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Knee Injuries: ACL, PCL, MCL, Meniscus, Emergency Medicine

Ilona A. Barash Reviewed 06/2017
 


Basics

Description

  • Cruciate ligament injuries:

    • Anterior cruciate ligament (ACL):

      • From the posteromedial aspect of the lateral femoral condyle to the intraspinus area on the tibia

      • Prevents excessive anteri...

Diagnosis

Signs and Symptoms

History

  • Cruciate ligament injuries:

    • Feeling knee “give way,” pop, tearing sensation

    • Most patients report immediate knee dysfunction, but some may ambulate despite complete ACL...

Treatment

Initial Stabilization/Therapy

  • ABC’s, ATLS

  • Immobilize knee

  • Document neurovascular function

  • Apply ice, elevate, analgesia

Ed Treatment/Procedures

  • Reduce locked knee from meniscus injury within 1st 2...

Follow-Up

Disposition

Admission Criteria

  • Isolated ACL, PCL, meniscus, or collateral ligament injury rarely requires emergent hospitalization

  • Low threshold to admit possible knee dislocations for monitori...

Pearls and Pitfalls

  • Do a careful neurovascular exam, and always examine 1 joint above and below the pain for associated injury or referred pain

  • Have a high index of suspicion for a reduced total knee d...

Additional Reading

  • Chen  L, Kim  PD, Ahmad  CS, et al. Medial collateral ligament injuries of the knee: Current treatment concepts. Curr Rev Musculoskelet Med.  2008;1(2):108–113.

  • Meuffels  DE, Po...

Codes

ICD9

  • 836.0 Tear of medial cartilage or meniscus of knee, current

  • 844.1 Sprain of medial collateral ligament of knee

  • 844.2 Sprain of cruciate ligament of knee

  • 844.0 Sprain of lateral collateral ligam...

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