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30 Cards in this Set
- Front
- Back
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What injury is associated with meniscal cyst development?
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Horizontal cleavage tear of the lateral meniscus
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In which interval can Baker's cysts generally be found?
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Between semimembranosus and and medial gastrocnemius
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What are the two conservative treatment options for Baker's cyst?
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Nonsteroidal anti inflammatory drugs (NSAIDS)
Compression sleeve |
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If conservative treatment fails, what are the next steps?
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MRI to evaluate for associated intraarticular pathology (e.g. meniscal tear
Operative treatment |
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How are discoid menisci classified? What are the three types?
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Watanabe classification
I: Incomplete coverage of lateral tibial plateau II: Complete coverage of lateral tibial plateau III: Wrisberg type |
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How does the posterior attachment differ between the types of discoid menisci?
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Incomplete & complete discoid menisci have intact posterior meniscotibial ligaments
Wrisberg variant has no meniscotibial ligament attachment to posterior horn |
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What is the clinical significance of this difference?
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Incomplete & complete discoid menisci generally do not have abnormal motion and are asymptomatic unless torn
Wrisberg discoid moves abnormally and is often symptomatic even without tear |
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What two radiographic features are suggestive of discoid meniscus?
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Square lateral condyle
Widened lateral joint space |
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What is the MRI appearance of a discoid meniscus?
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Bow-tie appearance on more than two consecutive sagittal images
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What are the two indications for surgery for discoid meniscus?
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Symptomatic tears of the incomplete and complete discoid types
Restoration of meniscal stability to a symptomatic Wrisberg type, even if not torn |
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Does medial or lateral partial meniscectomy lead to earlier degenerative changes?
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Lateral
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Three years after total meniscectomy, what percentage of patients has clinical osteoarthritis?
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20%
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. . .radiographic osteoarthritis?
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70%
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Total meniscectomy decreases the contact area by what amount?
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75%
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What is the "gold standard" approach? What is the suture technique? Why?
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Inside-out
Vertical mattress Highest number of circumferential fibers captured |
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What structure is at risk medially? How can injury be prevented?
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Saphenous nerve
Identify and retract nerve and infrapatellar branch before tying sutures |
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What structure is at risk laterally? How can injury be prevented?
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Peroneal nerve
Prevent by placing sutures anterior to biceps |
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What are the three general criteria for meniscal tears that do not need repair?
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Longitudinal tear<8 mm in length that cannot be displaced >3 mm
Stable partial tear Shallow radial tear<3 mm in depth |
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What are the six general indications for meniscal repair?
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Complete longitudinal tear>10 mm length
Tear within peripheral one third of the meniscus or within 3 to 4mm of meniscocapsular junction Unstable tear that can be displaced by probing Tear without secondary degeneration Tear in an active patient Tear identified during ligament stabilization procedure |
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What four factors have been proven to enhance meniscal repair?
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Trephination
Synovial rasping Fibrin clot Hyaluronic acid |
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Does medial or lateral partial meniscectomy lead to earlier degenerative changes?
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Lateral
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Three years after total meniscectomy, what percentage of patients has clinical osteoarthritis?
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20%
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. . .radiographic osteoarthritis?
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70%
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Total meniscectomy decreases the contact area by what amount?
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75%
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What is the "gold standard" approach? What is the suture technique? Why?
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Inside-out
Vertical mattress Highest number of circumferential fibers captured |
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What structure is at risk medially? How can injury be prevented?
|
Saphenous nerve
Identify and retract nerve and infrapatellar branch before tying sutures |
|
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What structure is at risk laterally? How can injury be prevented?
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Peroneal nerve
Prevent by placing sutures anterior to biceps |
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What are the three general criteria for meniscal tears that do not need repair?
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Longitudinal tear<8 mm in length that cannot be displaced >3 mm
Stable partial tear Shallow radial tear<3 mm in depth |
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What are the six general indications for meniscal repair?
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Complete longitudinal tear>10 mm length
Tear within peripheral one third of the meniscus or within 3 to 4mm of meniscocapsular junction Unstable tear that can be displaced by probing Tear without secondary degeneration Tear in an active patient Tear identified during ligament stabilization procedure |
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What four factors have been proven to enhance meniscal repair?
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Trephination
Synovial rasping Fibrin clot Hyaluronic acid |
