Anterior Cruciate Ligament
Functional Anatomy of the Anterior Cruciate Ligament:
The knee joint is a complex organ which allows for a multidirectional movement of the joint including an internal/external rotation, flexion/extension and a variety of valgus movements.
The direction of the knee joint movement is regularly controlled by the ligaments and geometric constraints of the articular surfaces (Woo et al., 1999). The movements of the knee can occur in different directions which gives each ligament a multifunctional purpose. The major function of the anterior cruciate ligament is to prevent extreme anterior tibial movement in different degrees of flexion. The ligament itself aids significantly to the stabilization and the kinematics of the knee joint.In addition, the ACL functions as a major secondary restraint to internal rotation, particularly when the knee is near full extension.(Duthon et al., 2006)
Origin/Insertion:
The ACL is a broad ligament joining the anterior tibial plateau to the posterior femoral intercondylar notch. The tibial attachment is to a facet, in front of, and lateral to the anterior tibial spine. The femoral attachment is high on the posterior aspect of the lateral wall of the intercondylar notch. The ACL originates at the medial wall of the lateral femoral condyle and inserts into the middle of the intercondylar area. (Heming, Rand & Steiner, 2007))
NORMAL: Extension to flexion
Male: normal ROM (6->140 degrees)
Female: normal ROM (5->145 degrees)
Anterior Cruciate Ligament tears:
Anterior cruciate ligament (ACL) injury is a devastating injury that occurs with high frequency during sport athletic participation. More than 200 000, ACL injuries are estimated to occur in the United States annually.1–3 previ...
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...ptions, the knee cannot be completely return to "normal." However, surgical reconstruction is an attempt to make it as close to normal as possible, or to the ability of the knee before injury.
Anterior Cruciate rehab
Anterior cruciate ligament rehabilitation has undergone a considerable amount of change within the past decade. With thorough research into the biomechanics of the injury itself and on the operated knee have both helped with the movement away from the techniques of the early 1980's.
The major goals of rehabilitation following ACL surgery are:
1) Restoration of the joint anatomy;
2) Delivery of static and dynamic stability;
3) Maintenance of the aerobic conditioning and psychological well-being;
These have help development an intensive rehabilitation program for the patient. It will take an active involvement by the patient to assure optimum recovery.
The elbow is a hinge joint, moving in only one dimension (flex or extend), making it relatively simple from an architectural and functional standpoint. The humerus bone in the upper arm connects to the two bones of the forearm by means of various connective tissues. For a pitcher, one of the most important of these connections is the unlar collaterial ligament (UCL). The UCL offers much of the stability that is necessary for the elbow to withstand the extreme stresses created by throwing a baseball at high velocity. Its function is to stabilize against lateral forces and to keep the arm connected across the joint space.
The cruciate ligaments are so named because of their cross-configuration within the joint. The anterior cruciate ligament attaches to the tibia on its anterior-superior surface, crossing through the joint from the medial side to its lateral attachment on the femur. The posterior cruciate ligament attaches on the posterior-superior aspect of the tibia, crossing diagonally and medially to its lateral attachment on the femur. The anterior and posterior cruciates protect against hyperextension and hyperflexion, respectively.
The incidence and prevalence rate of anterior cruciate ligament (ACL) injuries in female athletes continues to increase over time (Prodromos, Han, Rogowski, Joyce, & Shi, 2007). With the growing rate in the amount of young women participating in sports, data has shown that the rate of ACL injury increases linearly with this participation ("The Relationship Between Static Posture and ACL Injury in Female Athletes," 1996). This epidemic of ACL injuries in female athletes, young or old, continues to be problematic in the athletic world. This problem not only affects the athlete themselves, but also the coaches and the sports medicine community.
They permit immediate full weight bearing and restoration of full ROM after undergoing reconstruction. Rehab programs, however, still need to be progressed according to specific guidelines and parameters concerning the patient abilities. Patients participating in these programs progressed themselves faster through the protocols, and were actually gaining knee extension at much earlier periods despite the need to allow time for ligaments and collagen within the knee to heal before stressing the inserted graft. In addition, there were dramatic decreases in the number of surgical manipulations that would traditionally be required to achieve full ROM after the rehabilitation program began (8).
... middle of paper ... ... After the implementation of the stated interventions, the patient made physical and emotional progress towards the aforementioned goals. The above goals were not only met, but exceeded expectations of the patient and the nurses who provided care.
Infection following anterior cruciate ligament reconstruction (ACLR) is not a surgical emergency in most cases. Timely urgent surgical treatment is essential, but timing itself is not clearly defined in the literature for treatment of infection following ACLR. Most authors do agree that surgical intervention should take place without delay, on a prompt basis, or on the same day as the clinical presentation of an ACLR infection.
