Melissa Rozman
THE KNEE IS ONE OF THE LARGEST AND MOST COMPLEX JOINTS IN
THE BODY.
THE KNEE IS ESSENTIALLY A HINGED JOINT THAT IS HELD TOGETHER
BY THE MEDIAL COLLATERAL, LATERAL COLLATERAL, ANTERIOR
CRUCIATE, AND POSTERIOR CRUCIATE LIGAMENTS.
ON EITHER SIDE OF THE JOINT, BETWEEN THE CARTILAGE SURFACES
ARE THE MEDIAL MENISCUS AND LATERAL MENISCUS. THEY ACT AS
“SHOCK ABSORBERS.”
THE SMALLER BONE THAT RUNS ALONGSIDE THE TIBIA AND THE
KNEECAP (PATELLA) ARE THE OTHER BONES THAT MAKE THE KNEE
JOINT.
THE ACL IS ONE OF THE 4 MAIN LIGAMENTS WITHIN THE KNEE THAT
CONNECT THE FEMUR TO THE TIBIA (MCL, LCL, ACL, PCL.)
THE ACL RUNS DIAGONALLY IN THE MIDDLE OF THE KNEE,
PREVENTING THE TIBIA FROM SLIDING OUT IN FRONT OF THE FEMUR,
AS WELL AS PROVIDING ROTATIONAL STABILITY TO THE KNEE.
THE ACL IS ONE OF THE MOST COMMONLY INJURED LIGAMENTS OF
THE KNEE.
APPROXIMATELY 200 000 ACL RECONSTRUCTIONS PREFORMED A
YEAR.
50% OF ACL INJURIES OCCUR IN COMBINATION WITH DAMAGE TO
THE MENISCUS.
ACL TEARS CAN BE PARTIAL, (WHICH DOESN’T REQUIRE SURGERY) OR
COMPLETE.
70% OF ACL INJURIES OCCUR THROUGH NON-CONTACT MECHANISMS
SUCH AS PIVOTING, SHARP CUTS/TURNS, JUMPING AND LANDING
UNEVENLY, OR SIDE STEPPING MANEUVERS.
ACL INJURIES ARE HAVE A HIGHER RISK WITH ATHLETES WHO PLAY
BASKETBALL, FOOTBALL, VOLLEYBALL AND SOCCER.
SEVERAL STUDIES HAVE SHOWN THAT FEMALE ATHLETES HAVE A
HIGHER RISK OF THIS INJURY THEN MALES BECAUSE OF THE
DIFFERENCES IN PHYSICAL CONDITIONING, AND MUSCULAR STRENGTH.
http://www.youtube.com/watch?v=lpIOMuqXWrE
• X-ray
• MRI
• Movement Tests
• Lachman's Test
• Pivot Shift Test
• Your doctor will evaluate your knee injury based on questions about pain, swelling, and giving way. Also if you heard a painful "pop" or tear, or if your knee felt like it feel out of joint at the time of injury.
http://orthoinfo.aaos.org/topic.cfm?topic=a00297
2 Days Post-Op
3 Weeks Post-Op
1 Week Post-Op
2 Weeks Post-Op
1 Month Post-Op
WHEN LOOKING AT ACL INJURY PREVENTION ATHLETES HAVE TO REMEMBER THAT
EACH INDIVIDUAL IS DIFFERENT, WHAT IS GOOD FOR ONE PERSON MAY NOT BE
GOOD FOR ANOTHER.
ATHLETES CAN REDUCE THEIR RISK OF ACL INJURIES BY PERFORMING TRAINING
DRILLS THAT REQUIRE BALANCE, POWER AND AGILITY.
ADDING EXERCISES, SUCH AS JUMPING, AND BALANCE DRILLS HELPS IMPROVE
NEUROMUSCULAR CONDITIONING AND MUSCULAR REACTIONS AND ULTIMATELY
SHOWS A DECREASE IN THE RISK OF ACL INJURY.
YOU CAN ALSO PREVENT ACL TEARS BY WARMING UP AND STRETCHING PROPERLY
BEFORE AND AFTER ANY PHYSICAL ACTIVITY YOU ARE PARTICIPATING IN.
