Week 14

Question 1

When does a ACL tear most often occur

Answer 1

A cut or plant motion

2/3 are non contact cause
1/3 is due to contact or external object

Question 2

What are the biomechanics of an ACL tear

Answer 2

Hip adduction

Hip internal rotation

Knee valgus

Ankle eversion

Question 3

What is the sex bias in ACL tears

Why

Answer 3

Females are at 4-8 times higher risk than males

Strength - lower in the hip abductors
Anatomy - wider pelvis
Ligament laxity - varies with menstrual cycle

Question 4

What hormones relate to increase risk of ACL tears during menstrual cycle

Answer 4

Day 12-14

Estradiol increases as risk increases

Question 5

What is the gold standard for rehabilitation of ACL

Answer 5

ACLR

ACL reconstruction

Question 6

What are the types of ACLR

Answer 6

Allograft

Autograft

Question 7

What is a allograft

Answer 7

When you take a tissue from someone else

Insert into knee

Also synthetic tissue

Question 8

What is the autograft

What is most common

Answer 8

Use own tissue

Most common are:
Patellar tendon
Hamstring

Question 9

What is the problem with ACL tears

Answer 9

The incidence of a second ACL tear after ACLR and return to sport is HIGH

Re injury rates as high as 29% at a 2 year follow up

Question 10

In Dr. Hannigans research what did he find

Answer 10

Significantly higher Hip adduction in females in RUNNING

Significantly higher Hip adduction AND Knee valgus in females in CUTTING

Negative hip adduction in males in CUTTING

No Significant difference in drop landing

Question 11

What are the implications of the research

Answer 11

Females have worse kinematics than males post ACLR that place them at risk of re tear

Rehabilitation protocols need to improve

Question 12

What are the future directions of the research

Answer 12

Motor retraining for dynamic tasks during ACLR rehabilitation

Visual, verbal or tactile cues for cutting and landing

Question 13

What is knee osteoarthritis

Answer 13

When the protective cartilage on the ends of your bones wears down over time

Question 14

What are some risk factors of knee osteoarthritis

Answer 14

Previous knee injuries

Valgus or varus gait

Question 15

What are the 2 types of knee arthroplasty

Answer 15

Total knee arthroplasty

Unicompartmental knee arthroplasty

Question 16

What is total knee arthroplasty

Answer 16

Completely replace knee

Question 17

What are the positives and negative of total knee arthroplasty

Answer 17

Positive:
Generally more cost effective long term

Negative:
Replaces entire knee even if some tissue is healthy

Question 18

What are the positives and negative of unicompartmental knee arthroplasty

Answer 18

Positive:
Saves healthy tissue

Negative:
Patients will generally need TKA later in life

Question 19

What is a problem with knee replacement

Answer 19

Really common

Mechanical axis malalignment found in almost 1/3 of surgeries

Question 20

How are we looking to fix malalignment in surgeries

Answer 20

MAKO rio robotic arm system

Question 21

What are the stages of the MAKO ARM system

Answer 21

Before surgery:
CT scan

During surgery:
Feedback during bone resection
3D capture for knee alignment

Question 22

What were the functional outcomes of Dr. Hannigans research on Knee oestoarthitis

Answer 22

People who did the MAKO procedure were less aware that they had the surgery after

MAKO was generally better in all categories apart from pain compared to traditional

Question 23

What were the hip kinematic differences in Dr. Hannigans research on knee oestoarthitis

Why

Answer 23

Less hip movement for both surgical grounds

Less hip adduction in MAKO group compared to traditional

Slower walking velocity, possbily due to decreased gait stability

Question 24

What were the knee kinematic differences in Dr. Hannigans research on knee oestoarthitis

Answer 24

High valgus in MAKO group which is NOT ideal

Less knee varus than healthy group

Question 25

What were the knee moments differences in Dr. Hannigans research on knee oestoarthitis

Answer 25

Lowest external knee varus moment in MAKO group, less than traditional and healthy

Question 26

Summary of Dr hannigans research on knee oestoarthitits

Answer 26

Some functional scores are better with MAKO Both groups may have slower walking speed and less gait stability than healthy group Knee varus moments lower in MAKO group

Question 27

Which of the following is not a reason why females are more likely to tear their ACL compared to males?

Answer 27

Females have more knee range of motion, which increases injury risk

Question 28

An allograft is from the participant's own tissue, usually the patellar tendon or hamstring tendon.

Answer 28

False

Question 29

Dr. Hannigan found that females 1 year post-ACL rehabilitation have significantly greater knee valgus during cutting.

Answer 29

True

Question 30

Dr. Hannigan observed statistically significant differences in drop landing biomechanics between sexes.

Answer 30

False

Question 31

Which of the following is not a biomechanical risk factor for an ACL tear during cutting or jump-landing? Hip adduction Hip internal rotation Knee valgus Ankle inversion

Answer 31

Ankle inversion

Question 32

A unicompartmental knee arthroplasty is when only 1 compartment of the knee is replaced during surgery.

Answer 32

True

Question 33

Which of the following is not a component of the Mako Robotic System?

Answer 33

3D motion capture immediately after surgery to assess gait biomechanics and stability

Question 34

In Dr. Hannigan's research, the Mako group had less awareness of their artificial joint, according to the Forgotten Joint Score survey.

Answer 34

True

Question 35

What was the only KOOS sub-score that was lower in the Mako group?

Answer 35

Pain

Question 36

In Dr. Hannigan's research, the external knee varus moment was significantly higher in the Mako group compared to the traditional and control groups.

Answer 36

False