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2. Knee And Leg > ACL Tear > Flashcards

ACL Tear Flashcards

1
Q

What is the function of the ACL

A

Restrain arteriography translation of the tibia relative to the femur

It also contributes to rotational stability of the knee

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2
Q

What are the causes of ACL tear

A

History of twisting the knee whilst weight bearing

Most occur without contact and occur due to landing from a jump

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3
Q

what are the clinical features of ACL tear

A

Rapid joint swelling

Pain

Leg gives way

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4
Q

Why do you get rapid joint swelling with a ACL tear

A

Ligament is highly vascular therefore damage to it causes haemarthroisis => causing swelling in 15-20 mins

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5
Q

What are the two tests that can be carried out to identify potential ACL tear

A

Lachman test

Anterior draw test

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6
Q

What does the Lachman test involve

A

knee in 30 degrees of flexion and, with one hand stabilising the femur, pulling the tibia forward to assess the amount of anterior movement of the tibia compared to the femur. The other knee is then examined for comparison.

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7
Q

What does the anterior draw test involve

A

flexing the knee to 90 degrees, placing the thumbs on the joint line and their index fingers on the hamstring tendons posteriorly. Force is then applied anteriorly to demonstrate any tibial excursion, which is then compared to the opposite site.

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8
Q

Which tests is more sensitive at picking up ACL tears

A

Lachmans test

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9
Q

What the differential diagnosis

A

Fracture

Meniscal tear

Collateral ligament tear

Quadriceps or patellar ligament tear

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10
Q

What are the investigations you would do for a ACL tear

A

AP and lateral X-ray - exclusion of bony injuries, joint effusions, lipohaemarthrosis

Gold standard - MRI scan knee

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11
Q

How do you immediately manage an ACL tear

A

Immediate management of swollen knee - RICE

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12
Q

What is the conservative treatment of ACL tear

A

Strength training of the quadriceps

Canvas knee splint for comfort

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13
Q

How are ACL tears fixed surgically

A

Tendon/artificial graft

Surgery is carried out after:
prehabilitation’, whereby the patient will engage with a physiotherapist for a period of months prior to the surgery.

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14
Q

What are the complications of ACL injury and surgery

A

Post-traumatic OA

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15
Q

What is the function of PCL

A

Restrains the posterior tibial translation relative to the femur

Prevents hyperflexion of the knee

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16
Q

how do PCL tears most commonly occur

A

High energy trauma causing direct blow to the knee such as RTA

17
Q

What are the clinical features of PCL tear

A

Immediate posterior knee pain

Instability of the knee

Positive posterior draw test

18
Q

What is the fold standard investigation

A

MRI

19
Q

What is the conservative treatment for PCL tear

A

Knee brace

Physio

20
Q

What is the surgical treatment of PCL

A

Insertion of a tendon/ artificial graft

2. Knee And Leg (5 decks)

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