ACL Rupture

Question 1

Pathogenesis of ACL rupture?

Answer 1

• Turn upper body laterally on a planted foot

- Leads to internal rotation of the tibia

Question 2

What ports do ACL ruptures commonly occur in?

Answer 2

Football
Rugby
Skiing
High impact sport

Question 3

What is usually felt/heard in an ACL rupture?

Answer 3

Pop

Question 4

Symptoms of ACL Rupture?

Answer 4

• Haemoarthrosis developed within an hour
• Deep pain in knee

Chronically: rotatory instability giving way when turning on planted foot

Question 5

Signs of ACL rupture?

Answer 5

• Knee swelling: haemoarthrosis or effusion
• Excessive anterior translation of the tibia
• Rotatory subluxation

Question 6

What is haemoarthrosis?

Answer 6

Effusion due to bleeding in joint

Question 7

Testing excessive anterior translation of tibia?

Answer 7

• Anterior draw test

- Lachman test

Question 8

Pivot shift test tests?

Answer 8

Rotatory subluxation

Question 9

Response of patient to ACL rupture?

Answer 9

1/3 patients: compensate well and do whatever thy please

1/3 patients: Manage by avoiding certain movements

1/3 patients: Do poorly with frequent giving way

Question 10

Treatment of ACL rupture?

Answer 10

Physiotherapy
-Primary repair isnt really effective

RECONSTRUCTION= tendon raft

Question 11

How does ACL reconstruction work?

Answer 11

Pass through tibial and femoral tunnels at the usual location of the ACL & secured to the bone

• Intense rehabilitation
• 1 year to get back to high impact sports

Question 12

Which tendon is used for ACL tendon graft?

Answer 12

Patellar tendon 
OR
Semitendonosis 
OR
Gracilis