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405 acl presentation

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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