meniscus tear , knee injury ,lateral meniscus - Everything You Need To Know - Dr. Nabil Ebraheim
202.8 هزار بار بازدید -
8 سال پیش
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Dr. Ebraheim’s educational animated video
Dr. Ebraheim’s educational animated video describes knee pain examination of the meniscus. Knee pain diagnosis and knee pain treatment .It describes knee injury meniscus tear, meniscus pain, meniscus tear symptoms .it also describes meniscus tear tests and meniscus tear surgery and recovery.
The meniscus is a cushion that distributes the load and reduces the stress being placed on the knee joint. These menisci protect the hyaline cartilage and prevent arthritis of the knee joint.
There are two menisci; the lateral and the medial. We are going to discuss the lateral meniscus because the lateral meniscus has very special features that make it appealing for exam questions.
The lateral meniscus is circular in shape. The anterior and posterior horns of the lateral meniscus are close together. The lateral meniscus covers about 70% of the lateral tibial plateau. The medial meniscus is “C” shaped and covers about 50% of the medial tibial plateau. The lateral meniscus has less peripheral soft tissue attachment, therefore it has twice the excursion of the medial meniscus (lateral meniscus is more mobile). The medial meniscus is less mobile and has three times the incidence of injury. The lateral meniscus is not injured as often as the medial meniscus.
The lateral meniscus is involved with acute ACL tear. Tear of the ACL is usually peripheral and can be missed on MRI. In tibial plateau fractures, the lateral meniscal tear is more common than medial meniscal tears. The lateral meniscal tear is usually associated with a Schatzker Type II fracture, which is a split depression fracture.
If you see a depression or widening greater than 5 mm in the tibial plateau, then it is probably associated with a lateral meniscal tear.
The lateral meniscus has the hiatus for the popliteus tendon. The fibula identifies the lateral meniscus on MRI. The fibular is lateral and posterior.
The lateral meniscus can be involved with multiple tear types.
There are some special conditions that we need to be aware of:
• Tear Type
• Pathological condition of the meniscus.
• Bucket handle tear of the lateral meniscus
- Will give you the double anterior horn sign of the lateral meniscus on sagittal view MRI.
• Meniscal Cyst
- Usually occurs from a horizontal tear of the lateral meniscus.
• Discoid meniscus
- Occurs more on the lateral meniscus.
• Meniscal repair on the lateral side can injury the peroneal nerve and popliteal vessels
- The popliteal vessels are behind the posterior horn of the lateral meniscus.
- Keep the approach and the dissection anterior to the biceps femoris tendon.
• Tears of the peripheral 25% of the lateral meniscus (red zone)
- This area is vascular and will heal if we repair/suture the meniscal tear.
- There is a risk associated with suturing the peripheral tear.
- The success rate associated with lateral meniscus repair increased with simultaneous ACL reconstruction.
McMurray’s Test
• Classic test that helps in the diagnosis of meniscal tears.
• With tear of the lateral meniscus, you will have a positive McMurray’s test with internal rotation of the knee.
Some structures may mimic a tear of the lateral meniscus (false positive MRI).
• Meniscofemoral Ligament
- Connects the meniscus into the PCL
- Arises from the posterior horn of the lateral meniscus and it has two parts (Humphrey is anterior and the Wrisberg is posterior to the PCL).
• Transverse Meniscofemoral Ligament
- Connected to the lateral meniscus anteriorly
• Fluid around the sheath of the popliteus tendon may mimic a tear
Become a friend on facebook:
Facebook: drebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati...
The meniscus is a cushion that distributes the load and reduces the stress being placed on the knee joint. These menisci protect the hyaline cartilage and prevent arthritis of the knee joint.
There are two menisci; the lateral and the medial. We are going to discuss the lateral meniscus because the lateral meniscus has very special features that make it appealing for exam questions.
The lateral meniscus is circular in shape. The anterior and posterior horns of the lateral meniscus are close together. The lateral meniscus covers about 70% of the lateral tibial plateau. The medial meniscus is “C” shaped and covers about 50% of the medial tibial plateau. The lateral meniscus has less peripheral soft tissue attachment, therefore it has twice the excursion of the medial meniscus (lateral meniscus is more mobile). The medial meniscus is less mobile and has three times the incidence of injury. The lateral meniscus is not injured as often as the medial meniscus.
The lateral meniscus is involved with acute ACL tear. Tear of the ACL is usually peripheral and can be missed on MRI. In tibial plateau fractures, the lateral meniscal tear is more common than medial meniscal tears. The lateral meniscal tear is usually associated with a Schatzker Type II fracture, which is a split depression fracture.
If you see a depression or widening greater than 5 mm in the tibial plateau, then it is probably associated with a lateral meniscal tear.
The lateral meniscus has the hiatus for the popliteus tendon. The fibula identifies the lateral meniscus on MRI. The fibular is lateral and posterior.
The lateral meniscus can be involved with multiple tear types.
There are some special conditions that we need to be aware of:
• Tear Type
• Pathological condition of the meniscus.
• Bucket handle tear of the lateral meniscus
- Will give you the double anterior horn sign of the lateral meniscus on sagittal view MRI.
• Meniscal Cyst
- Usually occurs from a horizontal tear of the lateral meniscus.
• Discoid meniscus
- Occurs more on the lateral meniscus.
• Meniscal repair on the lateral side can injury the peroneal nerve and popliteal vessels
- The popliteal vessels are behind the posterior horn of the lateral meniscus.
- Keep the approach and the dissection anterior to the biceps femoris tendon.
• Tears of the peripheral 25% of the lateral meniscus (red zone)
- This area is vascular and will heal if we repair/suture the meniscal tear.
- There is a risk associated with suturing the peripheral tear.
- The success rate associated with lateral meniscus repair increased with simultaneous ACL reconstruction.
McMurray’s Test
• Classic test that helps in the diagnosis of meniscal tears.
• With tear of the lateral meniscus, you will have a positive McMurray’s test with internal rotation of the knee.
Some structures may mimic a tear of the lateral meniscus (false positive MRI).
• Meniscofemoral Ligament
- Connects the meniscus into the PCL
- Arises from the posterior horn of the lateral meniscus and it has two parts (Humphrey is anterior and the Wrisberg is posterior to the PCL).
• Transverse Meniscofemoral Ligament
- Connected to the lateral meniscus anteriorly
• Fluid around the sheath of the popliteus tendon may mimic a tear
Become a friend on facebook:
Facebook: drebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati...
8 سال پیش
در تاریخ 1395/09/09 منتشر شده
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