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29 Cards in this Set
- Front
- Back
What is the most common mechanism of ACL injury?
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Noncontact pivot
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What gender is most at risk for sustaining an ACL injury?
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Female
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How often does an acute bloody knee effusion correlate with a ruptured ACL?
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75%
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What test is most sensitive on physical examination for ACL rupture?
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Lachman test
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What is clinically significant KT-1000 (arthometry) difference side-to-side?
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3 mm
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Once the ACL is disrupted, what is the primary restraint to anterior translation?
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Meniscus
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What plain radiographic finding is classically associated with an ACL injury?
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Segond fracture
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What is the MRI appearance of a bloody effusion? Non bloody effusion?
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Bloody: high T1, low T2
Non-bloody: low T1, high T2 |
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What are the three preoperative requirements to minimize the risk of arthrofibrosis?
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Full range of motion (ROM)
No effusion Good quadriceps function |
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With a preoperative varus thrust, what procedure should be considered before ACL reconstruction?
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High tibial osteotomy (HTO)
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Of the graft options, which has the highest ultimate tensile load?
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Quadrupled hamstring
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What two hamstring tendons are used as graft for reconstruction?
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Gracilis
Semitendinosus |
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What nerve is at risk with hamstring harvest?
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Sartorial branch of the saphenous nerve
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What graft option has strength characteristics most similar to those of the native ACL?
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Bone-patellar tendon-bone
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What nerve is at risk with patellar tendon harvest?
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Infrapatellar branch of saphenous nerve
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In which direction is an intraoperative patellar fracture generally oriented?
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Vertical
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How can the strength of the graft be increased by about 30%?
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Rotate 90 degrees
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What is the benefit of preconditioning the graft?
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Reduces stress relaxation by 50%
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What are the two most reliable tibial tunnel landmarks?
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Just anterior to PCL
Native ACL footprint |
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In which direction is a postoperative patella fracture generally oriented?
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Horizontal
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At 6 weeks after surgery, what percentage of original graft strength has returned? At 1 year?
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<20% of original at 6 weeks
<50% of original at 1 year |
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After ACL, what rehabilitation exercises are preferred? What is the goal of rehabilitation? What type of training is emphasized? Are prone hangs permissible?
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Closed chain, weight bearing as tolerated (WBAT) exercises
Safe quadriceps strengthening Emphasizes proprioceptive training Prone hangs are OK |
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What is the worst ACL postoperative exercise? What is the ideal PCL postoperative exercise?
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Worst ACL: active extension 15 to 30 degrees
Ideal PCL: active extension 90 to 0 degrees |
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What four factors have been associated with good 2 -year outcomes after ACL reconstruction?
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Accurate tunnel placement
Strong grafts Solid graft fixation Rational rehabilitation program |
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What is the most common cause of immediate postoperative ACL failure?
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Failure of fixation
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What is the most common operative complication overall?
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Aberrant tunnel placement
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What is the upper limit of acceptable screw divergence?
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20 degrees
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What is the consequence of a too anterior femoral tunnel?... tibial tunnel?
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Femoral tunnel too anterior: decreased flexion
Tibial tunnel: impingement in extension |
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If the femoral tunnel is too far back (over top), what is the consequence in flexion?... extension?
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Lax in flexion
Tight in extension |