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LE Ortho

General Knee Facts

Three Functions of Meniscus 1. Increase stability and congruence 2. Load distribution and transmission 3. Shock absorption
Name the attachments for the medial meniscus Semimembranosus and MCL
Which region of the meniscus is vascular? avascular? Outer 1/3 is the RED ZONE (vascular) Inner 2/3 is the WHITE ZONE (avascular)
Movement of the meniscus in flex/ext is determined by the __________ Movement of the meniscus in rotation is determined by the _________. Flex/Ext: movement in direction of tibial plateau Rotation: movement in direction of femoral condyles
Describe the shearing action caused on the meniscus when a football player plants and changes direction? (CKC) Flexion: causes meniscus to move posterior (tibial plateau attachment) External Rotation: causes posterior to move anterior (determined by femoral condyles).
Surgical indications for Vascular vs. Avascular portions of mensicus Blood Supply: meniscal repair Avascular:menisectomy to recreate normal anatomy
Age for "normal tears"? How is the meniscus usually injured before this age? 40 years old. Before 40, meniscus usually requires trauma since it is softer and not as brittle.
Signs and symptoms of Meniscal Injury 1. Posterior joint line pain 2. Effusion 3. Locking and Catching 4. Some would say Mcmurray's sign however it is not as reliable
What factors determine treatment progression for pts. with a menisectomy? Inflammation and pain. Could return to activity in as little as one week, usually 4-6.
Which type of tear will often times cause locking in the joint? Bucket Handle Tear. The other tear we are responsible for is the Longitudinal tear, which if located in the avascular portion would need to be cut out
Limitations for Meniscal Repairs post-surgical 1. Zero or Weight bearing in full extension for 4-6 weeks 2. Avoid HS contractions or adductor exercise for medial mensicus repairs. 3. Limit to 90 degrees of flexion for 4 weeks.
3 Weeks post-op: SLR's Med.: Not in extension or adduction Lat: Yes in all 4 directions
3 Weeks post-op: OKC: Knee Extension Yes from 90º-0º
3 Weeks post-op: CKC Partial squats No. Cannot weight bear into flexion
3 Weeks post-op: Standing Hamstring Curls Medial: NO Lateral: YES
Created by: Phillypino