Knee Ii

Front 1

a. What two findings are indicative of a lateral patellar dislocation on an MRI?

Back 1

i. Torn medial patellar ligament
ii. Bruise of lateral epicondyle

Front 2

b. What are the risk factors for patellar dislocation?

Back 2

i. Female
ii. Family hx
iii. Prior hx
iv. Degree of trauma

Front 3

c. What is the function of the medial patellofemoral ligament?

Back 3

i. Primary stabilizer of lateral displacement (50-60%)
ii. First 20-30 degrees of flexion-- stabilizer

Front 4

d. What muscle weakness can increase the incidence of MPFL rupture?

Back 4

i. VMO dysplasia

Front 5

e. What is the non-operative treatment of patellar dislocation?

Back 5

i. Pelvifemoral rehab
ii. Core strengthening
iii. VMO strengthening
iv. Orthoses
v. Taping

Front 6

f. What is the rate or redislocation in MPFL rupture?

Back 6

i. 15-44%

Front 7

g. What is the gold standard for surgical treatment of MPFL rupture?

Back 7

i. Reconstruction

Front 8

h. When is surgery indicated in MPFL rupture?

Back 8

i. Hx of 2 documented patellar dislocations
ii. Excessive lateral mobility on PE

Front 9

i. What tissues are used for a graft it MPCL reconstruction?

Back 9

i. Tibialis anterior (allo)
ii. Hamstring (auto)

Front 10

j. What is the recovery time for an MPFL reconstruction?

Back 10

i. 3 months to get back to sports

Front 11

k. What is the recovery time for an ACL rupture?

Back 11

i. 6 months

Front 12

l. What is the redislocation rate after an MPFL reconstruction?

Back 12

i. 1%-2%

Front 13

a. What is a Segond fracture?

Back 13

i. Avulsion fracture of new anterolateral ligament of knee
ii. Associated with ACL tear

Front 14

b. What are the symptoms of a meniscus tear?

Back 14

i. Unable to continue (sport)
ii. Clicking and pain on medial side of knee

Front 15

c. What is a meniscus tear?

Back 15

i. Disruption of meniscus integrity

Front 16

d. What makes up the menisci?

Back 16

i. Fibrocartilage

Front 17

e. What is a bucket-handle tear of the meniscus?

Back 17

i. Vertical longitudinal tear
ii. Becomes displaced into intercondylar notch of femur
iii. Leg can’t extend fully, can flex a little
iv. EMERGENT PROBLEM

Front 18

f. What can cause a meniscal tear?

Back 18

i. Twisting
ii. Stepping wrong
iii. Antecedent minor injury

Front 19

g. How do you dx a meniscal tear?

Back 19

i. Clinically
ii. MRI to evaluate character of tear
iii. **Joint line pain
iv. McMurray test

Front 20

h. How many meniscal tear patients develop radiographic arthritis in 10-20 years after surgery?

Back 20

i. 50%

Front 21

i. What are some factors that can make a meniscus tear worse?

Back 21

i. Women
ii. Obesity

Front 22

a. What does A mean in a Lachman test?

Back 22

i. Good endpoint

Front 23

b. What does B mean in a Lachman test?

Back 23

i. No solid endpoint

Front 24

c. What Lachman grade indicates an ACL tear?

Back 24

i. Grade II

Front 25

d. What is indicative of an ACL tear on an MRI?

Back 25

i. Bone bruise of lateral femoral condyle

Front 26

e. How long is the recovery for an ACL tear?

Back 26

i. 4-6 months
ii. Can be seen in office up to a year later

Front 27

f. What can cause an ACL tear?

Back 27

i. Twist on planted foot
ii. Fall from height

Front 28

g. What are the symptoms of an ACL tear?

Back 28

i. Joint effusion
ii. Lachman grade II
iii. + pivot shift

Front 29

h. What happens to the ACL bundles during extension?

Back 29

i. Anteriomedial-- loosens
ii. Posteromedial-- tightens

Front 30

i. What happens to the ACL bundles during flexion?

Back 30

i. Anteromedial tightens
ii. Posterolateral loosens

Front 31

j. At what degree is the anteromedial bundle of the ACL tensioned during a repair?

Back 31

i. 30 degrees

Front 32

k. What is crepitation?

Back 32

i. Crackling or grinding in knee

Front 33

l. What % of adults develop osteoarthritis 10 years after an ACL reconstruction?

Back 33

i. 50%

Front 34

a. What are the elements of management of osteoarthritis?

Back 34

i. Weight management
ii. Self management education
iii. Physical activity
iv. Injury prevention

Front 35

Back 35

ACL tear MRI

Front 36

Back 36

ACL tear MRI

Front 37

Back 37

Meniscal tear

Front 38

Back 38

Patellar dislocation MRI

Front 39

b. What should a person with a BMI >25 do to reduce their risk of OA?

Back 39

i. Lose 5% BW

Front 40

c. What are some activities you can do for non-operative management of OA?

Back 40

i. Education
ii. Low impact aerobics
iii. Maintain flexibility
iv. Quad strengthening
v. Patellar taping

Front 41

d. What medications can you take for OA?

Back 41

i. NSAIDs and/or acetaminophen
ii. Don’t rx glucosamine and chondroitin

Front 42

e. What medications should someone with GI problems take for OA?

Back 42

i. Acetaminophen
ii. Topical NSAIDs
iii. COX-2 inhibitors

Front 43

f. What is the use of steroid injections in the tx of OA?

Back 43

i. Provide short-term relief

Front 44

g. What treatments are contraindicated for OA?

Back 44

i. Hyaluronate products
ii. Needle lavage
iii. Arthroscopy for primary dx of DJD

Front 45

h. What will a radiograph show in OA?

Back 45

i. Loss of joint space
ii. Subchondral cysts
iii. Sclerosis
iv. Osteophyte formation

Front 46

i. What is the technique behind marrow stimulation?

Back 46

i. Microfracture

Front 47

j. What is the last resort for OA tx?

Back 47

i. Knee arthroplasty