ACL: Cruciate Trauma

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Wehbe 1 The ACL is a cruciate ligament that is one of four primary stabilizing ligaments in the human knee. The ACL is important for knee stability, acting as the primary restraint to anterior translation of the tibia on the femur (Cameron). This ligament also functions as a secondary restraint to forces of varus, valgus and internal/external rotation. It is located at the center of the knee, consisting of two bundles of fibers – an anterior medial and posterior lateral - which extend from the anterior medial tibia to the posterolateral femoral condyle (Griffin). These particular bundle names were given due to their location of insertion into the tibia plateau. The ACL attaches in front of the intercondyloid eminence of the tibia, blending…show more content…
Research shows that the causes that are responsible are multifactorial in nature and include extrinsic, intrinsic and neuromuscular risk factors (Duarte). It has been reported that 70% of ACL injuries occur from noncontact with the remaining 30% being contact related. The few consistent mechanisms of ACL injuries amongst women were determined to be, valgus, extended knee and a widened stance due to their hip placement. Neuromuscular factors that mediate the degree of the hip and knee flexion during landing or cutting, can be key mediators of this ligamentous injury (Griffin). Another factor contributing to women’s ACL injury rate is their increased anterior translation. This mechanism is related to the natural laxity within female ligaments that allow for the tibia to move anteriorly before its’ supporting muscles are able to control the movement (Duarte). Co-activation of the hamstrings and quadriceps help to decrease the amount of tibial movement during landing, pivoting, rapid deceleration and acceleration (Duarte). However, women athletes tend to respond by more so activating their quadriceps. Through these deficits in strength and engagement of the hamstrings, the maximal quad contraction exceeds the strength of the ACL, subjecting it to overloaded tension and stress…show more content…
Radiographs are a typical testing aid that are normal in determining ACL injury, with lateral marginal fractures being a common characteristic of a tear. This device may also depict a lateral notch sign (an exaggeration of normal indentation), on the lateral femoral condyle (Bach). Lastly, there is always an MRI (Magnetic Resonance Imaging) that is quite commonly used for an ACL injury if the diagnosis of the tear is unclear (Cameron). The care and treatment of a torn ACL is extremely crucial to the future capabilities and functions of the knee joint and it’s surrounding muscles. Initial care following an injury should consist of ice, compression, elevation, and unweighting (using crutches), continuing to use these measures until the swelling and spasm within the surrounding muscle subside (Griffin). Different treatment options exist for this particular injury as well. Patients who don’t desire any type of reconstruction and who show no symptoms of a meniscal tear, can be treated non-surgically, by using a custom or generic ACL brace to reduce the severity and frequency of the knee giving out. The brace also protects against secondary restraints as well. Once acute symptoms subside, the knee range of motion has returned (to what it can) and the surrounding muscles are stronger (approximately 2-6 weeks), other options for further treatment can be

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