MSK pathology- Anterior cruciate ligament sprain

Question 1

where does the anterior cruciate ligament (ACL) run from?

Answer 1

the anterior intercondylar area of the tibia to the medial aspect of the lateral femoral condyle in the intercondylar notch

Question 2

what ligament of the knee runs from the anterior intercondylar area of the tibia to the medial aspect of the lateral femoral condyle in the intercondylar notch?

Answer 2

ACL

Question 3

what displacement does the ACL prevent?

Answer 3

it prevents anterior displacement of the tibia in relation to the femur

Question 4

the ACL prevents __ displacement of the tibia in relation to the __

Answer 4

anterior; femur

Question 5

how is the extent of an ACL sprain classified?

Answer 5

according to the extent of ligament damage

Question 6

grade I ACL sprain

Answer 6

involves microscopic tears to the ligament

Question 7

what grade ACL sprain involves microscopic tears to the ligament?

Answer 7

grade I

Question 8

grade III ACL sprain

Answer 8

indicates a completely torn ligament

Question 9

what grade ACL sprain indicates a completely torn ligament?

Answer 9

grade III

Question 10

ACL sprain etiology?

Answer 10

noncontact twisting injury associated with hyperextension, varus or valgus stress to the knee

Question 11

ACL sprains are typically __ twisting injuries associated with __, __ or __ stress to the knee

Answer 11

noncontact; hyperextension, varus or valgus

Question 12

ACL sprains often involves injury to what other knee structures?

Answer 12

medial capsule
MCL
menisci

Question 13

signs and symptoms of ACL sprain?

Answer 13

MOI
hearing a loud pop
feeling of knee giving way/buckling followed by dizziness, sweating and swelling

Question 14

special tests (3) to identify the presence of an ACL tear?

Answer 14

anterior drawer test
Lachman test*
lateral pivot shift test

Question 15

acute treatment of an ACL sprain?

Answer 15

RICE
NSAIDs
analgesics
*all as needed

Question 16

conservative treatment of an ACL sprain?

Answer 16

lower extremity strengthening
exercises emphasizing the quads and hamstrings

Question 17

for what grade ACL sprain is surgical intervention often warranted?

Answer 17

grade III- complete tear of ACL

Question 18

what does ACL surgery typically consist of?

Answer 18

intra-articular reconstruction using the patellar tendon, ITB or hamstring tendon

Question 19

ACL surgery typically consists of __ reconstruction using the __ tendon, __ or __ tendon

Answer 19

intra-articular
patellar, ITB or hamstring tendon

Question 20

when is a derotation brace beneficial for a patient? with what type of medical management does it have limited benefit?

Answer 20

beneficial for a patient with an ACL deficient knee
limited benefit for patient following surgical reconstruction