Collateral Ligaments - KaNee Flashcards
(49 cards)
What is the main way the ACL gets injured?
Through non-contact injuries
- usually a combination of hyperextension and valgus
What is the function of the ACL?
as the primary stopper to anterior movement of the tibia on the femur
secondary stopper of IR and ER of a NWB knee
What are the subjective findings regarding ACL injuries?
- women are 2-8x more at risk (!!)
- twisting or hyperextion as a mechanism of injury
- that popping or giving out feeling
- pain and onset dysfunction
- instability of the affected knee and can’t walk w/o assistance
- swelling right away (acute hemarthosis)
What is seen in the objective findings for ACL?
- increased swelling
- pain
- (+) anterior stability tests
- other knee structures are affected
What are the special tests conducted for ACLs?
Anterior drawer (Sn = 0.41 / Sp = 0.95)
Lachman (Sn = 0.82 / Sp = 0.97)
Pivot shift (Sn = 0.82 / Sp = 0.98)
Lelli’s
What is the gold standard for ACL special test?
The lachman’s test with the most sensitivity for acute ACL rupture
- (+) in 80% of nonanesthetized pts and 100% in anesthetized
What is the difference between an intact vs sprained ligament?
intact = abrupt and firm end-feel
sprained = soft or distinct end feel depending on the injury
What is the typical prognosis of an ACL tear?
Usually has other structures that are affected
- a post-op = 8-12 months for return to activity
What is the process of ACL reconstruction surgery?
It doesn’t fix the damanged/torn ligament but creates a new ligament using other tissues in the leg
can use their autograft or allograft
What is an autograft?
using own tissue which is usually, patellar tendon, hammies and quad tendon
What is an allograft?
using a tissue from a cadaver
What are the pros of allografts?
- lack of harvest morbidity
- less trauma and quicker surgery (due to less cutting)
- decreased post-op pain
- easier and early rehab
- sizing limits
What are the cons for allographs?
slower rate of biologic adaptation
longer inflammatory response
be able to “stretch”
slower revascularization and recellularization
What is the biggest problem for allographs?
HIGH fail rate (~ 25%) in youth
What are the usually load failures for native and autographs for ACL reconstruction?
Native = 1725 to 2160 N
Hammies = 2640 N
Patellar = 1580 N
Quads = 2185 N
Patellar -> Quads -> Hammies (strongest)
What is the overall graft failure rate?
11%
- the graft choice has no effect on the failure rate
What is the contralateral ACL injury rate?
13%
- possible compensations and just the worse luck ever
What are the major goals of rehab for ACL-injuries?
get good functional stability
bring back muscle swoleness
return to functional level
↓ the possibility for re-injury
using proper techniques like closed and open chain for proper rehab and progression
What is the most important movement
factors for ACL recovery?
getting full knee extension and good quad activation
What is the “general” time frame for ACL?
most people agree on a minimum of 6 months before getting back out there
the assumption is around 7-10 months with around a year recovery
4-5 months is jogging :)
What is the concern for return to sports for ACL injuries?
81% = return to some sport
65% = pre-injury level
55% = back to competitive sports
the risk of the second ACL is GREATER in both knees BUT more likely to happen on the opposite side :0
What is the main characteristic that differentiates the PCL from the ACL?
THAT BIH STRONG AS HELL
- the strongest and largest intra-articular ligament in the human knee
- it usually is either a stretch or complete rupture
What is the function of the PCL?
Primary stopper for posterior translation of the tibia onto the femur
How prevalent is a PCL injury?
less common than ACLs
- 3% of OP knee injuries
- 38% of acute traumatic knee hemarthroses
- 95% happens with other injuries (how bad the causes are for this thang)
