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3 rd Degree ACL Sprain

Jenny Jefferis Tarryn Hardgrove. 3 rd Degree ACL Sprain. Background. 18 Yr. Old Female Basketball Player Guard Division 1 College Injury happened at practice Went up for a rebound, landed on R leg and knee buckled inward Positive Tests Anterior drawer Lachman’s. ACL Sprains.

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3 rd Degree ACL Sprain

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  1. Jenny Jefferis TarrynHardgrove 3rd Degree ACL Sprain

  2. Background • 18 Yr. Old • Female • Basketball Player • Guard • Division 1 College • Injury happened at practice • Went up for a rebound, landed on R leg and knee buckled inward • Positive Tests • Anterior drawer • Lachman’s

  3. ACL Sprains • Most commonly injured knee ligament • Max stress positions • Full extension • 90◦ flexion • Common MOI • Valgus stress with lateral rotation when foot is planted • Sudden knee hyperextension with rotation

  4. Signs and Symptoms • A pop may be felt or heard • Pain • Instability • Swelling • Limited ROM

  5. MRI

  6. Portals •Arthroscopy begins ACL surgery •3 incisions used to create portals •Camera feeds image to a monitor •Cannula is used for pumping sterile saline solution into the joint

  7. Autograft • Bone-patellar tendon-bone • Quadrupled semitendinosus/gracilis tendons • Quadriceps tendon

  8. Images

  9. Allograft • Achilles tendon with attached calcaneal bone • Bone-patellar tendon-bone • Anterior tibial tendon • Posterior tibial tendon

  10. Images

  11. Pros and Cons Allograft Autograft • + No donor site • + Smaller incisions • + Reduced surgery time • - Possible rejection • - Disease transmission • HIV • Hepatitis • - Cost and availability • + Your own tissue • No risk of disease • No risk of rejection • - Patella tendonitis • - Patella fracture • - Donor site morbidity

  12. Considerations for Rehabilitation • Type of graft used • Allograft or Autograft • BPTB, Achilles, Semitendinosus… • Other injuries or repaired structures • Meniscal repairs • MCL injury

  13. Rehabilitation Plan • Week 1: Post-op • Pain • Edema • Passive ROM • Muscular Control • Week 2: Post-op • Pain • Edema • Passive ROM • Muscular Control • Normalize Gait • Strengthening

  14. Rehabilitation Plan • Weeks 3 -12: Post-op • Pain • Edema • Muscular Control • Active ROM • Proprioception • Conditioning

  15. Rehabilitation Plan • Post-op: Months 4-6 • Pain • Edema • Muscular Control • Active ROM • Proprioception • Conditioning • Functional Exercises • Functional Tests

  16. Surgical Video • Double Bundle ACL Surgery

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