Introduction
The most common ligamentous injury to the knee is injury to the anterior cruciate ligament (ACL) (Teske 2010), and it is the second most common injury in the lower extremity. It has become so common of an injury that 1 in 3000 individuals in the United States will be affected with an ACL tear (Micheo 2010) and there are 200,000 new cases per year (Wilk 2012). It is most commonly seen in people 15-30 years of age (Teske 2010). It is also more common in females than males (Fayad 2003, Teske 2010, Bowerman 2006). This is due to increased joint laxity in post-pubescent females compared to post-pubescent males (Bowerman 2006) and differences in muscle activation. Males tend to have a more balanced quadriceps to hamstrings ratio
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It is a modified hinge joint that allows flexion and extension, as well as anterior and posterior gliding and minimal rotation. The bony articulations of the knee include medial and lateral tibio-femoral articulations and a patello-femoral articulation. There is also an articulation between the head of the fibula and the tibia, but the fibula does not bear weight and is not considered part of the knee joint itself. The afore-mentioned articulating surfaces are incongruous, and the stability of the knee relies mostly on the integrity of the supporting muscles and ligaments. The muscles that span the knee are the quadriceps anteriorly, the hamstrings and gastrocnemius posteriorly, and the tensor fascia latae (iliotibial band) laterally (Moore 2014).
The quadriceps are comprised of four muscles: vastus lateralis, vastus medialis, vastus intermedialis, and rectus femoris. These muscles attach proximally at differing locations along the shaft of the femur and on the hip bone (rectus femoris only). They span the length of the femur and converge on the quadriceps tendon on the superior aspect of the patella and continue to the tibial tuberosity via the patellar tendon. The quadriceps are responsible for extending the knee, assisting in proper tracking of the patella, and preventing posterior translation of the tibia on the femur (Moore
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If a knee is hit from the outside, especially while the foot is planted, it will be forced into genu valgus. This puts several structures at risk, namely the ACL, MCL and joint capsule. These structures specifically prevent valgus forces and are expected to be damaged when subjected to excessive genu valgus. The nature of the force can also damage the bones because valgus will cause the lateral condyles of the femur and tibia to be compressed while the medial condyles will be distracted. This can result in bruising of the bone or damage to articular cartilage of the compressed side. In addition, the menisci can be involved depending on the direction of the force, especially if rotation occurs. The lateral meniscus can be damaged without rotation if it is compressed between the condyles or with rotation by getting torqued between the condyles. The medial meniscus is at a lesser risk of being damaged due to compression because the medial condyles are being distracted from one another. However, because it has attachments to both the ACL and MCL, if one or both of those are damaged, the medial meniscus is at risk. Therefore, a 20 year-old male rugby player who was side tackled may very well present with a torn ACL, MCL, and medial
Each year, approximately a quarter of a million physically active young people experience an anterior cruciate ligament (ACL) injury, and seventy percent of these ACL injuries will be sustained while engaging in non-contact activities such as sudden deceleration while landing (Begalle et al., 2012). This type of injury is grossly detrimental not only on the occasion in which it occurs but also for the subsequent years to come. The majority of individuals who injure their ACL also go on to either, re-injure that same ACL, or injure the opposite knee. Furthermore, our bodies are put in tremendously vulnerable planes of motion during sporting events, especially during activities such as, basketball, football, or soccer. In this day
The foremost cruciate ligament (ACL) gives security and quality to the knee by averting front interpretation of the tibia under the femur and inordinate pivot through the knee it essentially keeps the knee from turning the distance around. The ACL is harmed amid running ball games, skiing, or bouncing game, so this is discovered more in more youthful grown-ups. It is frequently joined by damage to the average security ligament (MCL) and the average meniscus and that is known as a blown knee when you tear every one of the three. These mix wounds are connected with a higher commonness of radiographic osteoarthritis at 10-15 years, yet these patients demonstrate no distinctions in capacity contrasted with those with an detached ACL damage. The patient with an ACL break usually report a sudden sharp torment and precariousness amid rotating or a fast alter of course, or on effect, for example, a fall or handle. They additionally have heard or felt a thump as the joint separates or a snap of the muscle. On the off chance that there is intra articular muscle harm, the patient will report swelling (because of haemarthrosis). They might likewise give lost extent or development because of the torment and a sentiment unsteadiness on the weight bearing knee. The GP will watch, inspect the knee, screen and upgrade on swelling and emission. The foremost drawer tests the adaptability of the front ligament, Lachman test and the turn shift test are most normally used to test the strength of the knee joint. The level of crack or vicinity of different wounds can be affirmed by X-ray. Different ways while inspecting the patient in the event that they give atypically or abnormal amounts of torment are bone wound, microfractures, post-corner harm and tibial level breaks. All patients with suspected ACL wounds ought to see a physiotherapist inside of the initial two
First and foremost, your knee has four ligaments. The ligaments line up your bones and help control the way you move. It prevents the shins from moving too far forward. ACL injuries sometimes requires surgery.
