Determinist Linear Exercise

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.

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

The Anterior Cruciate Ligament (ACL) and the Posterior Cruciate Ligament (PCL) are located inside the knee joint. The ACL and PCL form an ‘X’ behind the kneecap (patella), with the ACL resting in front of the PCL. Both of these ligaments are responsible for controlling the back and forth motion of the knee joint; however, the ACL is responsible for stabilizing the kneecap ). In addition, the ACL is responsible for preventing the shin bone (tibia) from sliding forward on the thigh bone (femur). The ACL provides the knee with stability while an individual pivots or twists. This ligament is critical because without it, performing any kind of rotational activity is impossible, particularly when it comes to playing sports like soccer and basketball.

In this article, FoxNews.com reports Dr. Steven Claes and Dr. Johan Bellemans, knee surgeons from the University Hospitals Leuven in Belgium, have been conducting revolutionary human knee anterior cruciate ligament (ACL) tear research by dissecting cadaver knees for the last four years. The two knee surgeons were trying to find out the reason patients, who had undergone ACL repair, experienced a condition called “pivot shift” (i.e., intermittent periods in which the knee destabilizes). The article states the two knee surgeons identified a novel knee ligament, which they termed anterolateral ligament (ALL), which, when damaged contributed to the “pivot shift” knee condition.

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 purpose of this article is to compare the laxity and stiffness of the knee joint in male and female cadavers. Three different directions will be evaluated, anterior-posterior, internal-external, and varus-valgus. Females are at a two to eight times greater risk of an ACL injury than a male. This is due to the laxity in the joints. Females also have limited proprioception in the knee joint, which may attribute to some injuries. This study used a technique using cadaver knees to complete this study.

The ACL (anterior cruciate ligament) prevents anterior forward movement of the tibia off of the femur, as well as hyperextension of the knee. It provides stability to the joint and allows for a dynamic motion. It also helps the bending of the knee sideways toward the body.

An anterior cruciate ligament tear can be confirmed by the Lachman test, the dynamic extension test, and the Pivot jerk test. The Lachman test and dynamic extension test is helpful in, “making a diagnosis, particularly in the acute injury.” (1) The lateral pivot test reproduces, “the rotatory subluxation that occurs in ACL defiency. The test is difficult to perform and takes residents and fellows in my practice approximately three months of intensive training to be able to adequately perform the jerk test in the unanaesthetised patient.”(1) The test is important because the demonstration of the lateral pivot jerk is the replication of the instability that the patient has. The initial goals of treatment immediately after injury are to reduce pain, reduce

This study hypothesizes that knee joint auscultation during Lachman test is capable of judging Anterior Cruciate Ligament on the basis of objective data. Particularly, frequency of Lachman sound is able to access ACL condition.MethodologyThis study was conducted in accordance to the protocol proved by the Institutional Review Board, which entailed two separate phases. First phase involved 30males and 30 females,healthy volunteers while the second phase involved 24 patients who went through ACL reconstruction.The Lachman test was performed by one orthopaedic surgeon

The test has the physician move the patellar back and forth while the patient flexes the knee at 30 degrees (Saladin, 1998, p. 44). This test helps diagnose how severe the patella is dislocated and decide the best treatment option. Another test a physician can do is called the patella tracking assessment where they have the patient single leg squat and then stand (Slamaian). If the “patella that slips medially on early flexion is called the J sign, and indicates imbalance between the VMO and lateral structures” (Saladin, 1998, p. 41). Both of these test help diagnose the correct treatment, the difference is the patellar apprehension test is used for more severe cases but both lead to the best treatment

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

This study included 28 patients who underwent ACL surgery performed by the same 2 surgeons and standard rehab protocol was done in the same physical therapy clinic, with all the same exercises and progressions. The Battery Test uses exercise analysis to grade the participants. The exercises include measurement of isokinetic strength, single hop for distance, triple hop, side hop, and a jump-landing assessment. There were also patient surveys that asses their feelings about the overall health of their knee. The participants completed this testing 6 months after surgery, which is the average RTP time frame for basic ACL rehab protocol. Out of all 28 patients, only 2 individuals passed this test and can be considered safe for RTP. This information is extremely important for anyone who has the authority to grant RTP to any athlete. Allowing patients back to play too soon is extremely dangerous and can cause further injury. Using this specific test to determine RTP decisions is a great technique to utilize in athletic

Conclusions: This study shows that in patients who had failure of reconstruction of the ACL, the intra-articular orientation of the graft and the bone tunnels were in a non-anatomical position when compared to the native ACL values.

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)

A torn ACL is one of the most serious and common knee injuries. Many aspects play a role in the treatment and rehabilitation of this injury. This paper will discuss the anatomy of the knee, describe a torn ACL, and the rehabilitation.