Case Study : An Orthopedic Doctor

The anterior cruciate ligament (ACL) is one of the four main ligaments in the knee joint that connect it to the shin bone (tibia) and thigh bone (femur). It 's located deep within the joint, behind the kneecap (patella), above the shinbone, and below the thighbone. The ACL lies diagonally across the middle of the knee and plays a role in keeping the knee stable during movement. Partial tears of the ACL can occur, but are rare. Most ACL tears are either near-completes or complete tears. After experiencing an ACL tear, an athlete has a 15 times

Sport injuries have come to the forefront with the worldwide coverage of all sports. Of these injuries, the most common is knee injuries. A large portion of knee injuries are Medial Collateral Ligament (MCL) stains and tears.

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

The ACL is one of the most frequently uinjured ligaments of the knee.( 59 )

The medial collateral ligament (MCL) is a tough band of tissue that connects the thighbone to the shinbone. Your MCL is located on the outside of your knee. It prevents your knee from moving too far inward and helps keep your knee stable. A MCL sprain is an injury caused by stretching the MCL too far. The injury can involve a tear in the MCL.

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 ACL originates from the medial and anterior aspect of the tibial plateau and runs superiorly, laterally, and posteriorly toward its insertion on the lateral femoral condyle. Together with the posterior cruciate ligament (PCL), the ACL guides the instantaneous center of rotation of the knee, therefore controlling joint kinematics. To a lesser degree, the ACL checks extension and hyperextension. The ACL is not as strong as the posterior cruciate ligament (PCL), and it is less strong at its femoral origin than at its tibial insertion. Muscles surrounding the knee joint contribute to knee stabilization during lower extremity movements.

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)

Presentation and Examination: The knee anterior drawer test is a commonly used during orthopedic examinations to evaluate the integrity of the anterior cruciate ligament (ACL). The test is conducted with the patient supine; hips and knees are flexed at a 45 and 90-degree angles with feet flat on the table. While holding the calf distal to the knee joint pulling suddenly away from the patient tests the anterior drawer while pushing back tests the posterior drawer. In this case, the positive anterior drawer test indicated ACL damage.

In sport an ACL injury is the most frequently ruptured ligament of the knee (Johnson, 1983), it is described by Flynn 2005 as a serious, common and costly injury (Flynn, 2005). In many cases an ACL injury is the result of noncontact and studies done by Barrett et al 1972 and Beckett et al 1992 support this as they reported that 78% and 71% of ACL injured patients described noncontact mechanisms of injury such as landing with too much knee extension or change in direction (pivoting) (Barrett et al 1972 and Beckett et al 1992) and also can happen due to contact such dominant kicking leg, fall on the knee or even a forceful blow to the knee. Bjordal et al 1997, in their findings showed that 58% and 42% of ACL injuries were

The knee is a hinge joint which gives the legs mobility. The muscles and ligaments of this joint allows flexion and extension of the leg. “Because the knee supports the majority of the body weight, it is at risk of overuse and traumatic injuries” (France). The knee is composed of 3 major bones; the femur, tibia, and the fibula. The femur is the biggest bone in the human body, the inferior end flares out into two rounded landmarks called femoral condyles. Their name comes from the side of the body they are on, which is where we get Lateral Femoral Condyle and Media Femoral Condyle. Superiorly to these condlyes are the medial and lateral femoral epicondyles. The bones inferior to the femur are the Tibia and Fibula. The superior end of the Tibia flares out into slightly concave structures called the Tibial Plateaus. A crescent wedge shape of cartilage sits in each plateau. These are the Medial Meniscus and the Lateral Meniscus. This cartilage acts as a shock absorber and distributes forces. “The menisci are bathed by the synovial fluid of the knee” (France). The meniscus is what separates the each side of the Tibia and Femur and the transverse ligament connects each menisci. There is a circular bone on the

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.

Neurosurgeon participants at a ventricular endoscopic course then performed an endoscopic approach to the intraventricular tumor model lesion via an ipsilateral frontal burr hole. The properties of the SRSDP mixture could be manipulated through varying concentrations of source materials in order to achieve the desired consistency of a nodular solid lesion and allow for piecemeal resection. The tumor could be injected into the lateral and/or third ventricles. The tumor model allowed participants to compare both normal and pathological endoscopic anatomy in the same specimen.

Description: Orthopedic surgeons are experts in treating the conditions of the musculoskeletal system. Read about Indian orthopedic surgeons on Tour2India4Health.