Traumatic Arthritis

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    Meniscal Injury

    • Typically associated with twisting movement of the knee with popping or tearing sensation
    • Symptoms:
      • Catching
      • Locking
      • Pain with particular movements. 
    • Physical Exam:
      • Knee Effusion (hemarthrosis?)
      • Joint-line tenderness
      • Positive provocative tests (McMurray or Thessaly Test)
      • No ligamentous instability (MCL, LCL, ACL)
    • Management:
      • Minor meniscal injuries resolve spontaneously
      • Larger tears impair smooth knee motion (causing locking)
        • Can lead to premature OA
      • In absence of hemarthrosis or gross instability
        • Conservative with rest, ice, crutches if needed. 
        • Physical Therapy (strengthen quadriceps, hamstrings, to support joint)
      • MRI is controversial (American College of Radiology suggests MRI if focal tenderness or effusion)
      • Orthopedic surgeon consultation advisable if
        • MRI reveals PERIPHERAL meniscal tear
        • Vascular portion of meniscus
        • Patient continues to have locking of knee, joint effusions, disabling symptoms after 4-6w of conservative management
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