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15 visible knowledge nodes in sports
ACL Reconstruction — Techniques
Gold standard for young active patients with ACL-deficient knee. Grafts: Bone–Patellar Tendon–Bone (BTB), Hamstring (STG), Quadriceps tendon, Allograft. Tunnel drilling: transtibial vs anteromedial portal vs all-inside. Fixation: interference screws, suspensory devices, cross-pins. Complications: graft failure, tunnel malposition, stiffness, infection.
Open topicBoutonnière & Swan Neck
Define Boutonnière & Swan Neck with common etiologies and pathoanatomy. List key classifications or staging systems used in exams. Clinical features and focused examination; special tests as applicable. Imaging: first‑line and advanced; measurements that change management. Nonoperative indications and protocols. Operative indications; approach and key steps. Implant/technique options with pros/cons. Complications and how to prevent/manage them. Rehabilitation milestones and outcome expectations....
Open topicCRPS — Budapest Criteria
Define CRPS — Budapest Criteria with common etiologies and pathoanatomy. List key classifications or staging systems used in exams. Clinical features and focused examination; special tests as applicable. Imaging: first‑line and advanced; measurements that change management. Nonoperative indications and protocols. Operative indications; approach and key steps. Implant/technique options with pros/cons. Complications and how to prevent/manage them. Rehabilitation milestones and outcome expectations...
Open topicHallux Rigidus
Degenerative osteoarthritis of the 1st MTP joint causing dorsal osteophytes, stiffness, and pain—especially with push‑off. Coughlin–Shurnas clinical–radiographic grading guides treatment (Grade 1: mild stiffness → Grade 4: severe stiffness with sesamoid involvement/near ankylosis). Cheilectomy ± Moberg (dorsal closing wedge) osteotomy for low‑grade disease; 1st MTP arthrodesis is the gold standard for advanced disease in active patients. Arthroplasty/hemicap considered selectively in low‑demand...
Open topicMeniscal Tears — Basics
Red‑red (peripheral) zone heals best; red‑white intermediate; white‑white avascular. Vertical longitudinal (bucket handle) tears in young → repair; complex/degenerative tears in older → debride selectively. Clinical tests: McMurray, Thessaly; MRI is sensitive but clinical correlation vital. Repair techniques: all‑inside, inside‑out, outside‑in; address concomitant ACL tears. Meniscal preservation reduces risk of OA; root tears need repair to restore hoop stress.
Open topicMeniscus Repair vs Meniscectomy
Meniscus vital for load transmission, shock absorption, joint stability. Repair preferred when possible (red-red, red-white tears, vertical longitudinal). Meniscectomy indicated for irreparable, degenerative tears. Repair techniques: inside-out, outside-in, all-inside devices. Meniscectomy → ↑ risk of OA long term.
Open topicMorton’s Neuroma
Perineural fibrosis of the common plantar digital nerve—classically in the 3rd webspace—causing burning plantar forefoot pain. Provocative tests: web‑space compression, Mulder’s click (palpable snap with medial–lateral squeeze), sensory symptoms into adjacent toes. Initial management is non‑operative: wide toe‑box shoes, metatarsal pads, activity modification; steroid injections provide short‑term relief; ultrasound‑guided ablation/PRP considered. Failure of conservative care → neurectomy of the...
Open topicPatellar Dislocation — MPFL
First‑time dislocation: non-op unless loose bodies/osteochondral fracture or gross instability. Recurrent instability → MPFL reconstruction; address bony factors (TT‑TG distance, trochlear dysplasia, patella alta). Imaging: MRI for MPFL injury/OC defects; CT to measure TT‑TG (>20 mm abnormal). Surgical pearls: Anatomic femoral tunnel at Schöttle point; avoid over‑tightening to prevent medial overload. Rehab: brace, early ROM, VMO strengthening; return to sport after strength and stability restor...
Open topicPCL Injuries — Diagnosis & Management
PCL resists posterior tibial translation. Mechanism: dashboard injury, fall on flexed knee with foot plantarflexed. Clinical: posterior sag sign, posterior drawer test, quadriceps active test. Isolated low-grade PCL often treated nonoperatively. High-grade or multi-ligament injuries need reconstruction.
Open topicPlantar Fasciitis
Degenerative fasciosis (not true 'itis') of the plantar fascia origin at the medial calcaneal tubercle due to repetitive micro‑trauma. Classic history: sharp 'first‑step' pain on arising or after rest; eases with a few minutes of walking, recurs after prolonged standing. Risk factors: tight gastrocnemius–soleus, cavus or planus foot, prolonged standing, obesity, running/sudden training change. Exam: point tenderness at medial calcaneal tubercle; positive Windlass test (pain with 1st MTP dorsifle...
Open topicRheumatoid Arthritis — Hand
Autoimmune symmetric polyarthritis causing synovitis and progressive joint destruction—typical deformities in the hand: ulnar drift at MCPs, swan‑neck and boutonnière deformities, and caput ulnae syndrome. Early goal‑directed medical therapy with DMARDs/biologics is cornerstone; hand surgery addresses pain, deformity, and function (synovectomy, tendon procedures, joint arthroplasty/arthrodesis). Radiographs show periarticular osteopenia, marginal erosions, and joint space loss; ultrasound/MRI de...
Open topicRotator Cuff Repair
Rotator cuff provides dynamic stability and elevation of shoulder. Tears: acute traumatic vs degenerative. Indications for repair: symptomatic full-thickness tear, acute traumatic tear in young, failed conservative treatment. Techniques: open, mini-open, arthroscopic. Complications: re-tear, stiffness, infection, deltoid detachment (open).
Open topicShoulder Instability — Revision Surgery
Recurrent instability may follow failed Bankart repair. Causes: capsulolabral failure, glenoid bone loss, engaging Hill-Sachs. Workup: MRI, CT for bone loss quantification. Revision options: repeat Bankart, remplissage, Latarjet, bone grafting. Complications: recurrence, stiffness, graft nonunion, arthritis.
Open topicShoulder Stiffness — Adhesive Capsulitis
Idiopathic or secondary; painful stiffness with capsular pattern (ER most limited). Stages: painful freezing → frozen → thawing; natural history 1–3 years. Nonoperative: NSAIDs, PT, intra‑articular steroid injections. Operative: MUA or arthroscopic capsular release for refractory cases. Rule out secondary causes (diabetes, thyroid, post‑surgical).
Open topicTarsal Tunnel Syndrome
Entrapment neuropathy of the posterior tibial nerve under the flexor retinaculum behind the medial malleolus. Symptoms: burning dysesthesia/paresthesia in plantar foot, worse at night or with prolonged standing; positive Tinel’s sign posterior to medial malleolus. Etiologies: space‑occupying lesions (ganglion, varicosities), tenosynovitis, trauma, hindfoot valgus/flatfoot causing traction, systemic neuropathies. NCS/EMG supports diagnosis; ultrasound/MRI detects masses and tendon pathology. Trea...
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