acl

Question 1

Origin insertion of ACL

Answer 1

A
runs Posterioly
inserts in External (lateral) condyle of femur

Question 2

function of ACL

Answer 2

resist anterior translation of tib on femur
resist rotation of femur on tib

resist valgus
assist in screw home mechanism

Question 3

mechanism of ACL injruy

Answer 3

70% non contact

between 0-30 deg flexion

Question 4

can ACL injury happen from excessive hyper flexion and extention

Answer 4

yes

Question 5

T/f ACL is most frequent totally disrupted ligament in KNEE

Answer 5

true

Question 6

Why higher in females

Answer 6

intrinsic

Extrinsic factors

Question 7

Extrinsic factors

Answer 7

ligament dominance,
supporting mm don’t absorb GRF,
quad dominant,
stiff landing posture

leg dominance

Question 8

intrinsic

Answer 8

anatomy
limb posture
joint laxity
size of indracondyal notch

Question 9

which leg at greater risk for ACL

Answer 9

the unfavoured leg

Question 10

diagnosing ACL

Answer 10

history
observation
special tests

Question 11

what in history makes you think ACL

Answer 11

pain
unable to play on
swelling, when and how much
instability

Question 12

condition that accompany an ACL

Answer 12

mensical damage
capsular damage
secondary ligament
fracture

Question 13

Is surgery best

Answer 13

we don’t know whats best long term

Question 14

first thing after ACL

Answer 14

get quad strength pre op
increase load
open chain

Question 15

name 2 types of ACL surgeries

Answer 15

semitendinosus - gracillis

bone-patellar tendon - bone

Question 16

sequences of events in graft healing

Answer 16

avascular necrosis
cellular infiltration
vascular invasion
remodelling (1-3 years)

Question 17

potential ACL surgery complications

Answer 17

pain/swelling
loss of ROM
laxity
nerve injury
infection
DVT

Question 18

two elements of proprioception

Answer 18

joint position sense

sense of limb movement

Question 19

what provides proprioception

Answer 19

mechaoreceptors
nociceptors
mm afferents

Question 20

t/F acl has proprioceptive properties and is a mechanical stabilizer

Answer 20

t

Question 21

whats a major factor in ACL injury / re injury risk

Answer 21

poor control of dynamic movements

Question 22

t/f deficits in uninjured leg post op has similar deficits

Answer 22

t

Question 23

goal of ACL patients

Answer 23

inc unconscious motor response
improve nervous systems optimal mm firing for stability

unlearn some movements

Question 24

if ACL left untreated what are some deficits

Answer 24

mm weakness

impaired neurological control

Question 25

how to increase demand in ACL exercises

Answer 25

add internal and external perturbation

Question 26

stages in post op ACL

Answer 26

``` pre op immediate post op (1week) early rehab (2-4) inter rehab (4-10) advanced activity (10-16) Return to activity (16-22) ```

Question 27

do isometric hamstring exercise >60 degs endanger the graft

Answer 27

no

Question 28

which exercise results in more axial orientated forces and mm co contraction

Answer 28

closed k chain

Question 29

when is graft week

Answer 29

6-12 weeks

Question 30

goals in pre op phase

Answer 30

reduce swelling pain ROM mm activity eduation

Question 31

immediate post op goals

Answer 31

``` extention swelling / pain flexion quad control ind ambulating hamstring strength to 8-% ```

Question 32

when should ACL have 90 deg flexion by

Answer 32

day 5 | and 100 by 7

Question 33

goal of early post op

Answer 33

``` ext swelling pain flexion proprioception patellar mobility hamstring back to full ```

Question 34

which phase should hamstring be back to full strength

Answer 34

early post op week 2-4

Question 35

intermediate post op goals

Answer 35

``` ROM LE strength proprioception, banche, control mm endurance limb confidence ```

Question 36

is there a role for open chain quad strengthening

Answer 36

yes - more quad stretch and RTS but no difference in lax

Question 37

how to avoid undue stress on healing graft

Answer 37

limit knee rom from 90-45 deg for any NWB exercise progress to 90-10 deg by week 12

Question 38

advanced activity phase

Answer 38

``` LE prop, balance power , endruace sport specific hop test ```

Question 39

where should the hop test bee by week 12

Answer 39

>85%

Question 40

Return to activity phase

Answer 40

unrestricted in sport | progress training

Question 41

why do we care if the meniscus was repaired

Answer 41

more post op restriction | i.e. limited in ROM in WB