ranggit juread

7/28/2019 ranggit juread

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At the medial

wall of the

lateral femoral

condyle and

inserts into the

middle of theintercondylar

area.


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Specifically, the ACL prevents the uppertibia, or "shin-bone", from slippingforward, out from under the lower end ofthe femur (thigh-bone) during kneetwisting movements and contraction of

the quadriceps (frontal thigh) muscles


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Commonly happen in pivoting sports

Sudden stops Change of dirrections

Acceleration

Deceleration
http://localhost/var/www/apps/conversion/tmp/scratch_7//localhost/Users/ranggit/Documents/journal/juread/file%20ranggit/ACL%20injury%20in%20sports.flv


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twisting or wrenching injury history

heard a pop as the tissues snapped

painfull ( partial tear ), painless (complete tear )

Swollen

Anterolateral rotatory instability Anteromedial rotatory instability


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Red

swelling

Pain

Unstable

warm


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Drawer test

Lachman test


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Lateral pivot shift manoeuvre
http://localhost/Users/ranggit/Documents/journal/juread/file%20ranggit/ACL%20Exam%20Lachman's%20Test,%20Pivot%20Shift,%20Drawer%20Test%20performed%20by%20Dr.%20Eric%20Janssen.flvhttp://localhost/Users/ranggit/Documents/journal/juread/file%20ranggit/ACL%20Exam%20Lachman's%20Test,%20Pivot%20Shift,%20Drawer%20Test%20performed%20by%20Dr.%20Eric%20Janssen.flvhttp://localhost/Users/ranggit/Documents/journal/juread/file%20ranggit/ACL%20Exam%20Lachman's%20Test,%20Pivot%20Shift,%20Drawer%20Test%20performed%20by%20Dr.%20Eric%20Janssen.flv


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MRI

Arthroscopy


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Normal ACL Torn ACL

Kissing anterior bone


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Acl reconstructions


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Bone pattelar tendon bone ( goldstandart )

Drilling the femoral tunnel
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Prospective Randomised Cohort Study


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To study patient-reported long-termoutcome after ACL reconstruction.

To study whether there were anycorrelations between clinical test whichwere performed 2 years after ACLreconstruction and knee function andknee-related quality of life on anaverage 9,5 years later.


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Unilateral ACL combined with or withoutassociated meniscal injury

Patients with collateral ligament injuries,posterior cruaciate ligament injuries, ACLinjury in the contralateral knee


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The present study comprised 30 malesand 32 females with mean age of 27,5

year at the time of surgery

6 patients were lost to follow-up at 2years.


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Measurement at the 2-year follow-up :

One-leg hop test for distance, isocinetic

muscle torque measurement, sagittal knee

laxity, Lysholm knee scoring scale and Tegneractivity scale

Measurement at 9,5 years later :

Knee injury osteoarthriitis outcome score

(KOOS), short form health survey (SF-36),

Lysholm knee scoring scale and Tegner

activity scale


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http://localhost/var/www/apps/conversion/tmp/scratch_7//localhost/Users/ranggit/Documents/journal/image/tegnerjpg.jpg


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Lysholm Knee function : 14 patient < 77,20 patient > 91 (exellent), 22 patient > 77

(good). Tegner activity scale : the decrease in

activity level preoperatively to the 11,5year follow-up was not significant(p=0,18)


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Study group (n = 56)Md (range)

Control group (n = 25)

Md (range)

Pain 94 (67100) 100 (60100)Function, daily life 100 (60100) 100 (47100) Recreation/sport 75 (0

100) 100 (40100) Quality of life 81 (0

100) 100 (44100)

Knee function according to KOOS at the long-term follow- up

after ACL reconstruction in comparison with a control groupof individuals without knee injuries


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SF-36 health survey : no significant differences werefound between the reference group and the

studied patients at their long-term follow-up afterACL reconstruction, when compared to an age-and gender-matched normal population inSweden

Gender : No significant differences in respect ofgender were found in any of the investigatedparameters.

Correlation between clinical assessment 2 and 11.5years after surgery : None of the following threepostoperative variables were significantlycorrelated with KOOS


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discusion


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In 6 month follow-up the Tegner activity

scale of patient have rather low activity

levels but a good knee function asevaluated the Lysholm knee scoring scale,

indicating that there are no severe

problems during daily living .

By the 2-year follow-up they reported aneven better knee function with Lysholm

knee scoring scale, and in addition a higher

activity level according to Tegner activity

scale, indicating that many patients hadreturned to the same activity level as

before injury without severe problems


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patients in this study reported a good kneefunction (KOOS, Lysholm) and a similar degree ofhealth conditions (SF-36) as an age- and gender-

matched normal population in Sweden on anaverage 11.5 years after ACL reconstruction withBPTB graft.

Neither objective nor subjective measurements at

the 2-year follow-up after ACL reconstruction couldpredict long-term results in our patient cohort.


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