Knee injuries

unhappy triad

  • anterior cruciate ligament
  • medial collateral ligament
  • meniscus (classically the medial meniscus but recent evidence shows that the lateral meniscus is more commonly injured)

specific injuries

Anterior cruciate ligament rupture
Mechanism
Clinical presentation
Associated injuries
Management
F/up and discharge advice
Patellar dislocation
Mechanism valgus stress + flexion + ext rotation, or direct trauma
Most common = lateral dislocation; superior is less comon
Clinical presentation - A popping sound/sensation
- Significant knee pain/tenderness
- Inability to straighten the knee affected
- Swelling of the knee
- Inability to walk/bear weight
Associated injuries Patellar tendon
Management Extend knee
Guide patella back into anatomical position
F/up and discharge advice Splint? Crutches

ottawa knee rule = do they need imaging?

  • age >55
  • isolated tenderness of patella
  • fibular head tenderness
  • unable to flex knee to 90 deg
  • unable to weight bear in ED AND immediately after