Meniscus injuries

Question 1

what are the most common types of meniscal tears?

Answer 1

posterior horn tears

Question 2

meniscal injuries are more common in…

Answer 2

men

Question 3

what physical exam signs will you see?

Answer 3

tenderness anterior and posterior to MCL

Question 4

what are surgical indications for a medial meniscus?

Answer 4

swelling and locking

Question 5

where does lateral meniscus pain occur?

Answer 5

lateral pain anterior to the LCL

associated with meniscal cyst

Question 6

which causes a longer return to play time? medial or lateral meniscus injury?
what is this due to?

Answer 6

lateral meniscus injury due to persistent postop effusion

Question 7

name this procedure: remove tear, balance the rim, remove debride, perserving remaining meniscus

Answer 7

partial meniscectomy

Question 8

what are the indications for a meniscal transplant?

Answer 8

meniscal symptoms
no full thickness chondral defect >15 mm
stable ligaments
normal axial alignment

Question 9

what is graft size determined by for a meniscal transplant?

Answer 9

MRI/Pre-op X-ray

Question 10

a meniscal transplant is a good idea for pts with…

Answer 10

> 2/3 meniscus removed & progressive varus deformity + pain
young

Question 11

when does pain at the menisci occur?

Answer 11

forced hyperextension

maximum flexion

Question 12

what is an activity lim/partiicpation restriction measure that can be performed?

Answer 12

single legged hop testing

Question 13

what are important post-operative rehab measures taken to protect a repair/graft?

Answer 13

avoid end range & WB flexion

avoid resisted hamstring exercises

Question 14

how long do you wear a brace for?

Answer 14

4 weeks

Question 15

what WB status immediate postop

Answer 15

PWB with knee locked in extension

Question 16

WB status 1 week postop

Answer 16

WBAT with brace unlocked

Question 17

when should you discontinue the use of crutches after surgery?

Answer 17

full extension w/o lag
>100 knee flexion
walk w/o bent knee
no/minimal swelling

Question 18

how much knee flexion do you have at 4 weeks for repair and 6 weeks for transplant?

Answer 18

90 degrees knee flexion

Question 19

by 8-10 weeks, how much flexion should you have?

Answer 19

within 10 degrees of opposite side

Question 20

Lag with >5 degrees at 1 week means

Answer 20

high intensity NMES

Question 21

how many degrees can you flex for WB exercises at 4-6 weeks?

Answer 21

0-45 degrees

Question 22

how many degrees can you flex for WB exercises at 6-8 weeks?

Answer 22

75 degrees

Question 23

examples of exercises?

Answer 23

Quad sets, SLR, NWB

no loaded squats

Question 24

when is return to strenuous sports not recommended?

Answer 24

meniscus transplant