Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

MSK- Pelvis and Lower Limb > Knee- Soft Tissue Injuries > Flashcards

Knee- Soft Tissue Injuries Flashcards

(84 cards)

Start Studying
1
Q

Where do the menisci have a blood supply? What is the significance of this?

A

Only at their periphery- tears aren’t particularly painful and also won’t heal well

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Knees pivot through what compartment during flexion and extension? What is the significance of this (regarding meniscal tears)?

A

Medial compartment, medial meniscus is more likely to tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What way does the tibia rotate on flexion?

A

Internally

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which has a better blood supply, MCL or LCL?

A

MCL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What will be seen on clinical examination of a patient with a meniscal tear?

A

Effusion (following day), joint line tenderness, + Steinmann’s test (tibial rotation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is a longitudinal meniscal tear?

A

Near the periphery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a bucket handle meniscal tear?

A

An extensive longitudinal tear, causing locking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What type of meniscal tear will cause the knee to click painfully?

A

Parrot beak

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Why are medial meniscal tears more common?

A

The medial meniscus is more fixed and less mobile, force from pivoting movements is centred there

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What will a locked knee in a displaced bucket handle meniscal tear present like?

A

15 degree springy block to extension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the mechanism of injury for a meniscal tear?

A

Usually as a sporting injury in young patients, or getting up from a squatting position (twisting force on a loaded knee)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Can meniscal tears occur spontaneously?

A

Yes, degenerate tears in older patients can (>40)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Rupture of what ligament is closely associated with meniscal tears?

A

ACL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the investigation of choice for a meniscal tear?

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What features imply worse healing of a meniscal tear?

A

Radial tears, aged > 25, increased time from injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What type of meniscal tears should be considered for repair?

A

Reasonably fresh bucket handle tears involving the outer 1/33rd of the meniscus in a younger patient

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What happens in a meniscal repair?

A

The meniscus is sutured to its bed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the failure rate of meniscal tear repairs?

A

25%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

When should an arthroscopic meniscectomy be considered?

A

In patients who still have pain or mechanical problems after 3 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

If meniscal repair surgery fails, what happens next?

A

Remove it (you only get one shot at repair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

An acute locked knee signifies what?

A

Displaced bucket handle meniscal tear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How soon must arthroscopic repair be done following a bucket handle meniscal tear?

A

6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

If the knee remains locked following a meniscal tear, what may this result in?

A

Fixed flexion deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What do degenerate meniscal tears signify?

