knee ligaments Flashcards
what is the ratio of non contact to contact ACL injuries
70% non
30% contact
what percentage of athlete knee injuries does ACL injuries make up
20% over 10 years study
What is the ratio of male to female ACL injuries
2.4-9.7x more likely for females
How do ACL injuires impact risk of meniscus injury
ACL deficient knees will have 40, 60 80% at years 1,2,3 post ACL injury
what are the most common multi ligament injuries of the knee
MCL adn ACL
PLC with ACL or PCL
describe the incidence of ACL injury as it relates to valgus laxity
20% ACL injuires with no valgus laxity
53% ACL injury with laxity at 30 degree
78% ACL injury with laxity at 0 degrees
what are the different parts of the ACL
anteromedial and posterolateral bands
What motion does the ACL restrain
anterior translation of the tibia
IR particularly when in extension
what part of the ACL is usally hurt
mid substance
what are the different parts of the PCL
anterolateral and posteromedial
what motion does the PCL restrain
posterior glide and ER
what are the most common mechanism of injury for PCL
- dashboard
- fall on a flexed knee with foot plantar flexed
- violent hyperextension
how layers does the MCL have
- superficial
- deep
- posterior oblique ligament
what makes up the PLC
- lateral head of gastroc
- poplitieus tendon
- LCL
- arcuate ligament-fabellafibular ligement
what percentage of people return to normal activity follow non-operative ACL injury
42% if avoid high risk activity
what is the greatest predictor of post operative ROM loss after ACL surgery
Presurgical ROM loss
Describe the strength and function deficits between copers and post ACL people
they are about the same
what are the risk factors for ACL injuries
- shoe surface interation for hight traction
- increased BMI
- narrow femoral notch
- increased joint laxity
- stage of menstrual cycle (late follicular, preovulatory phases both identified)
What is the prescreening criteria for identifying potential ACL deficient copers
- level 1 or 2 athlete or worker
- no concomitant injuries
- none to trace knee effusion
- full knee range of motion
- normal gait
- 70% quad strength
- hop up and down on leg without pain
what is the screening exam for identifying potential ACL deficient copers
- number of giving away episodes less than or equal to 1
- single limb 6m timed hop test 80% of uninvolved side
- KOS-ADL score greater than or equal t 80%
- glodal rating of precieved function greater than or equal to 60%
diagnostic criteria for ACL injury
- deceleration mechanism of injury
- pop at time of injury
- hemathrosis 0-2 hours post injury
- h/o giving away
- loss of knee extension
- lachman
- pivot shift
- 6m time hop test less than 80%
- MVC of quad less that 80%
diagnostic criteria for knee instability classification
- passive instability testing
- joint effusion
- aberrant movement
- joint pain
what is the MDC for KOS-ADLS, KOOS, IKDC 2000
- Knee injury and osteoarthritis outcome score - pain domain 13, sport domain 22, quality of daily life 15
- international knee documentation committee 11.5
- knee outcome survey ADL 8.8
what is the pivot shift test
The patient lies supine with legs relaxed. The examiner grasps the heel of the involved leg with examiners opposite hand placed laterally on the proximal tibia just distal to the knee. The examiner then applies a valgus stress and an axial load while internally rotating the tibia as the knee is moved into flexion from a fully extended position. [6] A positive test is indicated by subluxation of the tibia while the femur rotates externally followed by a reduction of the tibia at 30-40 degrees of flexion.
how does bracing impact recovering following acute ACL injury
short term improvements in the perception of stability, but by 6-12 weeks its benefit is gone. Long term questionable benefit. Overall it appears beneficial
what works better open or closed chain exercises for knee instability rehab
they both help and both are recommended
