Transcript File - Develop Athletes

Common Sports Injuries
ANTERIOR CRUCIATE LIGAMENT
Melissa Rozman
HUMAN
KNEE
 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.
WHAT IS THE ACL?
 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.
WHAT ARE THE CAUSES OF ACL
TEARS?
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
DOCTOR EXAMINATION
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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
1 Week Post-Op
2 Days Post-Op
3 Weeks Post-Op
2 Weeks Post-Op
1 Month Post-Op
-PREVENTION
-RECONSTRUCTION
-REHABILITATION
PREVENTION
 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.
PREVENTION EXCERSIES
• 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)
4/8/2015
RECONSTRUCTION
 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)
PATELLAR TENDON AUTOGRAFT
 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
AUTOGRAFT
 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.
QUADRICEP TENDON
AUTOGRAFT
 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.
ALLOGRAFT TENDON
AUTOGRAFT
 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
REHABILITATION
 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
REHABILITATION EXERSICES
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
4/8/2015
• 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
4/8/2015