ACL Rupture

Question 1

What is an ACL Rupture?

Answer 1

Injury to knee joint

Question 2

What are the functions of the Anterior Cruciate Ligament (ACL)? (3 things)

Answer 2

1. Stabilises knee joint
2. Limits ant. movement of tibia
3. Knee rotational stability

Question 3

How do ACL tears happen?

Answer 3

Sudden change of direction (twisting knee while flexed + weight bearing)

Question 4

What are the clinical features of an ACL Rupture? (3 things)

Answer 4

1. Rapid joint swelling
2. Pain
3. Instability (legs give way) (if delayed presentation)

Question 5

What are the special tests for ACL Ruptures? (2 things)

What do they involve?

Answer 5

1. Lachman Test
2. Anterior Draw Test

Pulling tibia forwards

Question 6

What is the gold standard imaging for ACL Ruptures?

Answer 6

MRI (90% sensitivity)

Question 7

What would an MRI also show in an ACL Rupture?

Answer 7

If there is a Meniscal Tear too

50% of ACL tears also have Meniscal tear

Question 8

What can you exclude with an XR for ACL Ruptures? (3 things)

Answer 8

1. Bony injuries
2. Joint effusion
3. Lipohaemoarthrosis (collection of fat + blood in joint)

Question 9

What is the special thing seen in ACL Ruptures on an XR?

Answer 9

Segond # (bony avulsion of lat prox tibia)

Question 10

What is the immediate management for ACL Ruptures?

Answer 10

RICE (Rest, Ice, Compression, Elevation)

Question 11

What is the Conservative management option for ACL Ruptures?

Answer 11

Rehab (strength training)

Question 12

What are the Surgical management options for ACL Ruptures? (2 things)

Answer 12

1. Surgical reconstruction (tendon / artificial graft)

2. Surgical repair (re-suturing ends of torn lig)

Question 13

What are the complications of ACL Ruptures? (2 things)

Answer 13

1. Haemarthrosis (bleeding into joints)

2. Post-traumatic OA

Question 14

Why does Haemarthrosis happen with ACL Ruptures?

Answer 14

Bc lig is highly vasc

Presents quickly, within 15-30 mins