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Meniscus Injuries

Where is the meniscus located? On medial and laterl tibial plateus
Where is the attachment? Periphery by cononary ligament
What are the functions? 1.Stability-make stibial plateaus are congruent) 2.Shock absorption-Load transmission distribute pressure evenly 3.Nurtition 4.Lubriction 5.Controls femoral/tibial arthrokinematic motion
Some characteristics of meniscus are? Elastic cartilage which cmpresses and then returns back to original state
Where else is elastic cartilage found? Disc
What is the blood supply? Mostly avascular-only blood supply at the out rings of meniscus Red-Red
What are the zones? Red on Red-outside. Red on White-middle, White on White-inside
What are the main characteristics of the Medial meniscus? C-chaped, wider curve, attach ant. to lat. meniscus, MCL, ACL, and semimembranous, and injured more often because of all its attachments
What are the main characteristics of the Lateral meniscus? O-shaped, narrow curve, attach to medial meniscus and PCL, injured less frequently because it is more mobile
What are the 5 main types of tears? 1.Horizontal 2. Longitudinal-Bucket handle 3.Degenerative 4.Flap-parrots beak 5.Radial-hon tear
What pt do most tears happen? Traumatic tears in younger pt (55-90%) caused by rotational twisting injury
What happens when adults tear? Degenerative tear caused by squatting or getting out of a car(insignificant activity)
What is the mechanism of injury? Non contact WB w/ combined forces of knee flex, rotation, compression, and shearing forces
What is it most commonly injured with? 55% chance of meniscal injury with ACL and MCL disruption
What are some clinical symtoms? History of a twisting injury with c/o -pain(can describe what they where doing when pain started) -locking of knee -catching -swelling of knee intracapsular
What is present with a Bucket Handle Tear? 1.Required repair or removal 2.Cannot fully extend knee-handle gets outside capsule 3.Flap-into intracondyle notch
What is present with a ant/post horn tear? 1.Radial 2.Horizontal 3. a. catching, b. knee unstable c. harder to localize pain 4.Usually quads atrophy 5.Intermittant swelling
What are some diagnostic tests? -Arthroscope - Camera inserted into joint capsule -Arthrogram - inject fluid dye into joint -CT scan -MRI -Manual Tests
What position is the pat in for the Apley's test? Pt is prone and affected knee flex at 90 degrees
What position is the PTA in? For distraction - stabilize distal femur witha strap or hand other hand grasps distal tabia and pulls it into distraction w/ IR/ER force on tibia
WHat are you looking for with Apley's distraction? Pain signifies the possibility of a ligament tear
What is the PTA position for the compression test of Apley's? One hand stabilizes distal femur other hand applies a compression force w/ IR/ER on tibia
What are the results with a compression Apley's presence of a meniscal lesion
What is the McMurray test? To reproduce sysmtoms of a tron meniscus
What position is the pt in? Supine w/hip and affected knee fully extended
What is the position of the PTA for Medial meniscus McMurray? Apply a valgus force to the knee with one hand while aplying external rot. force on the tibia while extending the knee is applied with other
What is the position of the PTA for Lateral meniscus McMurray? Apply a varus force with IR of tibia
What are the results of the McMurray Test? with either internal or exteral rotation of the knee, if a tear is present the pt may experience pain and an audible or palpable snap or pop
What position is the pt in for the Bounce home test? Pt is supine w/affected knee in flex in the air
What position is the PTA in for the Bounce home test? Supporting pt leg w/hand passively extend the knee to full ext
What are the results of Bounce home test? The knee may not fully exted because the torn tissue blocks ext and creates a rubbery springy end feel
What may indicate a meniscal tear? History of twisting knee injury, swelling locking of the knee, pain and catching
What test is used to reporduce symptoms of torn meniscus is called what? McMurray Test
What test is used to determine if the meniscus is preventing knee ext? Bounce Home Test
What surgical procedures leads to limited early WB early limited full knee flex and generally slower advances with CKc ex in rehab? Meniscal repair
Created by: demiller243



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