Knee ( Cruciate Ligament Tears (Anterior Cruciate Ligament ( Physical:…
Cruciate Ligament Tears
- ACL tear much more common than PCL tear
- Tissue Sources for ACL Reconstruction: Hamstring, Middle 1/3 patellar tendon, Allograft (e.g. cadaver)
Evaluation of Knee
- locking, Instability and swelling: torn meniscus/loose body in joint
- limited ROM without mechanical block: effusion, muscle spasm after injury, arthritis
- painful clicking: torn meniscus
- instability: cruciate ligament or meniscal tear, patellar dislocation
Tests of the Knee
- anterior and posterior drawer tests: demonstrate ACL and PCL
- Lachmann test: demonstrates torn ACL (similar to anterior drawer test, more reliable)
- Thessaly test: demonstrates meniscal tear
- posterior sag sign: demonstrates torn PCL
- pivot shift sign: torn ACL
- collateral ligament stress test.
- tests for meniscal tear: joint line tenderness, crouch compression test, McMurray’s test
- “catching and locking” which limits knee motion, and a “click” when the knee is forcefully extended
- medial tear much more common than lateral tear.
arthroscopic repair/partial meniscectomy
- Mechanism: trauma or tears of multiple ligaments.
- Features: knee instability, pain, Schenck classification
- Treatment: closed reduction,
- Complications: popliteal artery tear, peroneal nerve injury,