...The following is a review of literature pertaining to the anterior cruciate ligament (ACL) reconstruction and the rehabilitation used for it. First, an overview of the anatomy and physiology of the anterior cruciate ligament will be given. The process by which the ACL injury is managed through reconstruction, repair, and rehabilitation will be seen from previous literature. This research will examine the two main different types of exercise, open kinetic chain and closed kinetic chain. The Anterior Cruciate Ligament The Anterior Cruciate Ligament, ACL, is located in the knee behind the patella. It attaches to the tibia at the anterior intercondylar area space. The other end attaches to the medial side of the lateral condyle in the femur. The...
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...Lenoir-Rhyne University Date Submitted: December, 2013 Introduction One of the most common injuries in sports of both genders is the tearing of the Anterior Cruciate Ligament, ACL. Each year there are over 200,000 reported cases of a torn ACL (Kim & Smith, 2009). Out of the 200,000 reported cases, an ACL reconstruction was performed in 175,000 of them with the majority of the procedures ending successfully, but failure rates averaged from three percent to high as 10% - 25% (Bogunovic, 2013). An ACL injury usually occurs while doing a move you have performed over a 100 times (Kidzworld). In other cases, a torn ACL is normally caused by getting hit extremely hard on the side of your knee, overextending the knee joint or by quickly stopping and changing direction while running (Kim & Smith, 2009). The ACL is the ligament that connects the tibia to the femur, and when it becomes torn it usually swells and produces a sharp pain immediately. Since the ACL is a pivotal aspect to a person’s knee, it is very important for scientists and doctors to figure out a sufficient way to heal it. Normally when an ACL is diagnosed as torn, the first step of the healing process is to go through a couple weeks of rehab before surgery to help strengthen the quadriceps and hamstring muscle. The most common ACL procedure consists of taking a ligament from the patella tendon or the use of a hamstring graph. The use of the patellar tendon graft has been the “gold standard” choice for ACL repair...
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...preservation of the both cruciate ligaments.19 In 1973, Marmor designed a modular knee for unicompartment & bicompartment replacement .20 The Total Condylar Prosthesis (TCP) designed by Insall and others, its introduction in 1973 marked the beginning of the modern era of total knee arthroplasty. (Fig. 20) This prosthesis design allowed mechanical considerations to outweigh the desire to reproduce anatomically the kinematics of normal knee motion. Influenced largely by the previous ICLH (Imperial College London Hospital) design, both cruciate ligaments were sacrificed, with sagittal plane stability maintained by the articular surface geometry. The original cemented total condylar prosthesis dramatically reset the standard for survivorship...
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...Case Studies #1: Mr. MacPherson Mr. MacPherson came into the ER with burns on both of his arms and hands and on his face as the result of a grease fire in his kitchen. He complained of severe pain. His burns showed signs of blistering, swelling and fluid loss. According to the “rule of nines” (Thibodeau & Patton, 2010), it appears this patient has suffered burns over approximately 14% of his body surface (4.5% for each arm and 4.5% face for a total of 13.5%). These would be classified as second-degree burns (“Types of burns”, 2012) which involve the first two layers of skin and show signs of pain and blistering of which Mr. MacPherson complained. As a note of comparison, first-degree burns involve the top layer of skin, such as in sun-burn, and show signs of reddening, painful to touch, and mild swelling. Third-degree burns penetrate the entire thickness of skin and permanently destroy tissue layers, resulting in skin that is dry and leathery, appearing charred or having patches which appear white, brown, or black. Remarkably third-degree burns are often painless, although pain may be caused by patches of first- and second-degree burns which often surround third-degree burns (“Types of burns”, 2012). Case Studies #2: Margie Margie, who plays center on the women’s varsity basketball tem, complains that her knee is very sore and she felt a “pop” during a scrimmage tumble. Her knee, the largest and most vul-nerable joint in her body, buckles under her weight. ...
