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Cruciateligamentinjuries Collateral knee injuries • Mechanism = A twisting force applied to the MCL knee while the foot is fixed. Often in high • Mechanism = blow to the lateral side of the ACL impact sports like rugby knee with foot fixed • Presentation = immediate swelling and pain, • Presentation = most commonly in sport, generally unable tocontinue playing with effusion and tenderness over the • Test = anterior draw / Lachman’s test = result affected ligaments. inexcessivegliding. • Test = valgus stress test • Management = MRI imagining = gold standard, • Management = rest and firm support, conservative management can resolve surgery is rarely required for isolated MCL however­ instability will require surgical injuries management. LCL PCL • Mechanism = blow to the medial side of the • Mechanism = direct force on a flexed knee– knee with the foot fixed. ie:knee strikes the das h incarcrash. as much • Presentation = same as MCL less commontoinjure. • Test = Varus stress test. • Test = posterior draw test– resulting in • Management = less common injury but excessivegliding. tends to be more extensive with cruciate • Management = MRI for imaging, most involvement andcommonperineal nerve Primary stabilizing ligaments of the knee commonly managed conservatively. injury. Surgery if instability. § MCL (Medial collateral ligament),protects the medial side of the knee to lateral forces. Key point= when assessing any ligament assess the § LCL (Lateral collateral ligament), protects the Soft tissue other side for comparison to ensure pathology and knee injuries not hypermobility. lateral side ofthe knee from medial forces . § ACL (Anterior cruciate ligament),prevents By Gregorramage patella dislocation the tibia from moving too anteriorly in • Mechanism = due to twisting of the knee relation to the femur. and Dr Shaheer and contraction of the quadriceps. § PCL (posterior cruciate ligament),prevents Meniscal injuries Aslam Joiya • Presentation = the knee is flexed with a posterior displacement of the tibia relative to • Mechanism = twists to a flexed knee result in lateral deformity the femur. medial tears. Adduction and internal rotation • Management = reduce, throughmedial Meniscus cause lateral tears. pressure while extending the knee. ThenX § Split in to medial and lateral meniscus, • Presentation = can present with knee locking. rays to look for patella fracture. attached to the tibia, protecting the ends of • Test = McMurrays test = positive. Conservative through immobilization in a bones and roles in shock absorption and • Management = MRI = gold standard imaging, cast or brace followed by physiotherapy. stabilisation. knee arthroscopy if locked or persistent Recurrent subluxation can require MPFL § The medial meniscus is securely attached to symptoms. reconstruction or trochlearplasty if thee is evidence the joint capsule and more frequently torn of trochlear dysplasia. Other than the lateral meniscus which is more • Unhappy triad = damage to ACL, MCL and • Often have a positive patella apprehension mobile meniscus, often in high impact sports. test.