Dear all, This ppt contains the cause, types, clinical and radiological features, treatment and complication of Knee ligament injury and meniscus injury. I hope this is useful to you. Thank you

1. By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Ligament injuries

2. Mechanism
• Injured by mostly twisting or bending force
• MCL
– Valgus force. Abduction of leg on femur
• LCL
– Varus force. Adduction of leg on femur
– Avulsion fracture may occur
– Less common

3. • ACL
– Associated with MCL or LCL
– Twisting force on a semi flexed knee
– O’Donoghue triad

4. • PCL
– Tibia forced backward on the femur

5. Pathoanatomy
• Avulsion fracture
• Grade I, II, III
• May be isolated or more then one ligament
may injure

6. Diagnosis
• Pain and swelling
• History of fall, injury followed by sound of
something tearing
• Haemarthrosis
• MCL, LCL – Localized pain on medial, lateral
side
• ACL, PCL – Vague pain in knee

7. • Tests
– MCL tear test
– LCL tear test
– Anterior Drawer test
– Posterior Drawer test

8. • Radiological examination
• X-ray will be helpful in avulsion fracture. “No
bone fracture” in case of haemarthrosis
• MRI more helpful in diagnosis
• Arthroscopic examination may be done

9. Treatment
• Conservative method
• For Grade I, II injury
• Haematoma aspiration
• Once swelling subsides Physiotherapy will be
helpful

10. • Operative methods
• Indicated in grade III and in case of multiple
ligament injury
• Surgery after 2-3 week, once pain subsides
• Repair of ligament
– Done in case of fresh ligament injury

11. • Reconstruction
– Done in case of case presented late when knee
instability is there
– Ligament is reconstructed using patient’s tendon
and fascia
– Allograft or synthetic ligament has also been used

12. Complications
• Knee instability
• Osteoarthritis

13. Thank you

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15. By :- Dr. Bindesh D. Patel, PT
Deputy Registrar
P P Savani University
Meniscal injuries

16. Mechanism
• Semi flexed knee and twisting
• May occur while walking on uneven surface
• Meniscus may be stuck in and nipped as
rotation occurs
• Medial meniscus injury is common as it is less
mobile

17. Pathoanatomy
• Menisucs is torn most commonly at posterior
horn
• Meniscus is avascular structure
• It left untreated undergoes subtears and can
damage articular surface

18. • Types of meniscus tear

19. Clinical features
• Young male actively engaged in sports
• Recurrent episodes of pain and locking of
knee
• Patient may complaint of a sudden jerk while
walking or something flicking over inside the
joint
• Swelling, appears after few hours and lasting
for few days

20. • History of twisting injury followed by swelling
overnight
• Knee remains in 10 degree knee flexion.
Complete extension is difficult
• Mcmurray’s test
• Apley’s test

21. • Radiological examination
– No abnormal X-ray
– MRI is useful
– Arthrography

22. Treatment
• Acute meniscal tear
– If Knee is locked, it is manipulated under general
anesthesia. No special maneuver is needed.
– As knee relaxes, torn meniscus falls into place and
knee is unlocked
– Knee is immobilised for 2-3 weeks, followed by
Physiotherapy.
– Peripheral tear will heal.

23. • Chronic meniscal tear
– To excise the displaced fragment.
– Arthroscopic surgery is done
– Early return to work is possible
– Aim is to preserve the meniscus as much as
possible.

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