Knee Unit- ACL nonsurgical

Question 1

What is the ACL?

Answer 1

extends from the anterior intracondylar region of the tibia to the medial aspect of the lateral femoral condyle in the intracondylar notch

Question 2

What does the ACL prevent?

Answer 2

anterior translation of the tibia and posterior translation of the femur

-Permits 500 pounds of pressure prior to rupture

Question 3

Does the ACL have the ability to heal a complete tear?

Answer 3

No, because it has a poor blood supply

Question 4

What are the most common ways to injure an ACL?

Answer 4

• Hyperflexion
• Rapid deceleration
• Hyperextension
• Landing in an unbalanced position

Question 5

What is a grade 3 sprain?

Answer 5

complete tear with excessive laxity

ACL:Tear most often in midsubstance of the ligament and not at the ligaments attachment on the femur or tibia

-Laxity rarely occurs solely in a straight plane and instead is often classified as anterolateral or anteromedial

Question 6

What are contributing factors of ACL?

Answer 6

• high levels of agility and contact sports increases risk
• women>men, 14yrs-29yrs
• body movement and positioning
• muscle strength
• joint laxity
• Q angle
• Narrow intercondylar notch

Question 7

What does an ACL present like clinically?

Answer 7

• hearing a loud pop or feeling as though the knee buckled at time of injury
• Significant pain
• Effusion/edema that limits ROM (joint swelling quickly= hemarthrosis)
• might not be able to bear weight/assistive device

Question 8

What does ligamentous testing demonstrate?

Answer 8

visible laxity in the knee and may exacerbate the patients pain level

Question 9

How is ACL Diagnosed?

Answer 9

MRI:
-Check for ACL tear and damage to other soft tissues such as ligaments and menisci
>2/3 of the time will have meniscus injury

Xray: Rules out fracture

Question 10

What are the special tests for the ACL?

Answer 10

Lachman’s, anterior drawer, pivot shift test

Question 11

Management for an ACL?

Answer 11

• controlling edema
• increasing ROM
• strengthening
• improving fluidity of gait

Question 12

Important Rehab Considerations for ACL

Answer 12

-Avoid open chain knee extension from 60-0 with resistance and squatting from 60-90 degrees

> too much stress on the ligament
focus on hamstring strengthening

Question 13

Outcomes

Answer 13

-complete tear without surgery will likely be an increased risk for instability for and subsequent deterioration of the joint surfaces