Soft Tissue Knee Injuries Flashcards Preview

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Flashcards in Soft Tissue Knee Injuries Deck (45):
1

What is the purpose of the menisci?

to distribute load from convex femoral condyles to relatively flat tibial articular surfaces

2

What are the differences between the lateral and medial menisci?

medial is fixed whislt the lateral meniscus is more mobile; medial is under a greater amount of shear pressure

3

Why does the knee pivot on the medial meniscus through flexion and extension?

due to shpae and soft tissues the tibia interally rotates on flexion and externally rotates on extension

4

What type of stress does the MCL resist?

valgus stress

5

what type of stress does the LCL resist?

varus stress

6

What does the ACL resist?

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

7

What does the PCL resist?

posterior subluxation of the tibia and hyperextension of the knee

8

Why does the MCL heal well?

has a very good blood supply

9

What type of instability does an MACL rupture lead to?

valgus instability

10

What type of instability does an ACL rupture lead to?

rotatory instability

11

What type of instability does a PCL rupture lead to?

recurrent hyperextension or instability descending stairs

12

What causes a meniscal tear in younger patients?

a sporting injury or getting up from squatting positions

13

What can cause a medinscal tear in older patients?

atraumatic spontaneous degenrate tears

14

How are meniscal tears investigated?

MRI

15

Which meniscus is more likely to be torn?

medial 10x as common

16

Why is there limited healing potential with meniscal tears?

only the peripheral third has a blood supply

17

When should a menisectomy be considered?

mechanical symptoms- painful catching or locking or irreparable tear os failed meniscal repair

18

How should the menisci appear on MRI?

like a black boe-tie; any white in the bows indicates a tear

19

What does an acute locked knee signify?

a significant displaed bucket handle meniscal tear

20

What would happen if the knee remains locked for an extended period of time

Patient may develop fixed flexion defomrity

21

What is the link between a degenerative meniscal tear and OA?

probably represents the first stage of OA

22

What are hte grades in a knee ligament injury?

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

23

What are the treatments for an MCL injury?

brace; early motion; physi

24

How are ACL treated?

repair doesnt work- reconstruction only- autograft using patellar tendon or hamstrings;PT

25

What is the rule of thirds in ACL rupture

a third can compensate and are able to funcion well; a third can avoid instability by avoiding certain activites and a third do not compensate and have frequent instability

26

What is the role of ACL reconstruction?

to fix rotary instaibilty not responding to physio- does not treat pain or prevent arthritis

27

How is the LCL injured?

by varus and hyperextension

28

What nerve is commonly damaged in an LCL tinjury?

the common fibular nerve

29

What is the problem with an LCL injury?

it doesnt heal

30

What causes a PCL rupture?

a direct blow to anterior tibia or hyperextension injury

31

What are the symptoms of PCL ruptre?

popliteal knee pain and bruising

32

What type of instability results with PCL rupture?

recurrent hyperextension or feeling unstable when going downstairs

33

What are the common complications associated with knee disloactions?

popliteal artery injury (tear; intima tear and thrombosis); nerve injury- common fibular nerve; compartment syndrom

34

What is the managment fro a knee dislaction?

emergency reduction and recheck of neurovascular status; multi-ligament reconstruction

35

What causes a patellar dislocation?

rapid turn or direct blow

36

Who gets patellar dislocation?

females; adolescents; ligamentous laxity; valgus knee

37

How many patients with patellar disolcation get recurrent dislocation?

10%

38

What type of trauma causes an extensor mechanism rupture?

a fall onto flexed knee with quads contraction

39

What predisposes to an extensor mechanism rupture?

previous tendonitis; steroids; chronic renal failure; ciprofloxacin

40

What is seen on exam with an extensor mechanism rupture?

unable to straight leg raise; palpable gap

41

What is the treatment for an extensor mechanism rupture?

surgical repair

42

Haemarthrosis is seen with what injuries?

ACL rupture or fracture

43

What causes pain on the joint line?

meniscal/chondral pain

44

What is the most likely cause of this presentation? twist, pop, haemarthosis; generalised pain; pain settles after a few days; rotary instability

ACL rupture

45

what is the most likely cause of this presentation?- getting up from squatting, sudden sharp pain medial joint line, effusion, recurrent medial pain and catching +/- locking

meniscal tear