soft tissue knee injuries

Question 1

how do meniscal tears usually occur

Answer 1

• usually sporting injury in younger patients or getting up from squatting position
• atraumatic spontaneous degenerate tears in old patients

Question 2

symptoms of meniscal tear

Answer 2

pain and tenderness localized to joint line

Question 3

what are the four types of meniscal tears

Answer 3

• longitudinal tears
• radial tears
• bucket handle tear
• parrot beak tear

Question 4

which type of tear wont heal

Answer 4

radial

Question 5

what should you consider for acute traumatic peripheral meniscal tears in young people

Answer 5

arthroscopic meniscal repair

Question 6

when would you consider arthroscopic meniscectomy

Answer 6

for irreparable tears with recurrent pain, effusion or mechanical symptoms which fail to settle

Question 7

what type of tear does an acute locked knee signify

Answer 7

displaced bucket handle meniscal tear

urgent surgery required

Question 8

what causes degenerate tears

Answer 8

meniscus weakens with age and can tear spontaneously

Question 9

what type of stress does MCL resist

Answer 9

valgus stress

Question 10

what type of stress does LCL resist

Answer 10

varus stress

Question 11

what does ACL resist

Answer 11

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

Question 12

what does PCL resist

Answer 12

posterior subluxation of the tibia

Question 13

what are the three grades of knee ligament injuries

Answer 13

grade 1 - sprain - tear some fibres but macroscopic structure intact
grade 2 - partial tear
grade 3 - complete tear

Question 14

what can MCL rupture lead to

Answer 14

valgus instability

Question 15

what can ACL rupture lead to

Answer 15

rotatory instability

Question 16

what can PCL rupture lead to

Answer 16

recurrent hyperextension or instability descending stairs

Question 17

treatment for MCL injury

Answer 17

• brace
• early motion
• physio

Question 18

requirement for ACL rupture stabilization

Answer 18

time and physio

Question 19

when is surgery considered in ACL rupture

Answer 19

rotatory instability not responding to physio

Question 20

how long is the recovery for ACL reconstruction

Answer 20

3/12 to 1 year rehab

Question 21

how does LCL injury usually happen

Answer 21

varus and hyperextension

Question 22

how do PCL ruptures happen

Answer 22

direct blow to anterior tibia or hyperextension injury

Question 23

cause of patellar dislocation

Answer 23

rapid turn or direct blow

Question 24

causes of patellofemoral pain syndrome

Answer 24

• muscle imbalance
• tightness of lateral tissues
• bony malalignment
• flat feet

Question 25

cause of extensor mechanism rupture

Answer 25

fall onto flexed knee with quads contraction - rupture quads or patellar tendon

Question 26

what is osteochondritis dissecans

Answer 26

an area of the surface of the knee loses its blood supply and cartilage +/- bone can fragment off

Question 27

cause of bone bruising/bone marrow oedema

Answer 27

impaction to articular surface leads to microscopic fracture of trabecular bone with bleeding and inflammation

Question 28

cause of loose bodies

Answer 28

- trauma - OCD - joint degeneration

Question 29

what can happen to loose bodies in the joint

Answer 29

they can grow overtime getting nutrition from synovial fluid and may cause painful locking or catching some can stick to synovium or fat pad

Question 30

which bone is commonly misdiagnosed as a loose body

Answer 30

the fabella

Question 31

what do you do when the pain or swelling is worse than examination and x-rays

Answer 31

MRI to look for unusual pathology

Question 31

what do you do when the pain or swelling is worse than examination and x-rays

Answer 31

MRI to look for unusual pathology

Question 32

whats the diagnosis: football injury, twist, pop, haemarthrosis, generalised pain, pain settles after a few days, rotatory instability

Answer 32

ACL rupture

Question 33

diagnosis?: getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain and catching +/- locking

Answer 33

meniscal tear