads contracted
what will you usually find in the history of a patient with extensor mechanism rupture?
chronic renal failure -> ciprofloxacin
what will be found clinically in extensor mechanism rupture?
unable to straight leg raise
how is extensor mechanism rupture treated?
requires surgical repair
knee fills up with blood, comes up within an hour, causes generalised pain across the knee
comes up the following day
what does a haemarthrosis suggest?
ACL, fracture or very peripheral meniscal tear
what does an effusion suggest?
meniscal or chondral injury
what does pain along the joint line mean?
meniscal or chondral injury or a generalised haemarthrosis
what does hyaline cartilage do within a knee?
decreases friction & distributes load
which type of articular cartilage injury can heal?
only full thickness injuries can heal
how does hyaline cartilage heal?
with fibrocartilage which has greater friction & is less wear resistant
what atraumatic articular cartilage defects can occur?
an area of the surface of the knee loses its blood supply & cartilage +/- bone can fragment off
when is osteochondritis discerns most common?
what are the options of techniques for cartilage regeneration?
membrane induced autologous chondrocyte implantation
which compartment does load go through in varus knees?