Anterior Cruciate Ligament Rupture. By Sarah Hart. Learning Outcomes. To describe the background anatomy of an ACL. Describe the ACL mechanism of injury, and signs and symptoms. Explain the classification and aetiology of ACLR, concentrating on Grade III
By Sarah Hart
Anteromedial band- makes up 49% of the ligament. Tension occurs in this portion when the knee is flexed
Posterolateral band- makes up the remain 51%. Tension occurs during extension.
Intermediate band- some literature suggest there is an intermediate band which is an amalgamation of fibres from the posterolateral and anteromedial bands. (Beasley et al 2005)
Role in the body
The ACL provides both mechanical stability and proprioceptive feedback to the knee.
Restrains anterior translation of the tibia on the femur.
Prevents hyper-extension of the knee.
Secondary stabilizer to valgus stress
Controls rotation of the tibia on femur in the last 30 degrees of knee extension. (part of the locking mechanism) (Tortora 00)Background Continued
(Beasley et al 2005)
Widely range protocols are:-Shelbourne and Nitz 4-6 months
Andrews and Wilks 5-6 months
Fu and Irrang 6-9 months
Campbell Clinic 6-12 months
Paulos and Stren 9 months
Kerlan and Jobe 9 months.
General criteria for each programme:-
No joint effusion
Isokinetic testing reveals that hamstrings and quadriceps are within 85-100% of normal strength
Satisfactory ligament stability using an arthrometer
Successful progression from walking to running
Successful performance of functional task i.e. twisting.Different approaches