Page 105 - ASOP ROT Study Guide

8 . 3 Loose Bodies

8 . 3 . 1 Etiology

Small fragments of cartilage and bone (osteochondral fragments) may be sheared off in an injury. The knee
subsequently swells up from the associated bleeding into the joint (hemarthrosis). The osteochondral
fragment is called a loose body and is often not resorbed but lives floating free in the synovial fluid. The
bulk of the loose body, if not all of it, is cartilage and so may be invisible on X-rays.

8 . 3 . 2 Clinical presentation

The first incident may settle but months or years later the patient presents with locking, pain and giving way,
often with effusion.

8 . 3 . 3 Management

Such loose bodies are a nuisance and should be removed, preferably using the arthroscope. Very rarely, in
adolescents, osteochondral fragments occur spontaneously. This condition is known as
osteochondritis dissecans. Such a condition tends to settle spontaneously but loose bodies may require
removal.

8.4 Cruciate Ligamentous Sprains

Soft tissue injuries to the collateral ligaments of the knee heal spontaneously. This is because they have an
excellent blood supply. Cruciate ligament tears are quite different for the reasons described below.

http://www.donjoy.eu/en_US/ACL_Knee_Injuries.html

FIGURE. Right Knee Anterior View

8 . 4 . 1 Etiology

The cruciate ligament is commonly injured by either hyperextension or a twist, often in association with the foot
being anchored by a studded boot or a ski.