Sports Injuries

Question 1

Types of Soft tissue structures in Knee joint

Answer 1

1. Extracapsular
2. Intracapsular

Question 2

Extracapsular soft tissue knee structures

Answer 2

Collaterals:
1. Medial collateral ligament (MCL)
2. Lateral collateral ligament (LCL)

Question 3

Types of Intracapsular soft tissue knee structures

Answer 3

Intrasynovial: Menisci
Extrasynovial: Cruciate

Question 4

Names of Menisci

Answer 4

1. Medial meniscus (MM)
2. Lateral meniscus (LM)

Question 5

Names of Cruciate

Answer 5

1. Anterior Cruciate ligament (ACL)
2. Posterior Cruciate ligament (PCL)

Question 6

Note of Cruciate
Just study

Answer 6

MCL: Adherent to MM
LCL: Not adherent to LM (Adherent to fibula)

Question 7

Function of Collaterals

Answer 7

Coronal plane stability

Question 8

What happens to collateral when forceful varus force is given?

Answer 8

LCL tear -> Abduction/Valgus stress test (At 30 deg flexion) -> Lateral sided knee pain

Question 9

What happens to collateral when forceful valgus force is given?

Answer 9

MCL tear -> Abduction/Valgus stress test (At 30 deg flexion) -> Medial sided knee pain

Question 10

Management of Collaterals injury

Answer 10

1. Conservative brace (90%)
2. Surgery (10%)

Question 11

Functions of Menisci

Answer 11

1. Shock absorbers
2. Rotational stabilizers

Question 12

Forces which lead to Menisci injury

Answer 12

1. Torsion/forceful twisting of knee
2. Bucket handle tear (M/C type of injury)
3. MM > LM injury

Question 13

C/F of Menisceal Injury

Answer 13

Delayed onset
1. Knee pain
2. Swelling: Mild to moderate effusion
3. Pathological locking of knee

Question 14

What is Pathological locking of knee?

Answer 14

Incomplete extension
D/t trapping of fragment of menisci between tibial and femoral condyles

Question 15

Investigations of Menisceal injury

Answer 15

1. McMurray’s test
2. Apley’s grinding test
3. Joint line tenderness: Best test

Question 16

What is McMurray’s test?

Answer 16

Menisceal injury
Hyperflexion of knee -> Rotation + force -> Extension of knee (Provokes pain)

Question 17

What is Apley’s grinding test?

Answer 17

Menisceal injury
Prone position -> Grind knee at 90 deg flexion

Question 18

Investigations of Menisceal injury

Answer 18

1. MRI (Sagittal view): IOC
2. Arthroscopy: Gold standard

Question 19

Treatment of Menisceal injury

Answer 19

1. Meniscorrhaphy: Red zone tear (Good blood supply)
2. Meniscectomy: White zone tear

Question 20

Nutrition to meniscus

Answer 20

Peripheral (Red zone): Genicular vessel
Central (White zone): Synovial fluid

Question 21

Function of Cruciate ligaments

Answer 21

Sagittal plane stabilisers

Question 22

ACL injured by

Answer 22

Forceful anterior translocation

Question 23

PCL injured by

Answer 23

Forceful posterior translocation

Question 24

Knee movement prevented by Cruciate ligaments

Answer 24

ACL: Hyperextension
PCL: Hyperflexion

Question 25

Cruciate ligaments prevent translation of tibia

Answer 25

1. ACL: Anteriorly 2. PCL: Posteriorly

Question 26

C/F of Cruciate injury

Answer 26

1. Twisting injury to knee with hemarthrosis 2. Instability to walking 3. Difficulty going downstairs (ACL tear)/Upstairs (PCL tear)

Question 27

Investigations of ACL injury

Answer 27

1. Anterior drawer test: Painful in acute knee 2. Lachmann’s test: Most sensitive/best test 3. Pivot shift test: Most specific

Question 28

What is Anterior drawer test?

Answer 28

90 deg flexion of knee (45 deg hip flexion) -> Anterior translation of tibia

Question 29

What is Lachmann’s test?

Answer 29

20-30 deg flexion of knee -> Anterior translation of tibia

Question 30

Investigations of PCL injury

Answer 30

1. Posterior drawer test 2. Godfrey sag test

Question 31

What is Posterior drawer test?

Answer 31

90 deg flexion of knee -> Posterior translation/sag of tibia

Question 32

What is Godfrey sag test?

Answer 32

90 deg flexion at hip and knee -> Posterior translation d/t gravity

Question 33

Investigations of CL injury

Answer 33

1. MRI (Sagittal view): IOC 2. Arthroscopy: Gold standard

Question 34

Treatment of CL injury

Answer 34

Reconstruction with graft (Gracilis/semitendinosus)

Question 35

Unhappy/Painful/O’ Donoghue triad of knee

Answer 35

ACL tear + MCL tear + MM injury

Question 36

Hotchkiss Terrible triad

Answer 36

1. Elbow dislocation 2. Radial head fracture 3. Coronoid process fracture