Indications Critical Points Indications Mechanism of injury, low versus high velocity. Complete PCL rupture usually associated with other ligament injuries. Isolated PCL rupture represents serious injury, chance of functional deterioration, arthritis over time. Indications for chronic isolated complete PCL rupture:…
Introduction This chapter provides a summary of the important biomechanic principles gained from our publications and other investigations regarding the posterior cruciate ligament (PCL) and posterolateral structures (PLSs). The primary PLSs of the knee joint are the fibular collateral ligament…
Scientific Rationale and Supporting Investigations for Sportsmetrics Neuromuscular Retraining Program This chapter presents the scientific rationale, supporting data, and specific strategies for the implementation of Sportsmetrics, a neuromuscular knee ligament injury prevention training program. Since Sportsmetrics was first introduced to…
Video Content Video 11-4 Sportsmetrics Neuromuscular Conditioning Programs to Prevent ACL Injuries in Female Athletes Introduction It is well recognized that female athletes and military recruits have a higher incidence of noncontact anterior cruciate ligament (ACL) injuries than males participating…
Clinical Concepts Critical Points Clinical Concepts Protocols are evaluation based: Progression is based on continual evaluation using the principles of anatomy, physiology, biomechanics, and surgery. Goals Regain normal knee stability Control joint pain, swelling, and hemarthrosis Regain normal range of…
Introduction Considerable advances have been made in the treatment of complete anterior cruciate ligament (ACL) ruptures and reconstruction methods. These include the appropriate selection of patient candidates and criteria for goals that should be achieved before surgery, such as resolving…
Indications Critical Points Indications Determine factors that caused the prior ACL reconstruction to fail Address all pathologies before surgery: lower limb malalignment, muscle atrophy, limitation knee motion, gait abnormalities, misplaced tunnels. Goals, outcome of surgery depend on preexisting joint damage,…
Indications Critical Points Indications Complete ACL rupture: >5 mm of increased anterior tibial translation, positive pivot shift test. Profile patient for desired future activity level. High-risk activities (pivoting, cutting, twisting, and turning): reconstruct. Acute ACL rupture and concomitant displaced bucket-handle meniscus…
Ligament Fiber Length-Tension Properties Critical Points Ligament Fiber Length-Tension Properties Numerous publications demonstrate how ligament fiber function depends on the initial length and attachment site and the specific joint position of both flexion-extension and tibial rotation. These concepts form the…
Classification System for Knee Ligament Injuries Critical Points Classification System for Knee Ligament Injuries Purpose of a Classification System Make accurate distinctions between separate pathologic conditions in laboratory and clinical studies. Provide a common descriptive tool for investigators who wish…