परत खेळ! 3 महिने नंतर एसीएल सर्जरी | Dr. Manu Bora

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VIDEO TITLE - परत खेळ! 3 महिने नंतर एसीएल सर्जरी | Dr. Manu Bora

About ACL -
The Anterior Cruciate Ligament (ACL) in the knee is very important for keeping it stable. The ligament is very important for keeping the knee stable. This ligament joins the upper leg and lower leg bones to each other. There are chances of an injury in the anterior cruciate ligament while over-straightening of your knee, bending or twisting it, landing down incorrectly after a jump or while playing football. Women are more susceptible for contracting anterior cruciate ligament injury. ACL Surgeries are ideally done by orthopaedic surgeons.

Symptoms of ACL injury
People or athletes always present their symptoms like- ‘ I plant my foot, I felt my knee got twisted, the pop sound came and I was unable to continue the game.

However it is very rare but possible that a player injured his/her ACL but continues to play and later after the knee starts hurting, unable to move and swelling occurred; or they present whenever I walk on any ‘uneven surface’’ or inclined surface’ I felt instability in my knee. They feel that the knee is giving away.

Pain – Pain is very sharp, like cutting pain and can make you unable to move or lift the leg.

Swelling – There will be some swelling immediately after the injury but in some cases the swelling is progressive for next 24 hours. It can last up to a week.

Giving away – lack of confidence while walking, running or walking on an uneven surface or inclined surface, feeling of instability in the knee.

Laxity in the knee joint.
Feeling of shin bone moving excessively forward.
In common words the feeling of dislocation of the knee can happen if I walk or run. Painful weight bearing.
What are the types of ACL injuries?
There are three grade

Grade 1- The fibres of ligament are stretched but there is no tear, the ligament can still keep the knee joint stable.
Grade 2- The fibres of anterior cruciate ligament are partially torn means half fibres of ACL are torn or incomplete tear with hemorrhage, the ACL cannot provide full stability of the knee joint. Prognosis of grade 2 partial ACL tear is poor and requires surgery.
Grade 3- The fibres of ACL are completely torn means it’s completely torn into two parts. Grade 3 is the most common type of ACL injury.
Manual test to confirm ACL tear
1. Anterior draw test : Patient position is Supine. The knee is flexed or bent about 90°, examiner sits on the toes of the testing extremity to help stabilise. The examiner grasps the proximal tibia just below the knee joint and attempts to translate the tibia anteriorly.The test is considered positive if there is a lack of hard end point or excessive anterior translation relative to the contralateral or non-injured leg.
2. Lachhman test patient position is supine lying. Place the testing extremity in 20 to 30° of flexion, the examiner places one hand behind the tibia and other on the patient’s thigh. The examiner thumb should be on tibial tuberosity, leg should be in externally rotation position. On pulling the tibia anteriorly, anterior translation of tibia associated with the soft feel indicates the positive test. More than 2MM of anterior translation compared to the un-involved knee suggest ACL tear.
3. Pivot shift test The patient lying supine with the leg relaxed, examiner grasps the heel of the patient’s involved leg and examiner’s opposite hand placed laterally on the proximal tibia just distal to the knee. Apply a valgus force and an axial load while internally rotating the tibia as the knee moves from fully extended position to flexion, subluxation of tibia indicates the positive test while the femur rotates externally.
Management of ACL injuries

Injuries to the ACL rarely occur in isolation. the presence and extent of other injuries may affect the way in which the ACL injury is managed. Confirm diagnosis with MRI and physical assessment gives the absolute best assessment of ACL and other associated injuries.

Surgical or non-surgical management of an ACL tear is analysed through all the above diagnosis and the assessment.
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Видео परत खेळ! 3 महिने नंतर एसीएल सर्जरी | Dr. Manu Bora канала Dr Manu Bora - ACL Expert