Lecture 5 Flashcards Preview

P-2 Ortho 3 > Lecture 5 > Flashcards

Flashcards in Lecture 5 Deck (86)
Loading flashcards...
1

What is the MC knee injury in service members?

Meniscal tears are 10x more common

2

Which meniscus is most commonly torn?

Medial meniscus

3

Medial meniscus shape and what is it attached to?

It is semilunar and adherent to MCL

4

Shape and location of the lateral meniscus?

Circular
Covers more of the tibia

5

What is the purpose of a meniscus?

Distributes the load of the joint via circumferential or hoop stress

6

How much does lateral meniscus decrease compartment loads by>?

70%

7

Medial meniscus decreases compartment loads by___?

50%

8

Common tears of meniscus?

Vertical longitudinal (moon in the middle)

Vertical radial (a cut)

Horizontal (wear on the inside of the c)

Oblique (oblique cut)

Complex/degenerative (shit show)

Slide 8

9

What is the effect of a meniscal tear?

It disrupts the mechanics of the knee, leading to degenerative arthritis

10

Blood supply in meniscuses?

The more peripheral the higher the blood supply

The higher the blood supply the higher the chance of of healing

11

MOA for meniscus tear?

Usually pivot or twist

12

Meniscus warning signs

Joint line tenderness of medial or lateral side of knee

Pains worsens w twisting or squatting

Mechanical symptoms (locking, catching and popping)

Effusion >12hrs (slow leak)

13

PE for meniscal tear?

Joint line tenderness

Decreased ROM (esp w locked knee)

14

Special tests for meniscus tear?

McMurrays
Thessaly
Apley’s

15

Pt has a displaced “bucket handle” meniscal tear?

Surgery ASAP

16

What do radiographs show?

Eval for loose bodies/bone fragments

17

What grades of meniscus tear are visible on arthroscopy?

III and IV

You’re getting surgery

18

You get a meniscus tear and it gets fixed (or doesnt) what do you win?

Osteoarthritis will develop

19

Who should not get surgery?

Conservitavie management for:
- 40+ w pain but no mechanical symptoms
- degenerative tears and/or middle 1/3 (avascular)

20

Who should get surgery?

Young population
Tears between 1 and 4cm
Vertical tear
Red-red tears
Meniscal root tear
Failure of nonopp
Bucket handle/locked knee

21

We decide not to get surgery how do we treat your meniscal tear?

The same as any other musculoskeletal inj

Acute Rehab
Subacute rehab
Bracing
Back to life

22

96% of the time what are the surgeons doing for meniscus tears?

Debride

Only 4% repair

(Civilians)

23

How does the military handle surgery for meniscal tears?

The military does many more repairs than the civilian sector does

24

What meniscus tears get referred?

Trauma, mechanical symptoms or instability

Failed non-opp

All bucket handle tears

Young people

25

What is an OCD?

Osteochondritis dissecans : osteonecrosis of subchondral bone

Usually occurs in the knee but not always

26

MC location for OCD?

Posterolateral side of the medial femoral condyle

27

What causes OCD?

Repetitive small stress to the subchondral bone that disrupts the blood supply to an area of bone

Osteonecrotic bone separates

Shear forces fracture the articular surface

28

What happens to the osteonecrotic fragment once it breaks free?

It can become a loose body in the joint

29

Clinical presentation of OCD?

Gradual onset of knee pain

Knee effusion and catching or locking symptoms

30

MC site for OCD?

Medial femoral condyle, palpated with the knee flexed at 90*