Anterior Cruciate Ligament Injury

Question 1

Population most affected:

Answer 1

Young and sports-active

Question 2

ACL Injury leads to increased risk of injury of the:

Answer 2

Meniscus

Question 3

Abnormal kinematics, Subluxations, Menical injury and Early osteoarthritis:

Answer 3

Complications

Question 4

The ligament courses obliquely, running from:

Answer 4

the tibia anteriorly and medially to the femur posteriorly, superiorly, and laterally

Question 5

Restraint to anterior tibial translation:

Answer 5

Primary function

Question 6

Prevent varus and valgus, particularly in the extended knee:

Answer 6

Secondary function

Question 7

% of ACL injuries occur through noncontact mechanisms:

Answer 7

70%

Question 8

Experience of giving way of the knee when attempting to rapidly change direction:

Answer 8

Mechanism

Question 9

Direct contact ACL injuries are associated with:

Answer 9

Other ligament injury

Question 10

Management in Patients with sedentary lifestyles:

Answer 10

Nonoperative management with adequate rehabilitation

Question 11

Management in Patients that remain active:

Answer 11

Reconstruction

Question 12

“Meniscal injury is ____________ in those with ACL injury”:

Answer 12

Time-dependent

Question 13

% of patients that develop a rapid hemarthrosis:

Answer 13

80%

Question 14

50% associated injury:

Answer 14

Meniscal tears

Question 15

Menical tears, Bone bruising, Medial collateral ligament injury and fractures of the tibial plateaus and femoral condyles:

Answer 15

Associated injuries

Question 16

Hemarthrosis, Limited range of motion and Joint line tenderness:

Answer 16

Acute phase

Question 17

Special Tests that aid the diagnosis of ACL injury:

Answer 17

Lachman, Anterior draw and Pivot-jerk tests

Question 18

Negative Anterior draw test:

Answer 18

Dont exclude ACL injury

Question 19

% of negative anterior draw test:

Answer 19

50%

Question 20

Why occurs negative anterior draw test although the ACL injury:

Answer 20

Chronic cases or Because the posterior horn of the medial meniscus can block tibial translation

Question 21

Lab studies:

Answer 21

Not required

Question 22

Imaging studies:

Answer 22

Rx and MRI of the knee

Question 23

AP, Lateral view at 30°, Notch view, Patellofemoral view, Weightbearing PA view in extension and 45°:

Answer 23

Rx Routine series

Question 24

Accuracy of diagnosis of the MRI in the acute phase:

Answer 24

98%

Question 25

Can aid diagnosis and assist in providing pain relief in a large hemarthrosis:

Answer 25

Aspiration

Question 26

If the diagnosis is unclear after other testing, perform:

Answer 26

Arthroscopy

Question 27

Nonoperative management:

Answer 27

Extensive physical therapy and Activity avoidance

Question 28

The major indication for surgical reconstruction in chronic cases:

Answer 28

Recurrent instability

Question 29

Active infection and Soft-tissue abrasion:

Answer 29

Surgical contraindications

Question 30

-2 weeks from injury, Low activity levels, Skeletal immaturity, Preexisting osteoarthrosis and Inflamatory arthropathy:

Answer 30

Relative surgical contraindications

Question 31

Surgical techniques:

Answer 31

ACL reconstruction using patellar tendon (PT) or hamstring tendon (HT) autografts

Question 32

Allografts, Prosthetic ligaments and Xenografts:

Answer 32

Do not have the advantages of autografts

Question 33

Optimal time for the surgery:

Answer 33

3-8 weeks from injury

Question 34

Adjunct treatment:

Answer 34

Ice, Stability, Rest, Analgesia and Raise the Leg