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...Sci Sports 2014: 24: e180–e187 doi: 10.1111/sms.12120 © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd Relationship between jump landing kinematics and peak ACL force during a jump in downhill skiing: A simulation study D. Heinrich1,2, A. J. van den Bogert3,4, W. Nachbauer1 Department of Sport Science, University of Innsbruck, Innsbruck, Austria, 2Centre of Technology of Ski and Alpine Sports, Innsbruck, Austria, 3Orchard Kinetics LLC, Cleveland, Ohio, USA, 4Department of Mechanical Engineering, Cleveland State University, Cleveland, Ohio, USA Corresponding author: Dieter Heinrich, Department of Sport Science, University of Innsbruck, Innsbruck, Austria. Tel.: +43 512 507 4467, Fax: +43 512 507 2656, E-mail: dieter.heinrich@uibk.ac.at 1 Accepted for publication 8 August 2013 Recent data highlight that competitive skiers face a high risk of injuries especially during off-balance jump landing maneuvers in downhill skiing. The purpose of the present study was to develop a musculo-skeletal modeling and simulation approach to investigate the cause-andeffect relationship between a perturbed landing position, i.e., joint angles and trunk orientation, and the peak force in the anterior cruciate ligament (ACL) during jump landing. A two-dimensional musculo-skeletal model was developed and a baseline simulation was obtained reproducing measurement data of a reference landing movement. Based on the baseline simulation, a series of perturbed...
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...NAME: __________________________________ Class Period: ________ Anatomy & Physiology Case Study Assignment #3 For the following questions, please attach your answers to this sheet and submit it on the Skeletal System exam day. This assignment is worth 100 points towards your grade. Each correct answer is worth 10 points. All answers must be typewritten. Please be as complete and thorough as possible. You must attach a bibliography in MLA format with your references. Failure to do so will result in a 40 point deduction from your grade. DO NOT ‘CUT AND PASTE’ FROM THE INTERNET—I want to read YOUR ideas, concepts and responses! History #1: A 72-year-old woman presented to her physician with back pain that radiated laterally to the flanks. Upon examination, her physician noticed a pronounced kyphosis of her vertebral column. Radiographs revealed vertebral compression fractures in the thoracic and upper lumbar regions. Bone densitometry showed significant loss of bone mineral density. The patient was diagnosed with senile osteoporosis. The patient was prescribed Fosamax (Alendronate Sodium). 1. What is “senile osteoporosis” and how does it differ from “post-menopausal osteoporosis?” 2. How would you describe a pronounced kyphosis of the vertebral column? 3. BRIEFLY describe the process of bone resorbtion. 4. What cell type is responsible for bone resorbtion? 5. How would you expect the drug Fosamax (Alendronate Sodium) to affect osteoclasts...
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...have dinner all together at night at least you will be told about one incident minimum. Studies showed that 47% of people will have knee pain and about 19% have or will have ACL injury. That’s the point I want to focus on today, 19% ACL injury?! That’s quite a lot of people but if you compare it with the number of athletes that had or will had ACL injury in their whole career it’s not that spectacular if I can say, because the athletes have a number of 32% in ACL injury. An injury to the Anterior Cruciate Ligament can be a debilitating musculoskeletal injury to the knee, seen most often in athletes. Non-contact tears and ruptures are the most common causes of ACL injury. The anterior cruciate ligament (ACL) is an important ligament for proper movement. ACL injury more commonly causes knee instability that does injury to other knee ligaments. Injuries of the ACL range from mild such as small tears to severe when the ligament is completely torn. Symptoms of an ACL injury include hearing a sudden popping sound, swelling, and anterior instability of the knee (i.e. a "wobbly" feeling). Pain is also a major symptom in an ACL injury and can range from moderate to severe. Continued athletic activity on a knee with an ACL injury can have devastating consequences, resulting in massive cartilage damage, leading to an increased risk of developing osteoarthritis later in life. Other problems include anterior knee instability. ACL injury is a common cause of noncontact knee injury in football...
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...An Atlas of Surgical Anatomy An Atlas of Surgical Anatomy Surgical commentary by Alain C Masquelet, MD Illustrations by Léon Dorn © 2005 Taylor & Francis, an imprint of the Taylor & Francis Group First published in the United Kingdom in 2005 by Taylor & Francis, an imprint of the Taylor & Francis Group, 2 Park Square, Milton Park, Abingdon, Oxon OX14 4RN Tel.: +44 (0) 1235 828600 Fax.: +44 (0) 1235 829000 E-mail: info@dunitz.co.uk Website: http://www.dunitz.co.uk All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of the publisher or in accordance with the provisions of the Copyright, Designs and Patents Act 1988 or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, 90 Tottenham Court Road, London W1P 0LP. Although every effort has been made to ensure that all owners of copyright material have been acknowledged in this publication, we would be glad to acknowledge in subsequent reprints or editions any omissions brought to our attention. Although every effort has been made to ensure that drug doses and other information are presented accurately in this publication, the ultimate responsibility rests with the prescribing physician. Neither the publishers nor the authors can be held responsible for errors or for any consequences arising...
