Sports + Shoulder/Elbow Flashcards
Name the bundles of the ACL and their function
Posterolateral - tight in extension, improves rotational stability (if torn + pivot shift)
Anteromedial - tight in flexion, prevents anterior translation of tibia (if torn + lachman)
If tunnel position it too vertical you would expect this physical exam finding
+pivot shift test (no rotational stability)
Blood supply of ACL
Middle Geniculate artery
Most common location of meniscal injury associated with ACL tear?
Lateral meniscus tear
Segond fracture is pathoneumonic for ACL tear is an avulsion injury of this ligamentous structure?
Anterolateral ligament (ALL)
Location of bone bruises associated ACL rupture?
Mid lateral femoral condyle
Posterolateral tibia
What are the primary reasons for why women have higher rates of ACL rupture?
Differences in neuromuscular control
Lower rate of COL5A1 gene
Smallest acceptable diameter graft for ACL reconstruction?
8.5mm
Avoid these exercises in postop ACL rehab…
open chain (A squat, for example, where the foot presses against the floor to raise the body, is a closed chain kinetic exercise. Using a leg curl machine, where the lower leg swings freely, is an example of open chain.)
MPFL is tightest at what position?
30 deg of flexion. When doing MPFL reconstruction this is the degree of flexion at which you should anchor the graft. Attache between adductor tubercle and medial epicondyle.
Type of exercise where distal end of extremity moves freely…
Open chain exercise (ie leg extension). Do not do for ACL rehab.
Type of exercise where distal end of extremity is fixed…
Closed chain exercise (ie squat). Good to do for ACL rehab.
Concussion rehab is stepwise and takes this amount of time…
Stepwise progression minimum 7 days with only progression through one milestone per day.
No return to same day game if concern for concussion sx. No return to play if b/l neurologic sx. Can return for unilateral “stinger” injury if it improves.
