Function:
provides 85% of the stability to prevent anterior translation of the tibia relative to the femur
acts as a secondary restraint to tibial rotation and varus/valgus rotation
Mechanism is a non-contact pivoting injury
More frequent in female
Chronic ACL deficient knees associated with
chondral injuries
complexe meniscal tears ( Medial)
Presentation
felt a "pop"
pain deep in the knee
immediate swelling (70%) / hemarthrosis
physical exam
Lachman test
Pivot shift test
unstable knee
imaging and exams
Xrays : eliminate tibial spine avulsion or Segond fracture
MRI
Telos stress exams
GnRB
Segond Fracture
MRI
MRI
Telos
GnRB
Treatment
Physical therapy & lifestyle modifications: low demand patients with decreased laxity. High risk of chronic meniscal tears and Osteoarthritis
Surgery : ACL reconstruction. Many techniques !
A strict physiotherapy program is to be followed, starting immediatly after the operation