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405 acl presentation 405 acl presentation Presentation Transcript

  • ACL Tears
    Randi M. Haupert
    PED 488
  • Overview
    “Anterior Cruciate Ligament”
    1 of 4 major ligaments in the knee
    Primary function is stabilization
    Prevents extreme motion within the knee
    http://www.orthoinfo.org/topic.cfm?topic=A00549
  • Key Components/ Factors of Topic
    200,000 annual injuries
    ½ result in ACL reconstruction surgery
    50% occur in correlation with meniscus, articular cartilage, or ligament damage
    Able to perform DTL without a properly functioning ACL
  • Causes
    Sports – Related Injury
    Motor Vehicle Accidents
    Falls
    Work – Related Injury
    ACL TEARS OCCUR MOST FREQUENTLY WHEN PIVOTION OR LANDING STRAIGHT LEGGED FROM A JUMP
  • Sports Related Injuries
    • 80% “Non Contact” Injuries
    • Female athletes are at higher risk
    Hyperextension: Over Straightening
    More than 10° beyond normal extension
    Skiing, volleyball, basketball, soccer, football
    Pivoting (Inward Rotation of lower leg) : Plant and twist combination
    Football, tennis, basketball, soccer
    Other common sports
    Wrestling, gymnastics, martial arts, running
    • Most frequently opt for surgery
    • Tom Brady, Tiger Woods
  • Severity
    Position of the knee at time of injury
    Direction of blow
    Force of blow
  • Signs/ Symptoms
    Knee usually gives-out from underneath
    “Pop” in the knee
    Pain and Swelling
    Discomfort while walking
    Reduced range of motion
    Physician Examination
    Instability of the knee
    Lachman Test
    MRI
    Pain and swelling can reduce within a couple weeks
    http://www.google.com/imgres?imgurl=http://factotem.org/library/images/Knee-MRI-and-Xray-images/f5-MRI-fully-torn-ACL-side-view.jpg&imgrefurl=http://factotem.org/library/database/Knee-Articles/Knee-MRI-and-Xray-images.shtml&usg=__dPwX0fIVW5MhIkMdO3EtWxCmbe0=&h=496&w=372&sz=27&hl=en&start=0&sig2=ffm3jrvL9B96qowUXtcQiA&zoom=1&tbnid=gfK5_AwRSMV92M:&tbnh=152&tbnw=114&ei=Ff79TLitJ4a8lQef0Z2fCA&prev=/images%3Fq%3Dmri%2Bof%2Ba%2Btorn%2Bacl%26hl%3Den%26sa%3DG%26biw%3D1362%26bih%3D533%26gbv%3D2%26tbs%3Disch:1&itbs=1&iact=hc&vpx=541&vpy=156&dur=203&hovh=259&hovw=194&tx=106&ty=129&oei=Ff79TLitJ4a8lQef0Z2fCA&page=1&ndsp=15&ved=1t:429,r:3,s:0
  • Lachman Test
    Knee flexed 30°
    Pull tibia to assess anterior range of motion
    Positive: Increased forward ROM
    http://www.youtube.com/watch?v=dH_jnTy1rNk&list=PL09D0DFA4E90D92B7&index=51&playnext=3
  • Treatment
    Not all ACL tears require surgery
    “Do you routinely perform activities that normally require a functional ACL?”
    “Is there knee instability?”
    If ACL is not completely torn
    Sedentary lifestyle or light manual work load
    Growth plates
  • Physical Therapy and Rehabilitation
    Physical Therapy and Rehabilitation
    Very important
    Restores motion
    Builds up strength
    Improves stability of joint
    Learn techniques to keep from reinjuring
    Individualized progression
    Hinged knee brace
    Many experience second injury
  • Surgery
    ACL Reconstruction
    Tendon or ligament from patella or hamstrings
    Standard treatment for young, active population
    Patellar tendon graft
    Hamstrings graft
    Allograft
    • 90% have no complications post – op
    • Concern with children: Can disrupt growth and development
  • Post Surgery
    Jog at 4 months
    Road biking 4-5 months
    Run in a straight line at 5 months
    Agility drills with brace at 6-8 months
    Sport specific activities at 4-24 months
  • Benefits of Exercise
    Strengthen muscles surrounding ACL to reduce risk of re-injury
    Maintain (or lose) weight
    Reduces stress on knees and lower extremities
    Keeps blood circulation to reduce risk of developing clots post - op
  • Risk with Exercise
    Progressing too quickly (or slowly) during rehabilitation
    Risk of re-injury
    Avoid twisting exercises
    Balancing exercises
    One leg weight bearing exercises
    Avoid weight bearing lunges
    Avoid elevation jumping exercises
  • How It Relates to Me
    Sports Medicine Physician
    Work with Olympic athletes
  • Works Cited
    http://www.ehealthmd.com/library/acltears/ACL_activities.html
    www.orthoinfo.aaos.org/topic.cfm?topic=a00297
    www.orthopedics.about.com/od/aclinjury/tp/acl.htm