Orthopaedic Knee Conditions

Question 1

ACL

WHERE
SUPPLY
INNERVATION

Answer 1

Runs bw tibial eminences
to lateral wall of intercondylar notch of femur

Middle Geniculate Artery

Posterior articular (nerve branch of tibial)

Question 2

ACL Function

Answer 2

1ry restrain to anterior translation of the tibia relative to femur

2ry restrain to tibial rotation and varus/valgus stress

Question 3

ACL Tear

Non-Contact Pivot Injury

PRESENTATION

Answer 3

Females»Males
Quadriceps

POP/CRACK
DEEP PAIN
IMMEDIATE SWELLING - HAEMARHTROSIS
UNABLE TO CONTINUE PLAYING - can walk straight line

Question 4

ACL Examination

Answer 4

Lachman test
Anterior draw
Pivot Shift (instability test) - under anaesthetic

Look for effusion

Question 5

ACL Investigations

Answer 5

Lachman test
Anterior draw
Pivot Shift (instability test) - under anaesthetic

Look for effusionMEX-Ray 2nd Fracture
Avulsion of anterolateral ligament

MRI

• ACL
• MENISCI
  
  • Lateral: Simultaneous with ACL tear
  • Medial: Secondary to shear from chronic instability
• MCL