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--- group_5_presentation_3_-_anterior_cruciate_ligament_injury [2016/12/02 02:29]
chuneh
+++ group_5_presentation_3_-_anterior_cruciate_ligament_injury [2018/01/25 15:18] (current)
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 <style float-left>
-{{:acl.gif|}}
+{{:acl_bg.gif|}}
-**Figure 1**: The green line represents the
+**Figure 1**: The green line represents the placement
-placement of the ACL.
+of the ACL. (Source: http://www.leadingmd.com)
- (Source: http://www.leadingmd.com)
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 &nbsp; &nbsp; &nbsp; (Source: http://physioworks.com.au/)
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 In the U.S., there are about 100,000-200,000 ACL ruptures per year and about 100,000-150,000 ACL repairs per year. (Mall et al., 2014) These numbers are based on data from several years ago, thus may be higher today due to more younger individuals engaging in high-level sports and more older individuals staying active longer. The current incidence of ACL injuries and repairs is unknown. (Mall et al., 2014) The higher number of ruptures than repairs is due to those who opt for non-surgical treatment.
-ACL injuries generally occur beginning in late adolescence. Ages leading up to late adolescence do not typically sustain ACL injuries, but rather sustain growth plate injuries due to the relative weakness of the cartilage at the epiphyseal plate compared with the ACL. (Cimino et al., 2010)
+ACL injuries generally occur beginning in late adolescence. Ages leading up to late adolescence do not typically sustain ACL injuries, but rather sustain growth plate injuries due to the relative weakness of the cartilage at the epiphyseal plate compared with the ACL. (Popkin & Murnaghan, 2012)
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-&nbsp; &nbsp; {{:aclrisk1.png|}}
+{{:aclrisk1.png|}}
 &nbsp; &nbsp; &nbsp; **Figure 3**: Differences in female and male bodies leading to a difference in risk of sustaining an ACL injury.
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+<br>
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 ====== Diagnosis ======
+<style float-left>
+{{:yoyoyo.jpg|}}
+**Figure 4**: Illustrates the steps for the pivot shift test (Source: Fpnotebook,2016)
+</style>
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+<br>
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 For the clinical examination of a suspected ACL injury, the pivot-shift test, anterior drawer test and Lachman test are used.
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+<br>
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 The pivot shift is difficult to perform in the office, it is usually more helpful in the operating room with a patient under the influence of anesthesia. The pivot shift maneuver identifies abnormal motion of the knee joint when there is an ACL tear present.
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+<HTML>
-{{:wiki:orthokneepivotshiftkneebent.jpg|}}
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-**Figure X**: Illustrates the steps for the pivot shift test (Source: Fpnotebook,2016)
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 The drawer test is used in the primary clinical assessment of suspected rupture of the cruciate ligaments in the knee. During the test, the patient should be supine with the hips flexed to 45 degrees, the knees flexed to 90 degrees and the feet flat on table.
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+<br>
+</HTML>
 The Lachman test is known by most authorities as the most reliable and sensitive test, and usually a better alternative to the anterior drawer test. The ACL can also be detected using a magnetic resonance imaging scan (MRI scan).
+<HTML>
+<br>
+</HTML>
 Even though clinical examination if done by a professional can be accurate, the diagnosis is usually confirmed by MRI scan, which has significantly narrowed the need for diagnostic arthroscopy and which has a greater accuracy than clinical examination. It may also show a graphic of other structures which may have been involved in the injury, such as a meniscus, or collateral ligament, or posterolateral corner of the knee joint.
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 ====== Treatment ======
 <style float-right>
-{{:brace.jpg|Figure X: Illustrates a typical knee brace looks like.
+&nbsp; &nbsp; {{:brace.jpg|Figure X: Illustrates a typical knee brace looks like.
- (Source: Better Braces, 2016)}}
+&nbsp; &nbsp; (Source: Better Braces, 2016)}}
-**Figure X**: Illustrates a typical knee brace looks like.
+&nbsp; &nbsp; **Figure 5**: Illustrates a typical knee brace looks like.
- (Source:Better Braces, 2016).
+&nbsp; &nbsp; (Source:Better Braces, 2016).
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-{{:surgical_treatment_1.jpg|Figure X: Demonstrates the knee and ACL before and after surgery. (Source: A.D.A.M, 2013}}
+&nbsp; &nbsp; {{:surgical_treatment_1.jpg|Figure X: Demonstrates the knee and ACL before and after surgery. (Source: A.D.A.M, 2013}}
-**Figure X**:Demonstrates the knee and ACL
+&nbsp; &nbsp; **Figure 6**:Demonstrates the knee and ACL
-before and after surgery.