A

The first stage of knee OA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Will the Steinmann's test be positive in degenerate meniscal tears? What other signs and symptoms will be associated with this?
No, Steinmann's will be negative. There will be signs and symptoms of OA
26
What should you not treat degenerate meniscal tears with?
Arthroscopy
27
What may help control the symptoms in the early period of a degenerate meniscal tear?
Steroid injections
28
What is a grade 1 ligament injury?
Sprain- tearing of some fibres but macroscopically intact
29
What is a grade 2 ligament injury?
Partial tear, some fascicles disrupted
30
What is a grade 3 ligament injury?
Complete tear
31
Does the MCL heal well?
Yes
32
When would the MCL not heal well?
If associated with ACL or PCL rupture
33
How do you treat MCL rupture?
Bracing, early motion and physio
34
How long can it take for pain from an MCL rupture to settle?
Several months
35
What treatment can be used in chronic MCL instability?
Tightening or reconstruction with a tendon graft
36
Where may patients with an MCL rupture have laxity and pain?
On valgus stress, over the origin/insertion of the MCL
37
Do LCL ruptures happen alone?
Not often, they are usually part of multiple ligament injuries
38
What motions can cause LCL rupture?
Hyperextension or varus
39
Does the LCL heal well? What problems can you be left with?
It does not heal well- can be left with varus and rotatory instability (especially external)
40
Excessive stretch from varus/hyperextension in LCL ruptures can cause what nerve injury? What can this result in?
Damage to the common fibular nerve which can cause a permanent foot drop
41
LCL rupture is often found in combination with what other ligament ruptures?
PCL/ACL
42
If found within 2 weeks, how is an LCL rupture treated? What happens if it presents later than this?
Urgent repair. If late then reconstruction.
43
The ACL is the main stabiliser against what movement?
Internal rotation of the tibia
44
What is the principle complaint of ACL deficiency?
Rotatory instability which gives way on turning
45
How are ACL ruptures usually acquired?
Sports injury- football/rugby/skiing turning the upper body laterally on a planted foot
46
How are ACL ruptures treated?
Reconstruction
47
What will examination of an ACL rupture reveal?
Knee swelling with excessive anterior translation of the tibia on anterior drawer test and Lachmann's test
48
To give stability, the ACL can be stuck to which other ligament?
PCL
49
Recovery from ACL rupture comes under the rule of thirds, what is this?
1/3rd compensate and function well, 1/3rd avoid instability by avoiding certain movements, 1/3rd have frequent instability
50
When should surgery be considered for an ACL rupture?
Rotatory instability, no response to physio, protect a meniscal repair, return to professional sport, multi-ligament damage
51
After surgery for ACL repair, what is the recovery like?
Can be up to 1 year of intense rehab, some never get back to sport, often have arthritis within 10 years
52
What is the mechanism of injury of a PCL rupture?
Direct blow to the anterior tibia or hyperextension
53
How will a PCL rupture occur?
Popliteal pain and bruising
54
Is isolated PCL rupture common?
No
55
When is reconstruction used for PCL rupture?
If part of multi-ligament injury or if severe instability
56
What can PCL ruptures cause long term?
Instability, recurrent hyperextension, feeling unstable going downstairs
57
How would you describe a knee dislocation?
High impact injury with a high incidence of complications
58
What are some complications of knee dislocation?
Popliteal artery injury, nerve injury, compartment syndrome
59
What is the treatment for a knee dislocation?
Emergency reduction with possible external fixation, multiple ligament reconstruction
60
The patella will almost always dislocate in what direction?
Laterally
61
When the patella dislocates, what ligament is torn?
Medial patellofemoral ligament
62
As well as the torn ligament, what else may happen alongside patellar dislocations?
Osteochondral fracture (small opacification on x-ray)
63
What movements can cause a patellar dislocation?
Rapid turn or direct blow
64
What are some factors which predispose to patellar dislocations?
Female, adolescent, ligamentous laxity, values knees, high patella, femoral neck ante version, shallow trochlear groove
65
What % of people will have a recurrent patellar dislocation?
10%
66
What is the treatment for recurrent patellar dislocations?
Surgical stabilisation
67
What occurs following a patellar dislocation which causes a characteristic x-ray appearance?
Lipo-haemarthrosis
68
After a patellar dislocation, physiotherapy to strengthen which muscles may help?
Quadriceps
69
What components make up the extensor mechanism of the knee?
Tibial tuberosity, patellar tendon, patella, quadriceps tendon, quadriceps muscles
70
What is the mechanism of injury for an extensor mechanism rupture?
Fall onto a flexed knee with quadriceps contracted
71
What are some risk factors for extensor mechanism rupture?
Previous tendonitis (quinolones), steroids, chronic renal failure, diabetic, RA
72
What are the clinical signs of an extensor mechanism rupture?
Unable to straight leg raise and a palpable gap
73
What treatment should be avoided in an extensor mechanism rupture?
Steroid injections
74
At what ages are a) patellar tendon ruptures and b) quadriceps tendon ruptures more common?
a) < 40 b) > 40
75
On an x-ray, where will the patella lie in a) patellar tendon ruptures and b) quadriceps tendon ruptures?
a) high lying patella b) low lying patella
76
If a patient is obese and there is no palpable gap, what test can be used to assess for extensor mechanism rupture?
Ultrasound
77
What is the treatment for an extensor mechanism rupture?
Tendon to tendon repair or reattachment of the tendon to the patella
78
If there is a loose mechanical fragment in a meniscal tear, how may this present?
Feeling like the knee is going to give way
79
Is it possible to have a meniscal tear without locking?
Yes
80
Is pseudo-locking a sign of meniscal injury?
No
81
How soon after an ACL rupture will a haemarthrosis develop?
An hour
82
Valgus stress injuries usually tear which ligament? What other injuries may occur?
MCL - can also cause ACL damage and lateral tibial plateau fracture
83
A varus stress injury will usually damage what ligament? What other ligament may or may not be involved?
LCL +/- PCL
84
If a knee injury is though to be significant, what is the best test to do?
MRI

MSK- Pelvis and Lower Limb (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions