ACL PCL Persented by : Bahador Rafiee In the name of God ACL PCL Persented by : Bahador Rafiee

Anatomy Anterior Cruciate Lig. Posterior Cruciate Lig.

Function ACL , PCL

Examination 1-Anterior Drawer Test anterior force applied at 90 degrees of flexion

Examination 2-Posterior Drawer Test Most accurate test for PCL tear. Patient in supine position with knee flexed 90°. Apply a posteriorly directed force to proximal tibia.

Examination 3-Lachman Test best test for ACL laxity. Knee placed in 20-30 degrees of flexion, the femur is stabilized, and an anteriorly directed force  applied to proximal calf. 

Examination 4-Pivot-Shift Test Confirms complete ACL tear. Based on very early flexion causing anterior subluxation of the tibia that is reduced with further flexion (20-40 degrees) due to the posterior pull of the iliotibial tract.

Examination Mac Murray’s Test

Anterior cruciate ligament injury An ACL tear is most often a sports-related injury. ACL tears can also occur during rough play, mover vehicle collisions, falls, and work-related injuries. About 80% of sports-related ACL tears are "non-contact" injuries. This means that the injury occurs without the contact of another athlete, such as a tackle in football. Most often ACL tears occur when pivoting or landing from a jump. The knee gives-out from under the athlete when the ACL is torn.

Anterior cruciate ligament injury Female athletes are known to have a higher risk of injuring their anterior cruciate ligament, or ACL, while participating in competitive sports.

Clinical feature Noncontact injury An audible pop often accompanies this injury, which often occurs while changing direction, cutting, or landing from a jump (usually a hyperextension/pivot combination). Within a few hours, a large hemarthrosis develops. Patients usually are unable to return to play, secondary to pain, swelling, and instability or giving way of the knee. Contact and high-energy traumatic injuries These injuries often are associated with other ligamentous and meniscal injuries. The classic "terrible triad" (ACL, MCL, and medial meniscus tears) involves a valgus stress to the knee with resultant acute injury to the ACL and MCL; however, the medial meniscus tear is now thought to occur later, as a result of chronic ACL deficiency.

Radiography

Treatment In adult with bone fracture With other lesion Just ligament tearing : 1- normal people 2- athlete people Chronic tearing

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