The anterior cruciate ligament, more commonly known as ACL, is the most common knee ligament injury. An ACL injury mainly affects athletes or those participating in athletic activities. Over the years, sports have become more popular which has led to an increase in ACL injuries. This increase led orthopedic surgeons to create many operations over the past fifteen years that reconstruct this ligament.
With an ever increasing number of people becoming involved with athletic activities, there is an increasing number of injuries occurring which can be devastating for the individual. Most of the injuries that affect athletes occur in one of four structures in the human body: bones, muscles, tendons, or ligaments. Because ligaments attach bone to bone and play a major part in providing stability for joints, the major stabilizing ligament in the knee, the anterior cruciate ligament (ACL), assists in performing everyday actions of the human body including sitting, standing, walking, running, dancing, and participating in other sports. The injury that specifically affects this ligament is very serious and always
The Anterior Cruciate Ligament also known as the ACL is deemed the most commonly torn ligament in the knee and can result from both contact and noncontact injuries. Most Anterior Cruciate Ligament injuries result from an extreme force on the lateral side of the person’s knee causing a valgus force which pushes the knee inward (Kisner & Colby, 2012, pp. 802-803). This injury to the side of the knee can also cause a “Terrible Triad” injury which also injures both the medial meniscus and the medial collateral ligament (Kisner & Colby, 2012, p. 803). Our textbook further states that “the most common noncontact mechanism is a rotational mechanism in which the tibia is externally rotated on the planted foot….this mechanism can account for as many as 78% of all ACL injuries” (Kisner & Colby, 2012, p. 803). If the person does not seek medical help with this injury they are susceptible to also injuring the remaining support ligaments as well. Patients usually present with joint effusion; possibly 25 degrees of flexion, joint swelling if blood vessels are involved, limited ROM, stress pain and instability along with quads avoidance gait patterns (Kisner & Colby, 2011, p. 208)
If instability is evident then the menisci will get injured sooner or later which will set the scene for progressive, degenerative, arthritis of the knee. You can usually tell when an ACL in jury has happened because you will hear or feel a pop during a twisting movement or a fast deceleration which will also come with the inability to continue participation. Which will then be followed by swelling, this is said to indicate a 90% probability of rupture of the ACL. These injuries occur mostly when an individual suddenly stops or plants their foot hard into the ground like a cutting motion, also ACL Failure has been linked to heavy or stiff-legged landing, which can cause the knee rotation while landing, mainly when the knee in put into an abnormal position. Like I said before women or three times more likely to suffer one of these injuries than males, especially in sports such as; association football, Basketball and Tennis. This has been linked with the differences in anatomy because of gender, muscular strength, the reaction time of muscle contraction and coordination. Also training techniques are linked to this. A female’s pelvis is relatively wider than that of males, requiring the angle of the femur to turn towards the knees. The role of genetics is still an ongoing study and is speculative. Many cases of athletes landing flat on their heels has been a common occurrence. As this can cause the tibia to be force into the knee,
A test on the functional anatomy of the ACL by Amis showed that the different functional bundles of the ACL contribute to resisting anterior subluxation of the knee during flexion and extension. The ACL also plays a role in stabilization against rotatory loads (Petersen, 2006). Rotary loads occur in the knee when a force causes the turning of the tibia and/or femur inward or outward. Due to the connection of the ACL to both of these bones, it aids in stabilizing them and preventing their sliding (Tortora, 2009)
The knee is a complex joint. There are many different injuries that can occur during sports. The most predominant type of injuries to the knee is those done to the Meniscus and the ligaments. There are two areas of ligaments that are commonly affected; the cruciate ligaments and the Collateral ligaments. Within the Cruciate ligaments there are posterior and anterior injuries, and within the Collateral ligaments there are medial and lateral injuries. It is very important that these injuries be taken seriously in athletics due to the seriousness of their affects to the knee.