+&nbsp; &nbsp; before and after surgery.
-(Source:A.D.A.M, 2013).
+&nbsp; &nbsp; (Source:A.D.A.M, 2013).
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 {{:allograft.jpg|Figure X: Illustrates the different type of allografts that can be used for this surgery.
-  (Source: Mayo Foundation for Medical Education and Research, 2016)}}
+  (Source: Mayo Foundation for Medical Education and Research, 2016)}} &nbsp; &nbsp;
-**Figure 4**:  Illustrates the different type of
+**Figure 7**:  Illustrates the different type of &nbsp; &nbsp;
-allografts that can be used for this surgery.
+allografts that can be used for this surgery. &nbsp; &nbsp;
-(Source: Mayo Foundation for Medical
+(Source: Mayo Foundation for Medical &nbsp; &nbsp;
-Education and Research, 2016).
+Education and Research, 2016). &nbsp; &nbsp;
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+</HTML>
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-{{:autograft.jpg|Figure X: Illustrates the retrieval and extraction of an autograft. (Source: Mayo Foundation for Medical Education and Research, 2016}}
+&nbsp; &nbsp; {{:autograft.jpg|Figure X: Illustrates the retrieval and extraction of an autograft. (Source: Mayo Foundation for Medical Education and Research, 2016}}
-&nbsp; &nbsp; **Figure X**:Illustrates the retrieval and
+&nbsp; &nbsp; **Figure 8**:Illustrates the retrieval and
 &nbsp; &nbsp; extraction of an autograft.
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+<HTML>
+<br>
+</HTML>
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-{{:post_surgery.jpg|Figure X: Illustrates the surgical repair of the ACL and knee.
+{{:post_surgery.jpg|Figure X: Illustrates the surgical repair of the ACLand knee.
- (Source: Tower Orthopaedics, 2016)}}
+ (Source: Tower Orthopaedics, 2016)}} &nbsp; &nbsp;
-**Figure X**: Illustrates the surgical repair of the ACL
+**Figure 9**: Illustrates the surgical repair of the ACL &nbsp; &nbsp;
 and knee.
- (Source:Tower Orthopaedics, 2016).
+ (Source:Tower Orthopaedics, 2016). &nbsp; &nbsp;
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-<br>
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   * Excessive Bleeding and blood clotting
   * Persistent Knee Pain
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 ====== References ======
+American Academy of Orthopaedic Surgeons. (2016). Anterior Cruciate Ligament (ACL) Injuries. OrthoInfo - AAOS. Retrieved from http://orthoinfo.aaos.org/topic.cfm?topic=A00549
+Clayton, R. A. E., and Court-Brown, C. M. (2008). The epidemiology of musculoskeletal tendinous and ligamentous injuries. International Journal of the Care of the Injured. 39,  1338-1344.
+Cimino, F., Volk, B. S., and Setter, D. (2010). Anterior cruciate ligament injury: Diagnosis, management, and prevention. American Family Physician, 82(8), 917-918.
+Gianotti, S. M., Marshall, S. W., Hume, P. A., and Bunt, L. (2009). Incidence of anterior cruciate ligament injury and other knee ligament injuries: A national population-based study. Journal of Science and Medicine in Sport, 12, 622-627.
+Krans, B. (2016, February 22). ACL Reconstruction. Health Line. Retrieved from http://www.healthline.com/health/acl-reconstruction
+Mall, N. A., Chalmers, P. N., Moric, M., Tanaka, M. J., Cole, B. J., Bach, B. R., and Paletta, G. A. (2014). Incidence and trends of anterior cruciate ligament reconstruction in the united states. The American Journal of Sports Medicine, 42(10), 2363-2370.
 Mayo Clinic. (2016). Clinical updates. Retrieved from http://www.mayoclinic.org/medical-professionals/clinical-updates/orthopedic-surgery/anterior-cruciate-ligament-reconstruction-graft-selection
+Popkin, C, A., and Murnaghan, M, L. (2012). Knee injuries in the growing athlete. Journal of Clinical Orthopaedics and Trauma, 26(1), 12-19.
+UCSF. (2016). ACL Tear. UCSF Medical Center. Retrieved from https://www.ucsfhealth.org/conditions/acl_tear/
+Zazulak, B. T., Hewett, T. E., Reeves, P. N., Goldberg, B., and Cholewicki, J. (2007). Deficits in neuromuscular control of the trunk predict knee injury risk. The American Journal of Sports Medicine, 35(7), 1123.

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