Y5 - Knee: Anterior cruciate ligament (ACL) tear Flashcards

1
Q

what is the function of the ACL

A

prevents anterior tibial displacement

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2
Q

where does the ACL originate

A

the posteromedial aspect of the intercondylar notch on the lateral femoral condyle

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3
Q

where do the proximal fibres of the ACL run

A

along the medial wall of the lateral femoral condyle

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4
Q

what are the two bundles of the ACL

A

anteromedial

posterolateral

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5
Q

where does the ACL attach

A

onto the articular surface of the tibia, medial to the attachment of the anterior horn of the lateral meniscus

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6
Q

what does the ACL blend into

A

the anterior horn of the lateral meniscus

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7
Q

what is the common mechanism of injury for ACL tear

A

sudden change in direction causing the knee to rotate inwards

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8
Q

epi

A

more common in women than men due to anatomical differences in ACL

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9
Q

why are ACL tears more common in women than men

A

the synovial joint through which the ACL passes is smaller in women than in men causing greater susceptibility to damage due to higher levels of strain
also women use their quads>hamstrings which causes additional strain

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10
Q

define

A

a ligament which runs diagonally in the middle of the knee from the posterior femur to the anterior tibia

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11
Q

function of ACL

A

prevents anterior tibia displacement and provides rotational stability

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12
Q

what are the different strains for an ACL injury

A

Grade 1 - ACL has been stretched, knee is still stable
Grade 2 - ACL has been stretched and is now loose (partial tear)
Grade 3 - ACL has been completely torn

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13
Q

aetiology of ACL injury

A

changing direction rapidly
stopping suddenly
landing from a jump
direct contact or collision

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14
Q

epi

A

more common in women

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15
Q

signs and symptoms

A
a popping sound
pain & swelling
haemarthrosis
loss of range of motion
tenderness
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16
Q

who is avulsion with ACL injury most common in

A

children

17
Q

what is the most accurate manoeuvre for detecting an acute ACL tear

A

the Lachmans test

18
Q

what is the most accurate manoeuvre for detecting a chronic ACL tear

A

pivot shift test

19
Q

what is segonds fracture

A

a small capsular avulsion off the lateral aspect of the proximal tibia

20
Q

investigations

A

XRay - usually negative, may show segonds sign

MRI

21
Q

where may there by tenderness

A

at the lateral femoral condyle, the lateral tibial plateau

22
Q

management

A

depends on lifestyle, sedentary vs intense dynamic demands

23
Q

what different types of surgery are performed for ACL repairs

A

bone-patellar tendon-bone autograft

hamstring tendon grafts

24
Q

complications

A

bone bruising

medial collateral ligament injury

25
Q

what is the Unhappy Triad of O’Donoghu

A

a torn ACL
a torn MCL
a torn medial meniscus

26
Q

prognosis

A

good mechanical reconstruction

however few sportsman return, suggesting psychological factors