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...1. The article that was read talked about adolescent girl athletes having a higher risk in knee injuries than boys. It states that girls are eight times more likely to injure their anterior cruciate ligament (ACL) than boys. Throughout the study they looked at the reason why this injury affects mature girl athletes. The sports that have maneuvers like jumping and landing, or quick stops and turns are usually involved in the ACL injury cases. Other reasons for girls having a higher risk in ACL injuries are they tend to have larger quadriceps strength without increasing the strength of the hamstrings. This causes an imbalance on movements and increase stress on the ACL. The second reason is girl’s skeletal structure matures earlier during puberty. This makes girls have an upright position and placing stress on the ACL. More information was displayed in the article on the injury, but the conclusion shows girls have a higher risk of an ACL injury in sports due to physical growth and maturation. 2. The research article that we found talked a lot about the same issues as the journal article above. The knee joint is the second most frequently injured body part, falling behind the ankle. The research was done during 2005–2007 school years and 100 US high schools were randomly selected for a sample. Athletic trainers tracked all injuries using an online injury surveillance system. This research followed most injuries and came up with some conclusions and some insights on injuries...
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...Specific Aims. Tendon and ligament injuries are one of the most common orthopedic injuries. An estimated 1 in 1,000 persons injures their Anterior Cruciate Ligament (ACL) per year in the United States. The ACL does not heal spontaneously, most likely due to the lack of vascularization, growth factors and extracellular proteins that promote healing, thus requiring surgical intervention to restore knee function. Suturing the ruptured ACL is not always sufficient to promote healing, therefore the gold standard of care is a patellar tendon graft reconstruction [1]. While this surgery allows the patient to regain knee function, even with repair, patients experience early onset osteoarthritis, donor site morbidity, and potentially graft failure [2]....
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...Review Article Knee Surg Relat Res 2012;24(4):193-200 http://dx.doi.org/10.5792/ksrr.2012.24.4.193 pISSN 2234-0726 · eISSN 2234-2451 Knee Surgery & Related Research Patellofemoral Osteoarthritis Young-Mo Kim, MD, PhD and Yong-Bum Joo, MD, PhD Department of Orthopedic Surgery, Research Institue for Medical Sciences, Chungnam National University School of Medicine, Daejeon, Korea Patellofemoral arthritis is a fairly common disease, and it has been gaining interest with increasing number of studies due to its diverse treatment methods. Patellofemoral arthritis has a broad range of management options according to the characteristics of individual diseases. Identifying whether patellofemoral arthritis is the primary cause of knee pain and is compartment arthritis is necessary for establishing an adequate treatment method. rough investigation of the literature, the issues of recent knowledge of femoropatella arthritis and the diagnosis and treatment of which were studied. Key words: Patellofemoral arthritis, Diagnosis, Treatment. Introduction Unicompartmental arthritis of the knee generally refers to not only tibiofemoral arthritis but also to disorders of the patella and the cartilage. In particular, isolated patellofemoral arthritis is a relatively common disorder for which there has been increasing research regarding its treatment methods. Patellofemoral arthritis occurs due to the loss of the cartilage of the patella and the trochlear groove in approximately half...
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...Acquisitions Editor: Crystal Taylor Product Managers: Kelley A. Squazzo & Catherine A. Noonan Designer: Doug Smock Compositor: SPi Technologies First Edition © 2011 Lippincott Williams & Wilkins, a Wolters Kluwer business. 351 West Camden Street Baltimore, MD 21201 Printed in China All rights reserved. This book is protected by copyright. No part of this book may be reproduced or transmitted in any form or by any means, including as photocopies or scanned-in or other electronic copies, or utilized by any information storage and retrieval system without written permission from the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the abovementioned copyright. To request permission, please contact Lippincott Williams & Wilkins at Two Commerce Square, 2001 Market street, Philadelphia, PA 19103 USA, via email at permissions@lww.com, or via website at lww.com (products and services). Library of Congress Cataloging-in-Publication Data Lambert, Harold Wayne, 1972– Lippincott’s illustrated Q&A review of anatomy and embryology / H. Wayne Lambert, Lawrence E. Wineski ; with special contributions from Jeffery P. Hogg, Pat Abramson, Bruce Palmer. — 1st ed. p. ; cm. Includes index. ISBN 978-1-60547-315-4 1. Human anatomy—Examinations, questions, etc. I. Wineski, Lawrence E. II. Title. [DNLM: 1. Anatomy—Examination Questions...
