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ACL Injury/Repair

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Nathan Hall

on 6 August 2013

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Transcript of ACL Injury/Repair

Biomechanics of the ACL
ACL Repair
Minimally invasive
Non-emergent
Good prognosis
Impact on Gait
Change in gait long-term

Risk of osteoarthritis

Loss of muscle strength
Summary
Anatomy - Alton
Mechanism of Injury - Erik
Gait Impact - Nathan
Rehab - Tony
Rehab
Anatomy and Normal Motion
Anterior Drawer Test
Lachman's Test
Pivot Shift Test
ACL Injury
Types
Grades 1-3
Anatomical considerations
Failure of intra-articular healing
References
1. Spindler, KP, Murray, MM, Devin, C, et al. 2006. The central ACL defect as a model for failure of intraarticular healing. J Orthop Res 24: 401-406.
2. Phillips BB. Arthroscopy of the lower extremity. In: Canale ST, Beatty JH, eds. Campbell's Operative Orthopaedics. 11th ed. Philadelphia, Pa: Mosby Elsevier; 2007:chap 48.
3. Honkamp NJ, Shen W, Okeke N, Ferretti M, Fu FH. Knee: Anterior cruciate ligament injuries in the adult. In: DeLee JC, Drez D Jr, Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 23, section D.
4. Amy E, Micheo W. Anterior cruciate ligament tear: Knee and lower leg. In: Frontera WR, Silver JK, Rizzo TD Jr, eds. Essentials of Physical Medicine and Rehabilitation. 2nd ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 55, section 7.
5. "ACL reconstruction, ACL tear." UC San Diego Health System. N.p., n.d. Web. 4 Aug. 2013. <sportsmedicine.ucsd.edu/conditions/knee/Pages/acl-tear.aspx>.
6. O'Donoghue D (1964). "The unhappy triad: Etiology, diagnosis and treatment". Am J Orthop6: 242–7 PASSIM.
7. Barber, FA (1992). "What is the terrible triad?". Arthroscopy 8 (1): 19–22.doi:10.1016/0749-8063(92) 90130-4
8. Julie Agel, Elizabeth A. Arendt, Boris Bershadsky. Anterior Cruciate Ligament Injury in National Collegiate Athletic Association Basketball and Soccer: A 13-Year Review. Am J Sports Med April 2005 33 524-531.
9. Quatman, Carmen E., Catherine C. Quatman-Yates, and Timothy E. Hewett. "A ‘Plane’ Explanation Of Anterior Cruciate Ligament Injury Mechanisms."Sports Medicine 40.9 (2010): 729-746. Print.
10. Boden, B. P., and W. E. Garrett. "Mechanisms Of Injuries To The Anterior Cruciate Ligament 156." Medicine & Science in Sports & Exercise28.Supplement (1996): 26. Print.
11. "ACL Complications | eORIF." eORIF | eORIF. N.p., n.d. Web. 4 Aug. 2013. <http://eorif.com/acl-complications>.
12. "Arthrex - ACL Reconstruction." Arthrex - Helping Surgeons Treat Their Patients Better. N.p., n.d. Web. 4 Aug. 2013. <http://www.arthrex.com/knee/acl-reconstruction>.
13. "ACL injury: MedlinePlus Medical Encyclopedia Image." National Library of Medicine - National Institutes of Health. N.p., n.d. Web. 4 Aug. 2013. <http://www.nlm.nih.gov/medlineplus/ ency/imagepages/18003.htm.>
14. [Print Graphic]. Retrieved from http://www.schultzlegalgroup.com/images/Knee-Accident-Injury-Lawyer.jpg
15. Butler, R. (2010). Gait mechanics after acl reconstruction: implications for the early onset of knee osteoarthritis.British Journal of Sports Medicine, 43(5), 366-370. doi: 10.1136/bjsm.2008.052522
16. Michael Lewek, Katherine Rudolph, Michael Axe, Lynn Snyder-Mackler, The effect of insufficient quadriceps strength on gait after anterior cruciate ligament reconstruction, Clinical Biomechanics, Volume 17, Issue 1, January 2002, Pages 56-63, ISSN 0268-0033, http://dx.doi.org/10.1016/S0268-0033(01)00097-3.
17. Devita, P. (1997). Gait adaptations before and after anterior cruciate ligament reconstruction surgery. Med Sci Sports Excercise, 29(7), 853-859. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/9243483
18. Anterior cruciate ligament injury: pre- and post-operative rehabilitation. (n.d.). Retrieved from http://www.dubinchiro.com/features/acl1.html
19. Best knee brace for torn acl. (n.d.). Retrieved from http://www.betterbraces.com/best-knee-brace-for-torn-acl
20. Klimkiewicz, J. (n.d.). Anterior cruciate ligament rehabilitation guidelines. Retrieved from http://www.georgetownuniversityhospital.org/documents/Orthopedic Surgery/protocols/sportsmedicine/Anterior_Cruciate_Ligament_Rehabilitation_Guidelines.htm
21. Goradia, V. (n.d.). Anterior cruciate ligament reconstruction rehabilitation program. Retrieved from http://goortho.net/pdf/Rehab/ACL_Rehab.pdf
22. Parker, D. (n.d.). Acl reconstruction rehabilitation protocol. Retrieved from http://www.sydneyortho.com.au/webpgaclprot.pdf

Contact 28%
Terrible Triad
Mechanism of Injury
Terrible Triad
Non-Contact 72%
Procedure
Risks
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Alton Canady, Nathan Hall, Tony Harp, Erik Malone
Phase 1 (0-4 weeks) post operative

Phase 2 (4-8 weeks)

Phase 3 (2-6 months)

Phase 4 (6 month+)
Bracing
During physical therapy and even after PT, braces are used to limit the instability of the ACL.
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Full transcript