Knee soft tissue injuries

Question 1

what part of knee will increased weight affect the most

Answer 1

patella femoral joint

Question 2

what causes pseudo locking

Answer 2

lack of synovial fluid after a prolonged sitting

Question 3

who are ACL tears more common in

Answer 3

women

Question 4

what can predispose to a extensor mechanism rupture

Answer 4

previous tendonitis
steroids
chronic renal failure (ciprofloxacin)

Question 5

what are the signs of an extensor mechanism rupture

Answer 5

unable to straight leg raise,

palpable gap

Question 6

what is the treatment for an extensor mechanism rupture

Answer 6

requires surgical repair

Question 7

does the meniscus have innervation

Answer 7

peripheral 1/3rd does

Question 8

what tears of the meniscus can be ignored

Answer 8

radial

Question 9

how many ACL tears have meniscal tears too

Answer 9

50%

Question 10

will radial meniscal tears heal

Answer 10

no

Question 11

what can you consider in acute peripheral menisci tears

Answer 11

arthroscopic repair

Question 12

when is a menisectomy done

Answer 12

mechanical symptoms, irreparable tears, failed meniscal repairs

Question 13

what is a degenerative tear often the first stage of

Answer 13

OA

Question 14

what does the ACL resist

Answer 14

anterior subluxation of the tibia and internal rotation of the tibia in extension

Question 15

what does the PCL resist

Answer 15

posterior subluxation of the tibia and hyperextension of the knee

Question 16

what might ACL rupture lead to

Answer 16

rotator instability

Question 17

what might PCL rupture lead to

Answer 17

recurrent hyperextension or instability descending stairs

Question 18

what rupture causes haemoarthrosis

Answer 18

ACL

Question 19

what is bone bruising

Answer 19

bleeding inside the bone

Question 20

what is the treatment for an MCL rupture

Answer 20

usually heals well, brace, early motion, physio, pain takes several months to heal, rarerly surgery

Question 21

what is the main stabiliser against internal rotation of the tibia

Answer 21

ACL

Question 22

does ACL surgical repair work

Answer 22

no- has to be reconstruction (autograft- hamstring or patellar tendon) (allograft- achilles)

Question 23

what can stabilise ACL deficient knees

Answer 23

physio. if not responding to physio consider surgery

Question 24

does the LCL heal

Answer 24

no

Question 25

what artery can be affected in a knee dislocation

Answer 25

popliteal

Question 26

what is affected in a twisting injury

Answer 26

ACL/ meniscal

Question 27

what fall causes an extensor mechanism rupture

Answer 27

fall onto flexed knee with quads contraction

Question 28

what injuries can cause an extensor mechanism rupture

Answer 28

rectus femoris tear quadriceps tendon or patellar tendon rupture patellar fracture

Question 29

what are the roles of the menisci

Answer 29

distribute load, | make medial plateau more concave

Question 30

which menisci is more likely to tear

Answer 30

medial as more fixed than lateral, also under more shear stress

Question 31

what do 50% of ACL ruptures have

Answer 31

meniscal tear

Question 32

will radial tears heal

Answer 32

no

Question 33

how many arthroscopic repairs of acute peripheral menisci tears fail

Answer 33

40%

Question 34

what does an acutely locked knee signify

Answer 34

displaced bucket handle meniscal tear

Question 35

what is the treatment for a meniscal tear causing locked knee

Answer 35

urgent surgery, arthroscopic repair/ menisectomy

Question 36

what does the MCL resist

Answer 36

valgus stress

Question 37

what does the LCL resist

Answer 37

varus stress

Question 38

what might a MCL rupture lead to

Answer 38

valgus instability

Question 39

what is the rule of thirds of ACL ruptures

Answer 39

1/3rd compensate and can function well 1/3rd avoid instability by avoiding certain activities 1/3rd do not compensate, have frequent instabilities/ cant get back into high impact sport

Question 40

how many ACL ruptures end up having reconstruction

Answer 40

40%

Question 41

when is surgery used in ACL tears

Answer 41

when rotator instability not responding to physio professional sport/ high demand job adolescent or young adult- keen on sport

Question 42

what does ACL reconstruction not help

Answer 42

pain and prevention of arthritis

Question 43

what causes an LCL injury

Answer 43

varus and hyperextension

Question 44

what nerve can be affected in a LCL injury

Answer 44

common peroneal nerve

Question 45

what is the treatment for a complete LCL rupture

Answer 45

urgent repair (within 2-3 weeks)

Question 46

what causes a PCL injury

Answer 46

direct blow to anterior tibia/ hyperextension

Question 47

what is often involved in a knee dislocation

Answer 47

often high energy injuries; - popliteal artery injury (tear, intimal tear and thrombosis) - nerve injury (common peroneal nerve) - compartment syndrome

Question 48

what is the treatment for a knee dislocation

Answer 48

``` emergency reduction recheck neurovascular status - poss vascular surgery maybe temporary stabilisation maybe multiligament reconstruction ```

Question 49

what causes a patella dislocation

Answer 49

rapid turn or direct blow

Question 50

why gets patella dislocations

Answer 50

females more, adolescents, ligamentous laxity, valgus knee, torsional abnormalities

Question 51

twisting injuries think

Answer 51

ACL or meniscal

Question 52

getting up from squatting injury

Answer 52

meniscal

Question 53

haemarthrosis think

Answer 53

ACL or fracture

Question 54

effusion think

Answer 54

meniscal or chondral injury

Question 55

pain in joint line think

Answer 55

meniscal/ chondral

Question 56

Football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability =?

Answer 56

ACL rupture

Question 57

Getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain & catching +/- locking = ?

Answer 57

meniscal tear