Page 102 - ASOP ROT Study Guide

8. MECHANICAL KNEE PROBLEMS

8 . 1 Clinical Presentation
Knee problems may present as chronic discomfort, or acutely following injury. The patient complains of
symptoms:
♦ swelling
♦ locking
♦ giving way
♦ pain

8 . 2 Meniscal Lesions

8 . 2 . 1 Clinical presentations
Although seen in both sexes meniscal lesions are relatively rare in women, probably because they are not as
frequently involved as men in vigorous contact sports. Although not common, they can occur in adolescents and
occasionally children are born with an abnormal lateral meniscus. The symptoms are pain, excess fluid in the
joint (effusion), and sometimes locking and/or giving way. The abnormality is poorly localized on examination
(i.e. there is not a single tender spot), although generalized discomfort may be elicited by gently but forcibly
extending the knee.

8 . 2 . 2 Etiology and patterns
The principal cause of meniscal lesions is twisting injury, often associated with skiing, or games where studs
are worn on shoes or boots. In these situations the foot gets stuck on the ground and then the femur twists over
the stationary tibia causing a wrench to the meniscus which may be torn or pulled off the bone.
The medial meniscus is generally more frequently torn than the lateral. The meniscus may be torn at its
peripheral attachment to the joint capsule or actually within its substance. The meniscus may split horizontally -
a cleavage lesion, which is very common in old age. Occasionally these cleavage lesions act like flap valves
and allow a buildup of synovial fluid within the meniscus, forming a fluid filled cavity known as a cyst.

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