Graft retention following an infected ACL reconstruction is a viable option as a recent meta-analysis and systematic review reported a success rate of 85%.5 Matava et al surveyed 61 orthopaedic surgeons and found that graft removal was no popular as initial treatment, with only 6% and 33% doing this for
...newicht and Dunford (2004), physiotherapists, occupational therapists, Doctors, nurses, specialist pain teams and dieticians all care for the patient at once.
Though there are many ways to elevate the symptoms that occur with arthritis of the knee, many do not restore the patient’s life to its normal state. This is why many patients chose to have a total knee replacement (TKR) surgery done. In the United States more than 400,000 primary knee and hip arthroplasties are performed each year, costing more the over $10 billion (bachmeier). Total knee replacement (TKR) is done to restore joint functionality and to relieve a patient from pain (jabber). However, some patients still have pain after surgery is done. There are many studies to examine whether or not a patient’s life can be fully restored after total knee replacement surgery.
However, there was a considerable difference with the injured leg compared to the contralateral leg and the control group. After the reconstruction and 6 months of rehab, the joint sense in the injured leg greatly improved and only shown a small difference when compared to the uninjured leg and the control group. Overall, the authors found it important to incorporate proprioception exercises into the rehab program for an ACL reconstruction surgery. Doing these exercises can enhance the overall stability of the leg as well as positively impact the functional
The Anterior Cruciate Ligament (ACL) injuries are a growing problem in high school athletes is the primary stabilizers and is one of the four main ligaments in the knee. Although it is the smallest of the four it serves the most important function, it stabilizes the knee from rotational movement. ACL injuries are common in several sports such as football, basketball, tennis, soccer, and gymnastics. There are between 250,000 and 300,000 ACL injuries per year, and they're almost exclusively happening to athletes. The chances of a non-athlete suffering an ACL injury are 1,000 to 1. The most common ACL tear is caused by non-contact cutting. Girls are three to eight times more likely to suffer an ACL tear than boys. To determine if an athlete has
A study on the late effects of meniscectomy ten to thirty years after surgery revealed that only 10 percent of women who underwent the surgery had symptom-free knees [TAPPER et. al, 1969]. Less invasive methods such as arthroscopic surgeries have been introduced to preserve the joint capsule as much as possible and have provided satisfactory results. For instance, central quadriceps tendon-bone autograft performed on patients with ACL injuries produced successful results in a majority of patients 27 to 49 months post operatively [Lee et. al, 2004]. Therefore, the complicated interaction of tissues inside the knee plays a crucial role in the well-being of the organ. Thorough understanding of this complex interaction enables the healthcare professionals to design better treatment plans and also provide better injury prevention
The knee is a hinge joint which is located between the femur in the upper leg, the tibia and fibula in the lower leg and the patella it is the largest most complicated joint of its kind in the human body. This joint is the main reason we can walk as it is strong and durable while maintaining the wide range of motions necessary for locomotion. There are many internal and external ligaments that reinforce the knee as it holds up the entire body’s weight with little reinforcement from the surrounding bones, it is this lack of reinforcement allows the knee to slightly rotate when flexed while also allowing a large degree of flexion. The fibrocartilage called the meniscus found between the femur and tibia acts as a shock absorber to prevent collisions
Physical therapy is a fun and exciting healthcare profession that helps people. It is all about helping other people who have problems with their body, muscles, joints and other parts of their body. Patients includes accident victims and individuals with disabling conditions such as low back pain, arthritis, heart disease, fractures, head injuries, and cerebral palsy. Physical therapy will perform an evaluation of your problem or difficulty. They evaluate your problem by performing tests and measures to assess the problem. These tests includes muscle strength, joint motion, sensory and neurological, coordination, balance, observation, palpation, flexibility, postural screening, movement analysis, and special tests are designed for a particular problem. Next, they develop a treatment plan and goals and then manage the appropriate treatment to aid in recovery of a problem or dysfunction. Physical therapists are able to treat their patients by using many different treatments depending on the type of injury. Some of the treatments are electrical stimulation, hot and cold packs, infrared and ultrasound to reduce swelling or relieve pain. These treatments are used to help decrease pain and increase movement and function. Therapeutic exercises instructions will help restore strength, movement, balance, or skill as a guide towards full functional recovery. Physical therapy provides "hands on techniques" like massage or joint mobilizations skills to restore joint motion or increase soft tissue flexibility. They will focus on basic skills such as getting out of bed, walking safely with crutches or a walker, moving specific joints and muscles of the body. Physical therapists treatment includes patient education to teach them how to deal with a current problem and how to prevent the problem in the future. Such documentation is used to track the patient's progress, and identify areas requiring more or less attention. They encourage patients to use their own muscles. Their main goal is to improve how an individual functions at work and home.
and the posterior cruciate ligament (PCL). The ACL is attached to the tibia anteriorly and