Week 14 Flashcards
When does a ACL tear most often occur
A cut or plant motion
2/3 are non contact cause
1/3 is due to contact or external object
What are the biomechanics of an ACL tear
Hip adduction
Hip internal rotation
Knee valgus
Ankle eversion
What is the sex bias in ACL tears
Why
Females are at 4-8 times higher risk than males
Strength - lower in the hip abductors
Anatomy - wider pelvis
Ligament laxity - varies with menstrual cycle
What hormones relate to increase risk of ACL tears during menstrual cycle
Day 12-14
Estradiol increases as risk increases
What is the gold standard for rehabilitation of ACL
ACLR
ACL reconstruction
What are the types of ACLR
Allograft
Autograft
What is a allograft
When you take a tissue from someone else
Insert into knee
Also synthetic tissue
What is the autograft
What is most common
Use own tissue
Most common are:
Patellar tendon
Hamstring
What is the problem with ACL tears
The incidence of a second ACL tear after ACLR and return to sport is HIGH
Re injury rates as high as 29% at a 2 year follow up
In Dr. Hannigans research what did he find
Significantly higher Hip adduction in females in RUNNING
Significantly higher Hip adduction AND Knee valgus in females in CUTTING
Negative hip adduction in males in CUTTING
No Significant difference in drop landing
What are the implications of the research
Females have worse kinematics than males post ACLR that place them at risk of re tear
Rehabilitation protocols need to improve
What are the future directions of the research
Motor retraining for dynamic tasks during ACLR rehabilitation
Visual, verbal or tactile cues for cutting and landing
What is knee osteoarthritis
When the protective cartilage on the ends of your bones wears down over time
What are some risk factors of knee osteoarthritis
Previous knee injuries
Valgus or varus gait
What are the 2 types of knee arthroplasty
Total knee arthroplasty
Unicompartmental knee arthroplasty
What is total knee arthroplasty
Completely replace knee
What are the positives and negative of total knee arthroplasty
Positive:
Generally more cost effective long term
Negative:
Replaces entire knee even if some tissue is healthy
What are the positives and negative of unicompartmental knee arthroplasty
Positive:
Saves healthy tissue
Negative:
Patients will generally need TKA later in life
What is a problem with knee replacement
Really common
Mechanical axis malalignment found in almost 1/3 of surgeries
How are we looking to fix malalignment in surgeries
MAKO rio robotic arm system
What are the stages of the MAKO ARM system
Before surgery:
CT scan
During surgery:
Feedback during bone resection
3D capture for knee alignment
What were the functional outcomes of Dr. Hannigans research on Knee oestoarthitis
People who did the MAKO procedure were less aware that they had the surgery after
MAKO was generally better in all categories apart from pain compared to traditional
What were the hip kinematic differences in Dr. Hannigans research on knee oestoarthitis
Why
Less hip movement for both surgical grounds
Less hip adduction in MAKO group compared to traditional
Slower walking velocity, possbily due to decreased gait stability
What were the knee kinematic differences in Dr. Hannigans research on knee oestoarthitis
High valgus in MAKO group which is NOT ideal
Less knee varus than healthy group
What were the knee moments differences in Dr. Hannigans research on knee oestoarthitis
Lowest external knee varus moment in MAKO group, less than traditional and healthy
Summary of Dr hannigans research on knee oestoarthitits
Some functional scores are better with MAKO
Both groups may have slower walking speed and less gait stability than healthy group
Knee varus moments lower in MAKO group
Which of the following is not a reason why females are more likely to tear their ACL compared to males?
Females have more knee range of motion, which increases injury risk
An allograft is from the participant’s own tissue, usually the patellar tendon or hamstring tendon.
False
Dr. Hannigan found that females 1 year post-ACL rehabilitation have significantly greater knee valgus during cutting.
True
Dr. Hannigan observed statistically significant differences in drop landing biomechanics between sexes.
False
Which of the following is not a biomechanical risk factor for an ACL tear during cutting or jump-landing?
Hip adduction
Hip internal rotation
Knee valgus
Ankle inversion
Ankle inversion
A unicompartmental knee arthroplasty is when only 1 compartment of the knee is replaced during surgery.
True
Which of the following is not a component of the Mako Robotic System?
3D motion capture immediately after surgery to assess gait biomechanics and stability
In Dr. Hannigan’s research, the Mako group had less awareness of their artificial joint, according to the Forgotten Joint Score survey.
True
What was the only KOOS sub-score that was lower in the Mako group?
Pain
In Dr. Hannigan’s research, the external knee varus moment was significantly higher in the Mako group compared to the traditional and control groups.
False
