knee disorders Flashcards
what people are most at risk of knee injuries?
elderly
sportsmen and women
why is a knee disorder so disruptive?
- major for weight bearing
- major for walking - critial for health and fitness
it reduces mobility is injured = obesity and more likely to have falls
- people cant work
- psychological issues - pain, lack of independece = depression and socoal isolation
- diability
3 place for femoral shaft fracture?
example of injuries that will cause this?
how much blood os loss per femur fracture?
how to treat?
proximal shaft, mid shaft, suprecondylar
high energy: RTA and falls
1500ml - can ause hypovlaemtic shock(low volume low BP)
spilnt and fixation in surgery
what are tibial plateaux fractures?
what does bi and unicondylar mean?
what type of injury causes this?
what are the consequences of this injury?
how to treat?
fratcure on poximal tibia head where condyles are
bi = both condyles fractured, uni = 1 - need CT to se better
high energy e.g. falls, sports, RTA
articular cartillage damage, joint surface reduction, instability
fix articular segemnts to shaft, post tramatic OA
what are fractures of the patella ?
how to test for patella fracture?
what is the treatment for displaced and undisplaced fractures?
what are consequences of this injury?
what to be aware of?
when the patella bone breaks- can be direct or indirect force
straigt leg raise
displaced = reduce and fix, undisplaced = splint and protect
post traumatic OA
bipartite patella - 2 sections of patella is normal for some people and can look like a break
dislocation/subluxation of the patella
what actions cause it?
what are some common predispotitions?
how to treat?
twisting actions, fall on flexed knee
weakness of VM, laxe ligaments, shallow trachlear groove, long patella ligament, previous dislocations
reduce and immobilise, soft tissue reconstruction if knee keeps disloacting
what are menisical injuries?
what movement causes them?
symptoms?
how to treat traumatic and degenerative injuries?
tear of menisici
twisting injury in high flexsion
pain, swelling, locking / jamming knee
traumatic = menisectomy and or menisci repair
degenerative = leave alone and rehabilitate - usually in older people
what causes collateral ligament damage?
what force would cause medial damage?
what force wpuld cause lateral damage?
symptoms?
treatment?
contact/direct blow e.g. sport
medial = valgus force
lateral = varus force
pain and instability
brace and rehabillitation, surgery
what is the terrible triad?
- ACL injury
- medial collateral ligament injury
- medial menisical injury
cruciate ligament injuries: ACL
what causes damage ACL?
what do you hear?
treatment?
PCL
what causes damaged PCL?
how to treat?
landing funny/ direction change
pop/snap - often knee will keep giving way
rehabilitation/surgery
contact/ fall onto knee or hyperextension
brace and rehab
what is knee dislocation?
is it common?
how many ligamnets need to be injured?
what artery is at risk?
treatment?
when you diclate the knee joint (femorotibial)
no its uncommon
3/4 ligaments ruptured
popliteal artery as it it thertherd to back of knee - need angiogram to see if bleeding
reduce and stabalise
what are causes of swelling round the knee?
- bony - Osgood - Schlatters = tibial tuberosity grows due to over use - usually sorts itself out - happens. in teenagers
- soft tissue - cancer
- fluid
- knee effusuion - fluid inside knee joint - never normal
can be acute (onset within 6 hours) usually after a break, can be sub acute and onset the next day (reactive synovitis) e.g. menisci injury
what are acute knee effusions?
what is haemarthrosis ?
and what does this mean?
what is lipo-haemarthrosis?
what does this mean?
usually occur within 6 hours of injury and if swelling associated with fluid in the knee joint
haemorrhage into a joint space and can be regarded as a subtype of a joint effusion.
usually assumed its ACL injury
escape of fat from the bone marrow into the joint
usually means a fracture
what are busae?
what is bursitis?
what does it cause?
what is the pre patella burtitis aka?
what is the infrapatella burtitis aka?
what is suprepatella burisitis often misdiagnosed?
what semimenbranous bursitis often misdiagnosed?
fluid filled sacs protecting bone prominences
inflammation and fibrosis of bursa
chronic mechanical inflammation and swelling
housemaids knee
clergymans knee
knee joint effusion
popliteal cyst
knee arthiritis
what are the symptoms?
what does uni, bi and tri compartmental mean?
osetoarthiritis or inflammatory
joint surface damage, synovitis (swelling), reduced joint space, pain, stiffness, loss of function, deformites (varus, valgus, fixed flexsion)
medial, lateral and patellofemoral are all compartments - if 2 are subject to arthiritis = bi
