Knee Injuries

Question 1

Origin and insertion of ACL

Answer 1

Origin: lateral condyle of the femur
Insertion: intercondyloid eminence of the tibia

Question 2

Origin and insertion of PCL

Answer 2

Origin: posterior intercondylar area of the tibia
Insertion: medial condyle of the femur

Question 3

Origin and insertion of MCL

Answer 3

Origin: medial epicondyle of the femur
Insertion: medial condyle of tibia

Question 4

Origin and insertion of LCL

Answer 4

Origin: lateral epicondyle of the femur
Insertion: head of fibula

Question 5

Origin and insertion of LCL

Answer 5

Origin: lateral epicondyle of the femur
Insertion: head of fibula

Question 6

Function of MCL

Answer 6

Stabilises the knee from valgus force

Question 7

Function of LCL

Answer 7

Stabilises the knee from varus force

Question 8

Function of ACL

Answer 8

Stabilises the knee from anterior translation (opposes anterior draw test)

Question 9

Function of PCL

Answer 9

Stabilises the knee from posterior translation

Question 10

What surface anatomy corresponds to the MCL and LCL?

Answer 10

medial joint line and lateral join line

Question 11

Function of MCL

Answer 11

Stabilises the knee from valgus force (opposes valgus stress test)

Question 12

Function of LCL

Answer 12

Stabilises the knee from varus force (opposes varus stress test)

Question 13

Function of ACL

Answer 13

Stabilises the knee from anterior translation (opposes anterior drawer test)

Question 14

Function of PCL

Answer 14

Stabilises the knee from posterior translation (opposes posterior drawer test)

Question 15

What surface anatomy corresponds to the MCL and LCL?

Answer 15

medial joint line and lateral join line

Question 16

Hx of injury of MCL tear?

Answer 16

(valgus force) lateral blow/momentum to the knee while in fixed position

Question 17

Sx of MCL tear?

Answer 17

Swelling, point tenderness over medial joint line

Question 18

Px of MCL tear?

Answer 18

Positive valgus stress test

Question 19

Dx of MCL tear?

Answer 19

a. Clinical - positive valgus stress test

b. MRI - most accurate test in Dx

Question 20

Rx of MCL tear?

Answer 20

Isolated injury can be treated with immobilization via hinged cast.
Multiple or severe injuries are treated with surgical repair

Question 21

Rx of MCL tear?

Answer 21

Isolated injury can be treated with immobilization via hinged cast.
Multiple or severe injuries are treated with surgical repair

Question 22

Hx of LCL tear?

Answer 22

Medial blow (Varus position) or momentum to the knee while in fixed position

Question 23

Sx of LCL tear?

Answer 23

Swelling, point tenderness over the lateral joint line

Question 24

Px of LCL tear?

Answer 24

Positive varus stress test

Question 25

Dx of LCL tear?

Answer 25

Clinical. Positive varus stress test. The most accurate test is in diagnosis is MRI

Question 26

Rx of MCL tear?

Answer 26

Isolate injury can be treated with immobilisation via hinged cast. Multiple or severe injuries are treated with surgical repair

Question 27

Hx of ACL tear?

Answer 27

Non-contact injury = sudden stopping or pivoting (so there is anterior momentum of the leg) Contact injury = blow to posterior knee (so the leg moves forward)

Question 28

Sx of of ACL tear?

Answer 28

Swelling and pain of the knee

Question 29

Px of ACL tear?

Answer 29

Positive anterior drawer test

Question 30

Dx of ACL tear?

Answer 30

Anterior and posterior drawer test are not as sensitive therefore most accurate Dx is via MRI

Question 31

Rx of ACL tear?

Answer 31

Non-athletes may be treated with immobilisation. Athletes should be treated with surgical repair. The treatment depends on the degree of activity of pt

Question 32

Hx of PCL tear?

Answer 32

Direct blow to anterior knee | therefore pushes the lower leg backwards

Question 33

Sx of PCL tear?

Answer 33

Swelling and pain of the knee

Question 34

Px of PCL tear?

Answer 34

Positive posterior draw test

Question 35

Dx of PCL tear?

Answer 35

MRI

Question 36

Rx of PCL tear?

Answer 36

Same as ACL - non athletes is immobilisation, athletes is surgical

Question 37

Hx of meniscal tear?

Answer 37

Injury (often seen in sports) involving a sudden motion (any direction) associated with a POP or a CLICK experienced by a patient

Question 38

Sx of meniscal tear?

Answer 38

Pt able to walk after pain Protracted pain of knee (pain will continue and will not get better with immobilisation) Some swelling Clicking and popping when walking

Question 39

Px of meniscal tear?

Answer 39

Positive McMurray test

Question 40

Dx of meniscal tear?

Answer 40

MRI

Question 41

Rx of meniscal tear?

Answer 41

Arthroscopic repair of the meniscus

Question 42

Hx of knee dislocation?

Answer 42

High energy trauma (at least three of the major ligaments completely torn, therefore the leg is free floating from the rest of the thigh at the knee) - not common e. g. MVA

Question 43

Sx of knee dislocation?

Answer 43

Pain, swelling: often a gross deformity will be present or reported by ED

Question 44

Px of knee dislocation?

Answer 44

Gross deformity may be present, there may be neurovascular compromise distal from the injury. The popliteal at high risk! Assess pulses and ankle-brachial-index (systolic P at the ankles and dividing a systolic P at the arms)

Question 45

Dx of knee dislocation?

Answer 45

Clinical, XR should be performed after Rx

Question 46

Rx of knee dislocation?

Answer 46

Reduction; vascular consult for possible revascularisation

Question 47

If there is absent pulses of ABI

Answer 47

if absent pulses or ABI