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Flashcards in Knee Deck (59):
1

which of the menisci is fixed?

medial meniscus

2

what do menisci do?

distribute load from convex femoral condyles to relatively flat tibial articular surfaces

3

which plateau is slightly more concave?

medial

4

what does the MCL resist?

valgus stress

5

what does the LCL resist?

varus stress

6

what does the ACL resist?

anterior subluxation of the tibia /femur
hyperextension of the knee

7

what can an MCL rupture lead to?

valgus instability

8

what can an ACL rupture lead to?

rotatory instability

9

what can an PCL rupture lead to?

recurrent hyperextension or instability descending stairs

10

what can an posterolateral corner rupture lead to?

varus & rotatory instability

11

which kinds of patients usually have meniscal tears?

sporting injury in younger patients or getting up from squatting in younger patients

12

which patients can you see an atraumatic meniscal tear in?

spontaneous degenerate tears in older patients (40+)

13

what associated injury to 50% of ACL ruptures have?

meniscal tears

14

how would you investigate a meniscal tear?

MRI

15

which side is more commonly torn in meniscal tears?

medial

16

how would you repair a meniscal tear?

arthroscopic repair

17

how you repair a meniscal tear with mechanical symptoms (pain/catching), irreparable tears or failed meniscal repair?

arthroscopic menisectomy

18

what does acute locked knee signify?

displaced bucket handle meniscal tear

19

what is required with a displaced bucket handle meniscal tear?

urgent surgery (arthroscopic repair/partial meniscectomy)

20

what can develop if a knee remains locked?

FFD

21

what does a degenerate meniscal tear probably signify?

1st stage of OA

22

what's a grade 1 knee ligament injury?

sprain
tear some fibres but macroscopically still intact

23

what's a grade 2 knee ligament injury?

partial tear
some fascicles disrupted

24

what's a grade 3 knee ligament injury?

complete tear

25

describe what the healing like with an MCL injury?

usually heals well even if completely torn unless combined with ACL/PCL rupture

26

how would you treat an MCL injury?

brace
early motion
physiotherapy

27

how does ACL rupture usually come about?

sports injury - football, rugby, skiing

28

how do you treat ACL rupture?

reconstruction
- autograft
- allograft
- synthetic graft

29

how does an LCL injury usually come about?

varus stress & hyperextension

30

describe the healing of an LCL injury?

doesn't heal & can cause various & rotatory instability

31

what nerve damage can occur in LCL injury?

peroneal nerve palsy

32

what does an LCL injury often occur in combination with?

PCL/ACL injury

33

when would urgent repair be required in an LCL injury?

if complete rupture occurs

34

how does a PCL rupture usually occur?

direct blow to anterior tibia (dashboard/motorbike) or hyperextension injury

35

what will be seen clinically with PCL rupture?

popliteal knee pain & bruising

36

what complications can occur with knee dislocation?

popliteal artery injury
nerve injury
compartment syndrome

37

what's required fro knee dislocation to occur?

serious high energy injury

38

how does patellar dislocation occur?

rapid turn or direct blow

39

in which patient groups is patellar dislocation more likely?

females
adolescents
ligamentous laxity
valgus knee
torsional abnormalities

40

what can patellar dislocation cause?

chondral or osteochondral injury

41

how can extensor mechanism rupture occur?

all onto flexed knee with quads contracted

42

what will you usually find in the history of a patient with extensor mechanism rupture?

previous tendonitis
steroids
chronic renal failure -> ciprofloxacin

43

what will be found clinically in extensor mechanism rupture?

unable to straight leg raise
palpable gap

44

how is extensor mechanism rupture treated?

requires surgical repair

45

haemarthrosis

knee fills up with blood, comes up within an hour, causes generalised pain across the knee

46

effusion

comes up the following day

47

what does a haemarthrosis suggest?

ACL, fracture or very peripheral meniscal tear

48

what does an effusion suggest?

meniscal or chondral injury

49

what does pain along the joint line mean?

meniscal or chondral injury or a generalised haemarthrosis

50

what does hyaline cartilage do within a knee?

decreases friction & distributes load

51

which type of articular cartilage injury can heal?

only full thickness injuries can heal

52

how does hyaline cartilage heal?

with fibrocartilage which has greater friction & is less wear resistant

53

what atraumatic articular cartilage defects can occur?

osteochondritis dissecans
ostoearthritis
inflammatory arthritis

54

osteochondritis dissecans

an area of the surface of the knee loses its blood supply & cartilage +/- bone can fragment off

55

when is osteochondritis discerns most common?

in adolescence

56

what are the options of techniques for cartilage regeneration?

drilling/microfracture
osteochondral autograft/allograft
mosaicplasty
MACI

57

MACI

membrane induced autologous chondrocyte implantation

58

which compartment does load go through in varus knees?

medial compartment

59

which compartment does load go through in valgus knees?

lateral compartment