THERE ARE MANY ACL PREVENTION PROGRAMS YOU COULD BE APART OF TO
LOWER YOUR RISK.
• 1.Single leg sit to stand
• 2.Single or double leg ball hamstring curl
• 3.Resisted side stepping (elastic tubing around knees and/or feet)
• 4.Walking lunges with torso rotation (slowly)
4/10/2020
ACL TEARS ARE NOT USUALLY REPAIRED USING SUTURE TO SEW IT
BACK TOGETHER BECAUSE THEY HAVE GENERALLY FAILED OVER TIME.
THERE ARE FOUR SURGICAL TREATMENTS TO REPAIR ACL TEARS:
-PATELLAR TENDON AUTOGRAFT
-HAMSTRING TENDON AUTOGRAFT
-QUADRICEPS TENDON AUTOGRAFT
-ALLOGRAFT TENDON AUTOGRAFT (TAKEN FROM A CADAVER)
CONSIDERED THE “GOLD STANDARD”
THE MIDDLE THIRD OF THE PATELLAR TENDON OF THE PATIENT, ALONG THE
KNEECAP.
THE RATE OF GRAFT FAILURE IS THE LOWEST OUT OF ALL TREATMENTS (1.9%)
HAMSTRING TENDON ON THE INNER SIDE OF THE KNEE.
THIS CREATES A TWO- OR FOUR-STRAND TENDON GRAFT.
THERE ARE FEWER PROBLEMS WITH ANTERIOR KNEE PAIN OR
KNEECAP PAIN AFTER SURGERY.
THE QUADRICEPS TENDON AUTOGRAFT IS OFTEN USED FOR
PATIENTS WHO HAVE ALREADY FAILED ACL RECONSTRUCTION.
THE MIDDLE THIRD OF THE PATIENT'S QUADRICEPS TENDON AND A
BONE PLUG FROM THE UPPER END OF THE KNEE CAP ARE USED.
ALLOGRAFTS ARE GRAFTS TAKEN FROM CADAVERS AND ARE
BECOMING INCREASINGLY POPULAR.
ALLOGRAFT OPTIONS INCLUDE THE PATELLAR TENDON AND THE
ACHILLES TENDON, WHICH ARE AVAILABLE WITH BONE BLOCKS
.
http://www.youtube.com/watch?v=q96M0jRqn7k
A FULLY HEALED ACL TEAR TAKES ANYWHERE FROM 9 MONTHS TO A
YEAR TO BE HEALED.
YOU SHOULD SEE A PHYSIOTHERAPIST 10 DAYS AFTER YOUR SURGERY
AND THEN ONCE A WEEK FOR 3-6 MONTHS. AFTER APPROXIMATELY 6
MONTHS YOU SHOULD SEE YOUR PHYSIOTHERAPIST 2-3 TIMES A
WEEK.
YOUR PHYSIOTHERAPIST WITH STRENGTHEN YOUR QUADRICEPS,
HAMSTRING, AND CALF MUSCLES.
THE FOWLER KENNEDY SPORTS MEDICINE CLINIC IS ONE OF THE TOP
SPORT REHABILITATION CENTERS IN CANADA. http://www.youtube.com/watch?v=UxklUobyTq8
Stretching or Range of Motion
Exercises
• 1. Hamstring Stretches
• 2. Quadriceps Stretch
Strengthening Exercises
• 1. Leg Extension Exercises and
Straight Leg Raises
• 2. 1/4 Squats- Progressing from double leg to single leg
• 3. Step-ups- Forward and Lateral
4/10/2020
• http://fowlerkennedy.com/physiotherapy
• http://orthoinfo.aaos.org/topic.cfm?topic=a00297
• http://www.pamf.org/sports/king/kneerehab.html
• http://www.sportmed.ucalgary.ca/ACL
• http://www.pthealth.ca/conditions/knee-pain-treatment?ibpadgroup=tierfour&gclid=CMaDy_fH_LsCFclcMgodRg4AUA
• http://www.youtube.com/watch?v=q96M0jRqn7k
• http://www.youtube.com/watch?v=lpIOMuqXWrE
• http://www.youtube.com/watch?v=UxklUobyTq8
4/10/2020