Exam 1 - ACL. Flashcards
1
Q
ACL
A
Named for tibial side
2
Q
ACL Bundles
A
- anteromedial bundle
- posterolateral bundle
3
Q
Biomechanics
A
- ACL provides the main check at 20-45 degrees for anterior tibial movement
- most force through the ACL at 20-45 degrees
4
Q
Rotation
A
Lipke:
- cut the ACL in cadavers
- excessive anterior tibial movement
- excessive medial rotary tibial movement
5
Q
Bundle biomechanics
A
- AM bundle contains anterior stability
- PL bundle contains rotational stability
6
Q
Extended knee
A
- AM & PL parallel
- AM has more force through it
7
Q
Flexed knee
A
- AM & PL crossed
- PL has more force through it
8
Q
Injury
A
- ACL injuries occur when bones in the leg twist in opposite directions under full body weight
- contact
- non- contact
9
Q
Bone Bruise
A
- noncontact had longer bone bruise
10
Q
Reconstruction or no?
A
Patients decision Therapist role: - educate Deficients: - john elway: did not reconstruct - garrison hearst: did not know ACL was torn How to determine to get surgery: - dependent on exercise or sport
11
Q
Reconstruction lead to osteoarthritis?
A
- 35% in surgery
- 11% w/o surgery
12
Q
Graft choices
A
Reconstruction
- allograft
- autograft
- double bundle
13
Q
Allograft
A
- cadaver PROS - less pain - less trauma - earlier weight bearing - quicker motion return - better cosmesis - faster surgery - less motion loss CONS - infection - whose tendon? - site incorporation - stretches out? - cost - availability
14
Q
Autograft
A
- patellar tendon or hamstring/gracilis
- for younger
PROS - less infection
- better graft incorporation
- slow patient down
- BTBP gold standard - patella tendon
CONS - more pain
- arthrofibrosis
- slower to fully weight bear
- patellar fracture
- patellofemoral articulation lesion
- knee extension weakness
- decrease in hamstring strength p
15
Q
Double Bundle
A
- both
- NFL WR & RBs
- pivot shift test
Door hinges:
- shared work
Concepts:
- footprints
- bundles
- tunnel
- a la carne
16
Q
Not good for double bundle
A
- too small of footprint
- patient growing
- severe arthritis
- multiple ligament injury
17
Q
ACL Injury Prevention
A
CAUSE - bone of leg twist in opposite direction - valves movement NONCONTACT - jumping, landing, running & stopping abruptly PREVALENCE - females: 15-19 - Reinjury is highly predictable - usually in opposite knees
18
Q
Why females are more prone to ACL injury?
A
- 8x higher incidence rate than males
Q ANGLE - women wider hips
- aka knock knees
19
Q
Vulnerability
A
Quad/ham ratio
20
Q
Noncontact
A
70% of all ACL injuries
- volleyball
- soccer
- basketball
21
Q
Prevention
A
- implement strength turning program to warm up
Overhead squats Russian squats Lunges High knees Butt kickers Backward running
- stretching should only be 2-3 minutes of soreness
- being flexible can cause injury
- muscle activation