In her article, “High School ACL Injury Rates”, Dawn Comstock shows that in 2009, about sixty percent, of all sports surgeries involve the knee; within the sixty percent, about fifty percent of the knee surgeries are ACL reconstructions. Sports that could have a higher tendency for an athlete to tear the ACL are sports that require an athlete to decelerate quickly or need to cut and change direction instantly. For example, an article shows that a high-impact sport has a higher percentage of ACL tears when compared to a low-impact sport, such as football and women’s soccer; football has a forty-one percent ACL injury rate while women’s soccer only has nineteen percent. Not only does the level of impact effect the likelihood of ACL injury, but the gender of the athlete as well. When looking at women’s and men’s soccer, men have a merely thirteen percent ACL injury rate because their physical structure along with their techniques when doing certain exercises.
The anterior cruciate ligament (ACL) is a ligament that can be found in the knee. The ACL attaches two of three bones that link to form the knee joint. These bones are the tibia, which is the larger bone in the calf area, and the femur, which is the bone found in the thigh. The third, non-connected bone is the patella, which is the kneecap that offers protection to the overall area. The knee joint houses four primary ligaments, which are separated into the following two groups. The collateral ligaments, which consist of the lateral collateral ligament (LCL) and the medial collateral ligament (MCL), can be found toward the left and right of the patella. Collateral ligaments regulate sideways movements along with bracing for atypical
There are many important parts in your body, and the anterior cruciate ligament(ACL) is one of the most important part to your leg and fitness. The ACL gives the knee its stability and many injuries can happen to this part of the body, so people with these injuries often visit rehabilitation(rehab) therapy for faster recovery. This is one of the most common athletic injuries. Mostly teens, who play sports, get these injuries. A pop usually indicates that the ACL is torn. Many people come to rehab therapy, and even with this special treatment, it takes a very long time for full restoration. The torn ACL not only affects certain parts of your body, but also affects several parts that can cause more severe injuries.
All high school I have seen this injury happen to several athletes affecting their performance. Usually from what I have noticed this disability, although temporary, can ruin an athlete’s opportunity to continue in the sport thus making them lose several opportunities. The disability I am speaking of is an ACL tear. “A torn anterior cruciate ligament (ACL) is a common knee injury, especially for athletes. Ligaments are long, rope-like bands that fasten bones together. The ACL’s role is that it helps give the knee its stability. This injury usually occurs through movements such as pivoting, stopping, or turning on a dime. People also can also receive this injury if they jump up and when they are on their way down their knee is locked instead of flexed. This puts pressure on the knee joint and causes the ACL to tear or break apart”(Jr. A.). ACL injuries are quite often in sports I was privileged to interview someone who has experienced it on a
The quads include the rectus femoris, and the vastus lateralis, intermedius, and medialis. This muscle group shares a common tendon at insertion. The patellar tendon inserts at the tibial tuberosity, and within this tendon lies the patella. The patella is anterior to the femur-tibia articulation, and this sesmoid bone increases the leverage of the quads by acting as a pulley. The major contributor to the stability of the knee joint is the strength of the quads. The only muscle that assists in extension is the tensor fascia lata.
The knee joint consists of four ligaments, two intra-capsular which are the ACL and the PCL and two extra-capsular ligaments including the MCL and LCL. The ACL is an extremely strong stabiliser which prevents anterior displacement of the knee. The ACL is a ligament and therefore connects one bone to another, the femur with the tibia. The ACLs origin is from the anterior intercondylar eminence of the tibia (home,2017) and the fibres pass upwards, backward and laterally inserting into the lateral condyle of the femur.