Soft Tissue Knee Injuries

Question 1

Radial fibres of the menisci can resist what?

Answer 1

Tears

Question 2

What part of the meniscus has a blood supply

Answer 2

The outer third only - most is avascular

Question 3

What is one of the main differences between the lateral and medial menisci?

Answer 3

The lateral is flexible and the medial is fixed

Question 4

What do the knees pivot on

Answer 4

The medial compartment through flexion and extension

Question 5

Why are medial meniscus tears more common than lateral?

Answer 5

It is under a greater amount of shear stress

Question 6

MCL resists what type of stress

Answer 6

Valgus

Question 7

LCL resists what type of stress

Answer 7

Varus

Question 8

What does the ACL resist

Answer 8

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

Question 9

What does the PCL resist

Answer 9

Posterior subluxation of the tibia i.e. anterior sublucation of the femur and hyperextension of the knee

Question 10

Why do we usually expect the medial collateral ligament to heal

Answer 10

It has a great blood supply

Question 11

Where does the lateral ligament run form and to where

Answer 11

From the lateral epicondyle to the fibular head

Question 12

A MCL rupture may lead to what

Answer 12

Valgus instability

Question 13

What might an ACL rupture lead to

Answer 13

Rotatory instability

Question 14

What might a PCL rupture lead to

Answer 14

Recurrent hyperextension or instability descending the stairs

Question 15

Multiligament injuries often require what

Answer 15

Surgery

Question 16

Why will a radial tear not heal

Answer 16

Due to the lack of blood supply

Question 17

What do Bucket- Handle tears cause

Answer 17

Locking of the knee

Question 18

Who are at risk of having a meniscal tear

Answer 18

Young through sporting injuries or getting up form a squatting position.
Atraumatic spontaneous degenerate tears in older patients

Question 19

50% of ACL ruptures also have what

Answer 19

A meniscal tear

Question 20

What is the investigation of choice for knee ligaments

Answer 20

MRI

Question 21

What is the point in operating on a meniscal tear when there is a 40% failure rate

Answer 21

You can still preserve the cartilage

Question 22

What should be considered in a patient with mechanical symptoms with an irreparable tear or failed meniscal repair

Answer 22

Arthropscopic menisectomy

Question 23

What does an acute locked knee signify

Answer 23

Displaced bucket handle meniscal tear

Question 24

What is required for a Displaced bucket handle meniscal tear

Answer 24

Urgent Surgery

Question 25

What is meant by a grade 1 knee ligament injury

Answer 25

Sprain - tear some fibres but macroscopic structure intact

Question 26

What is meant by a grade 2 knee ligament injury

Answer 26

Partial tear - some fascicles disrupted

Question 27

What is meant by a grade 3 knee ligament injury

Answer 27

Complete tear

Question 28

What is the management for an MCL injury

Answer 28

Brace, early motion and physio

Question 29

What ligament is the main stabiliser against Internal rotation of tibia

Answer 29

ACL

Question 30

What can be done to help an ACL rupture

Answer 30

reconstruction only - autograft, allograft or donor tendon

Question 31

What can an LCL cause

Answer 31

Varus and rotatory instability

Question 32

If the LCL is completely ruptured what is required

Answer 32

Urgent repair

Question 33

An isolated PCL rupture is common. True or False

Answer 33

False, it is rare (i.e. with another injury)

Question 34

What are some of the complications of a knee dislocation

Answer 34

Popliteal artery injury Nerve injury Compartment syndrome

Question 35

Patellar dislocation is more common in men, True or false

Answer 35

False - more common in women

Question 36

what other groups are at an increased risk of a patellar dislocation

Answer 36

Adolescents Ligamentous laxity Valgus knee torsinal abnormalities

Question 37

What is the common presentation for an extensor mechanism rupture

Answer 37

Fall onto flexed knee with quads contraction Unable to straight leg raise Palpable gap

Question 38

What does an extensor mechanism rupture require

Answer 38

Surgical repair

Question 39

Twisting results in

Answer 39

ACL or meniscal injury

Question 40

If there is a haemarthrosis, what does this indicate

Answer 40

ACL or fracture

Question 41

If there is effusion, what does this indicate

Answer 41

Meniscal or chondral injury