knee injuries - Passmed

Question 1

what causes damage to Anterior cruciate ligament, and what is the signs of it

Answer 1

• Sport injury
• Mechanism: high twisting force applied to a bent knee
• Typically presents with: loud crack, pain and RAPID joint swelling (haemoarthrosis)
• Poor healing
• Management: intense physiotherapy or surgery
• Anterior drawer test and Lachman test may be positive if damaged

Question 2

what causes damage to posterior cruciate ligament, and what is the signs of it

Answer 2

dashboard injuries]
Mechanism: hyperextension injuries
Tibia lies back on the femur
Paradoxical anterior draw test

Question 3

what causes damage to medial collateral ligament, and what is the signs of it

Answer 3

skiing, valgus stress
abnormal passive abduction of the knee
Knee unstable when put into valgus position

Question 4

what causes damage to lateral collateral ligament, and what is the signs of it

Answer 4

isolated injury uncommon

Question 5

what causes damage to menisci and what is the signs of it

Answer 5

twisting injury
Delayed knee swelling
Joint locking (Patient may develop skills to ‘unlock’ the knee
Recurrent episodes of pain and effusions are common, often following minor trauma

Question 6

summarise chondromalacial paellae

Answer 6

Teenage girls, following an injury to knee e.g. Dislocation patella
Typical history of pain on going downstairs or at rest
Tenderness, quadriceps wasting

Question 7

summarise dislocation of patella

Answer 7

Traumatic primary event,
* direct trauma
* severe contraction of quadriceps with knee stretched in valgus and external rotation

RFs:
* Genu valgum,
* tibial torsion
* high riding patella

Ix
* Skyline x-ray views of patella
An osteochondral fracture is present in 5%
The condition has a 20% recurrence rate

Question 8

2 types of fractured patella

Answer 8

i. Direct blow to patella causing undisplaced fragments
ii. Avulsion fracture

Question 9

summarise tibial plateau fracture

Answer 9

• elderly, or sig trauma
• Mechanism: knee forced into valgus or varus, but the knee fractures before the ligaments rupture
• Varus injury affects medial plateau
• valgus injury -> lateral plateau depressed fracture occurs
  Classified using the Schatzker system