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...PHYSICAL ASSESSMENT EXAMINATION STUDY GUIDE Nursing Assessment 1. Part of Nursing Process 2. Nurses use physical assessment skills to: a) Obtain baseline data and expand the data base from which subsequent phases of the nursing process can evolve b) To identify and manage a variety of patient problems (actual and potential) c) Evaluate the effectiveness of nursing care d) Enhance the nurse-patient relationship e) Make clinical judgments Gathering Data Subjective data - Said by the client (S) Objective data - Observed by the nurse (O) Document: SOAPIER Assessment Techniques: The order of techniques is as follows (Inspect – Palpation – Percussion - Auscultation) except for the abdomen which is Inspect – Auscultation – Percuss – Palpate. A. Inspection – critical observation *always first* 1. Take time to “observe” with eyes, ears, nose (all senses) 2. Use good lighting 3. Look at color, shape, symmetry, position 4. Observe for odors from skin, breath, wound 5. Develop and use nursing instincts 6. Inspection is done alone and in combination with other assessment techniques B. Palpation – light and deep touch 1. Back of hand (dorsal aspect) to assess skin temperature 2. Fingers to assess texture, moisture, areas of tenderness 3. Assess size, shape, and consistency of lesions and organs 4. Deep = 5-8 cm (2-3”) deep; Light = 1 cm deep C. Percussion – sounds produced by striking body surface 1. Produces different notes depending on underlying mass (dull...
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...D.A.C.N.B. ABSTRACT Objective: This study investigates the clinical utility of testing functional systems within the central nervous system, compared to testing individual motor nerves with manual muscle testing. Design: Private practice. Study Subjects: Patients were examined by the treating chiropractor from his existing patient pool. Methods: Chiropractic management was decided on by the treating chiropractor. A series of twelve tests were designed to discover disorders of functional systems within the CNS. The tests described were to evaluate the function of 12 systems: 1) spinal cord, 2) myelencephalon/reticular formation, 3) vagal system, 4) trigeminal motor system-muscles of mastication, 5) vestibulospinal system, and bulbo reticular area, 6) reticular formation, 7) diencephalons and gait locomotion system, 8) mesencephalon, 9) cardiac sympathetic autonomic system, 10) pyramidal system, 11) limbic system, 12) sensory system. Results: This chiropractic approach tests the nervous system after provocation of functional systems instead of sensory challenges to more discreet portions of the body. Conclusion: For chiropractic patients who are not responding to discreet treatment programs, this method of evaluation may be valuable as it tests underlying system problems within the CNS. Nearly all the functional systems have a related motor activity that results in inhibition and facilitation patterns. Case series...
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...midterm and long-term results of a TKR, good alignment in /the frontal plane of the lower limb is mandatory. In an experimental study, Hsu et al 14showed that a femoral component in 7° valgus, with the tibial component placed at 90° to the long axis of the tibia, was the best position for the total condylar knee and produced equal force distribution between the medial and lateral plateaus. For the Kinematic knee, the best position was 9° valgus for the femoral component with 2° varus of the tibial component. A clinical association between failure of TKR and malalignment seems likely. Ritter et al 32 reported that varus knees had a lower survival at 10 years than aligned or valgus knees. Jeffery et al,16 with the first design of the Denham prosthesis, reported that at 12 years the incidence of loosening was 3% when, on long-leg standing radio-graphs, the line joining the center of the femoral head to the center of the body of the talus passed through themiddle1⁄3of the knee prosthesis. The incidence of loosening was 24% when the line was not in this range. Alignment in a narrow range around the neutral axis is a major objective of TKR even if the exact range is not clearly identified. To achieve this goal, different systems are available based on intramedullary or extramedullary rods that allow targeting. From experimental data18, 26, 31 and clinical studies, 4, 7, 13, 21 it has been shown that these systems...
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