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Sports Injuries Week 3 Lecture - Knee Injuries

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bethdrysdale94's version from 2017-01-12 17:53

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Question Answer
What are the movements of the knee joint?Extension, Flexion, Internal/External rotation, Valgus/Abduction, Varus/Adduction
What makes up the knee?Bones: Femur, Tibia, Fibula, Patella. Ligaments: ACL, PCL, MCL, LCL. Menicus: Medial and Lateral. Cartilage.
What are the common soft tissue injuries of the knee?Meniscus and ACL
What is the function of the ACL and how is it injured?Strong internal knee brace, usually injured during violent twisting and pivoting of the knee joint
What common sports is the ACL injured in?Football, handball, rugby, american football, skiiing.
What are the common symptoms of the ACL injury?Intensive pain, locking of the joint, reduced range of motion, feel or hear popping sound, cannot continue to play, anterior tibial translation, 75% have severe haemarthrosis, immediate swelling
What is the function of the meniscus and how is it injured?Shock absorber, reduces stress applied to articular cartilage. pivoting and twisting motion at the knee joint. locking sensation caused by meniscus jamming into joint when torn
What makes it difficult for the meniscus to heal?There is limited blood supply to the peripheries of it
What does loss of joint motion after meniscus injury require?immediate surgical treatment, usually repair or menisectomy within 2 weeks after swelling has gone.
What did the Oslo sports trauma research centre develop in 2005 for knee injuries?model-based image-matching (MBIM) motion analysis technique. collect videos of injury, scale skeleton of person, conduct MBIM analysis and obtain knee joint kinetics
What % knee injuries are knee-in toe-out?49%
What does the Lachman test look for?Signs of anterior subluxation when knee flexed at 30 degrees and anterior stress applied to tibia. ACL rupture
How do you perform the Anterior Draw Test?Knee flexed at 90 degrees. Anterior stress applied to tibia. ACL injury suggested if anterior subluxation present.
How do you perform the Pivot Shift Test?Patient supine and hip flexed to 30 degrees. Maintain lower leg and ankle at 20 degree internal tibial rotation. Apply valgus force (abduction) and flex the knee to feel for subluxation. ACL injury.
What tests can you use to diagnose ACL rupture? How useful are they?X - ray: Radiography, roentography, fluoroscopy (all not very useful). MRI (useful). Solid black band shows ACL intact. Disrupted ligament appears lighter in colour, may see breakage
What is the McMurray test?Meniscus injury: Flex hip and leg, rotate lower leg. Examine focal joint line tenderness. observe patients reaction, ask patient about tenderness, feel for clicking.
What imaging can be used for meniscus injury?MRI
What is the purpose of partial menisectomy?To preserve uninjured meniscus, repair injured meniscus, remove debris which restricts joint movement
What are the goals for ACL management?Restore stability, motion, muscle function (atrophy after disuse) and return to pre-injury level
How do you surgically reconstruct ACL?Remove torn ACL, Drill tunnels through femur and tibia, pass graft through tunnels, fix with screws.
What graft types can be used to reconstruct ACL?Auto/Allo/Xenograft. Bone-tendon-bone graft from patella tendon. Hamstring tendon
What strengths do the ACL graft types restore ?Bone-tendon-bone = 140% of ACL. Hamstring tendon = 70% of ACL strength.
How does bone-to-tendon healing occur?Progressive mineralisation og the interface tissue occurs. Bone grows into outer tendon and incorporates it. Collagen fibres reestablished - restoration of tendon bone junction.
What modalities can be used to promote bone-to-tendon healing?Cellular level: TGF-beta1, bone morphogenetic proteins-2, mesenchymal stem cells. Biomaterial: demineralised bone matrix, calcium phosphate cement. Biophysical: Ultrasound, shock wave therapy,
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