ACL Tears (Subscribe)  

The kNEEguru website presents a new course by Dr Frank Noyes on the reasons for ACL graft failure and the pitfalls of reconstruction surgery. Aimed at the consumer, but at a good level for family practitioners, the rehabilitation team, nurses and medical students.  [Free]

Contents
Introduction
Mechanism
Types of injuries – avulsions, mid substance tears
Diagnosis
Management
Controversy
Surgical options
Current consensus on surgical procedure
Outcome
Don Johnson MD Director Sports Medicine Clinic Carleton University Associate professor Orthopedic Surgery University of Ottawa Ottawa On, Canada KIS5B6

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Multiple techniques are available for reconstruction of the anterior cruciate ligament (ACL). Controversy certainly exists as to which autograft is best and which methods of placement and fixation should be used. Instances exist in which autograft is not available due to multiple reconstructions or in combined ligament injuries. In addition, after...

Discussion:
- anatomy of ACL
- biomechanics of ACL:
- mechanism: ACL Tear:
- natural history of the ACL-deficient knee
- partial ACL injury
- pediatric ACL injuries:
Wheeless' Textbook of Orthopaedics

The anterior cruciate ligament (ACL) originates from the tibial plateau just medial and anterior to the tibial eminence. The ACL tracts from the tibia superiorly, laterally, and posteriorly to its insertion on the posterior aspect of the medial wall of the lateral femoral condyle. The ACL is composed of 2...

The anterior cruciate ligament (ACL) is one of the most commonly injured ligaments of the knee. Injuries occur predominately in a young and sports-active population. Many patients are left with significant disability following injury to the ACL. Understanding and preventing associated meniscal pathology is the key to management of this...

Anterior cruciate ligament rupture, whether treated surgically or not, is associated with an increase in osteoarthritis in former soccer players.
J Feller Br J Sports Med. 2004 Aug;38(4):383-4.

Modern ACL reconstruction using Hamstrings. Diagrams and Video animation. Arthroscopic. Day case.
Anterior Cruciate Ligament Reconstruction.

- need to determine whether the fibrosis has primarily affected flexion or extension;
- need to determine either from radiographs or from MRI, whether incorrect tunnel placement, is the cause of the decrease motion...

The following is a summary of an article by Traina and Bromberg in Orthopedics Vol 20 No 6 June 1997 In the NCAA, the Injury rates are 2.4X greater in soccer and 4.1 X greater in basketball for female athletes. The reason for this increase is still speculative, but there are...

CONCLUSIONS: A high prevalence of radiographic knee osteoarthritis was seen in male soccer players 14 years after an ACL disruption. The injury and the osteoarthritis, irrespective of the treatment provided to these patients, often result in knee related symptoms that severely affect the knee related quality of life by middle...

Knee stability assessment on anterior cruciate ligament injury: clinical and biomechanical approaches
Anterior cruciate ligament (ACL) injury is common in knee joint accounting for 40% of sports injury. ACL injury leads to knee instability, therefore, understanding knee stability assessments would be useful for diagnosis of ACL injury, comparison between operation treatments...

Knee stability assessment on anterior cruciate ligament injury: clinical and biomechanical approaches
Anterior cruciate ligament (ACL) injury is common in knee joint accounting for 40% of sports injury. ACL injury leads to knee instability, therefore, understanding knee stability assessments would be useful for diagnosis of ACL injury, comparison between operation treatments...

- this is a variant of the anterior drawer test, in which the examination is carried out w/ the knee in 15 deg of flexion, and external rotation (relaxes the IT band);
Wheeless' Textbook of Orthopaedics