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PHTH 545 > ACL > Flashcards

ACL Flashcards

1
Q

The ACL passes from the anterior medial side of the tibial plateau and passes _______, ______ and _______ to the posterior notch of the femur

A

upward, backward, laterally

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2
Q

ACL resists ______ translation of the tibia on the femur

A

anterior

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3
Q

The ACL resists ______ of the femur on the tibia

A

rotation

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4
Q

ACL acts in conjunction with ______ ligaments to resist valgus forces

A

collateral

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5
Q

ACL assists with _____ -_____ mechanism

A

screw-home

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6
Q

Do ACL injuries occur more in contact or non contact situations ?

A

non-contact (70%)

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7
Q

What ROM do most ACL injuries take place in ?

A

0-30 degrees

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8
Q

4 MOI’s for ACL?

A
  1. planted food + rapid direction change (PIVOT)
  2. excessive anterior tibial translation
  3. hyper flexion or hyperextension
  4. direct trauma to the knee
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9
Q

What are 2 intrinsic factors that lead to higher incidence of ACL injuries in females?

A
  1. anatomic

2. hormonal

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10
Q

What are 3 anatomic factors that may lead to a higher incidence of ACL injuries in females?

A
  1. limb posture
  2. joint laxity
  3. size of intracondylar notch
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11
Q

What are 4 extrinsic factors that lead to higher incidence of ACL injuries in females?

A
  1. leg dominance
  2. ligament dominance
  3. quads dominance
  4. trunk dominance
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12
Q

When there is a _____ collapse, supporting muscles do not adequately absorb GRF and more forces are imparted through _______ restraints

A

valgus; static

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13
Q

____-____ landing posture, rather than flexed, = more risk for ACL tear

A

stiff-legged

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14
Q

Impaired core proprioception predicted knee injury in female, but not male athletes (T/F).

A

TRUE

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15
Q

4 factors in pt’s history that indicate an ACL injury?

A
  1. pain that is poorly localized 2. unable to continue to play on
  2. swelling (if it comes on within a few hours, most likely torn blood vessels in ACL)
  3. complaints of instability
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16
Q

4 special tests in examination for ACL tear?

A
  1. anterior drawer
  2. lachman
  3. lever sing or lelli’s test
  4. pivot shift
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17
Q

6 conditions that can accompany an ACL rupture?

A
  1. subchondral bone bruise
  2. chondral injuries
  3. meniscal damage
  4. capsular damage
  5. secondary ligament (often MCL!*)
  6. fracture
18
Q

What is the name of the # commonly associated with ACL tear?

A

Segond’s; small avulsion # of tibia

19
Q

What is the single most important predictor for knee function 2 years following ACLR?

A

pre-op quads strength!

20
Q

Recent ACL treatment has evolved to include more ____ with less ____, and ____ chain exercises

A

load; reps; open

21
Q

2 surgical reconstruction options of the ACL?

A
  1. bone-patellar tendon-bone

2. semitendinosus gracilis

22
Q

4 sequences of events in graft healing ?

A
  1. avascular necrosis
  2. cellular infiltration
  3. vascular invasion
  4. remodelling
23
Q

ACL contains _______ that provide the CNS with afferent info about joint position through the _____ nerve

A

mechanoreceptors; tibial

24
Q

Poor control of _____ movements is considered to be a major factor in ACL injury and re-injury risk

25
Q

The goal with post op ACL pt’s is to improve the NS ability to generate optimal muscle firing pattern to do what 3 things?

A
  1. increase joint stability
  2. decrease joint forces
  3. relearn or unlearn movement patterns and skills
26
Q

6 stages in post op ACL rehab?

A
  1. pre-op
  2. immediate post - op
  3. early rehab
  4. intermediate rehab
  5. advanced activity
  6. return to activity
27
Q

Immediate post op?

28
Q

Early rehab?

29
Q

Intermediate rehab?

A

weeks 4-10

30
Q

Advanced activity?

A

weeks 10-16

31
Q

Return to activity?

A

weeks 16-22

32
Q

6 Rehab STAGES?

A
  1. pre op
  2. post op
  3. progressive limb loading
  4. unilateral load acceptance
  5. sport specific training
  6. unrestricted sport specific training
33
Q

__-__ weeks post op is when graft is fairly week

34
Q

4 pre op goals of Rx?

A
  1. reduce inflammation, swelling and pain
  2. restore normal ROM (ESP EXT!)
  3. restore muscle activation
  4. provide education re surgery
35
Q

6 goals of Rx immediately post op?

A
  1. restore full passive extension
  2. diminish swelling and pain
  3. gradually restore flexion
  4. re-establish quad control
  5. control independent ambulation
  6. restore hamstring length 80%
36
Q

Should have __ deg flexion by day 5, ___ deg by day 7

37
Q

Goals or Rx early post op phase?

A
  1. maintain full knee extension
  2. diminish swelling and pain
  3. gradually increase knee flexion, progress to 115 deg by week 3
  4. muscle training and begin to restore proprioception
  5. patellar mobility
  6. restore hamstring length by 100% and progress as able
38
Q

5 goals of Rx intermediate post-op?

A
  1. restore full knee ROM
  2. improve lower extremity strength (quads 80%)
  3. enhance proprioception, balance and neuromuscular control
  4. improve muscular endurance
  5. restore limb confidence and Fx
39
Q

5 goals of Rx advanced activity phase?

A
  1. normalize lower extremity strength
  2. progress proprioception, balance and neuromuscular control
  3. enhance muscular power and endurance
  4. perform selected sports specific drills
  5. hop tests > 85% by week 12
40
Q

4 goals of Rx return to activity phase?

A
  1. gradual return to full unrestricted sports
  2. achieve maximal strength and endurance
  3. normalize neuromuscular control
  4. progress skill training

PHTH 545 (23 decks)

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