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Chapter-165 Anterior Cruciate Ligament-deficient Knee

BOOK TITLE: Textbook of Orthopedics & Trauma (4 Volumes)

Author
1. Pardiwala Dinshaw
2. Kadrekar Sujit
3. BR Yathiraj
ISBN
9789385891052
DOI
10.5005/jp/books/12869_166
Edition
3/e
Publishing Year
2016
Pages
7
Author Affiliations
1. Jiwan-Flat. 7a, Ii LD Ruparel Marg Malabar Hill, Mumbai, Maharashtra, Arthroscopy and Joint Preservation Service; Center for Sports Medicine, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India, Jiwan-Flat. 7a, Ii LD Ruparel Marg, Malabar Hill, Mumbai, Maharashtra, India, Centre for Sports Medicine; Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra,
2. Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
3. Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, Inida
Chapter keywords
Anterior cruciate ligament, ACL, Lachman test, pivot shift test, anterior drawer test, plain radiography, instrumented ligament testing, graft selection, graft fixation, joint stiffness

Abstract

The anterior cruciate ligament (ACL) is intracapsular but extrasynovial. The femoral origin of the ACL is on the lateral wall of the intercondylar notch at its posterior aspect and is oriented in the longitudinal axis of the femur. Most ACL tears occur as a noncontact injury involving a rapid deceleration or rotational force to the knee. A careful physical examination of the injured knee as compared to the normal knee will reveal most ligament disruptions if the patient is relaxed. Lachman test, pivot shift test and anterior drawer test are the tests which are performed for ACL. Plain radiography is important to rule out associated injuries, such as osteochondral fractures and pre-existing abnormalities. Magnetic resonance imaging (MRI), instrumented ligament testing, and examination under anesthesia and arthroscopy used for imaging the ACL-injured knee. The goals of treatment following an ACL injury are restoration of normal function. The primary candidates for ACL surgery are those patients with an active lifestyle who have an acute ACL deficiency and those with a chronic ACL deficiency that results in functional instability that endangers the menisci. There are many intra-articular and extra-articular surgical techniques for ACL reconstruction, some of them described in this chapter are graft selection, graft fixation and graft-site morbidity. Joint Stiffness and graft donor-site are the common complications of ACL surgery.

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