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PATHOPHYSIOLOGY ANTERIOR CRUCIATE LIGAMENT INJURY

PROBLEM BASED LEARNING (PBL)

PREPARED BY: MUHAMMAD ARIFF B. MAHDZUB

BACHELOR MEDICINE AND SURGERY (MBBS)

UNIVERSITY COLLEGE SHAHPUTRA, KUANTAN

Part of a cruciate ligament of each knee that attaches the front of the tibia with the back of the femur.

The anterior cruciate ligament (ACL) lies inside the knee joint.

It consists of strong fibers (or collagen) that function like the strands of a rope or cable.

Prevent hyperextension of the knee.

Limits excessive tibial rotation.

Provides most of the support that prevents the tibia from slipping forward against the femur.

A condition of over-stretching or tearing of the anterior cruciate ligament (ACL) in the knee.

A tear may be partial or complete.

Partial tears of the anterior cruciate ligament are rare.

Most ACL injuries are complete or near complete tears.

Occur along with damage to other structures in the knee, such as articularcartilage, meniscus, or other ligaments.

Injured ligaments are considered "sprains" and are graded on a severity scale.

• Mildly damaged.

• Slightly stretched, but is still able to help keep the knee joint stable.

GRADE 1

• Becomes loose.

• Referred to as a partial tear of the ligament.

• Rarely occur.

GRADE 2

• Most commonly referred to as a complete tear.

• The ligament has been split into two pieces, and the knee joint is unstable.

GRADE 3

GENERAL CAUSES•Changing direction rapidly.

•Stopping suddenly.

•Slowing down while running.

•Landing from a jump incorrectly.

•Direct contact or collision, such as a football tackle.

•Twisted leg – skier.

ACTUAL MECHANICS OF THE INJURY

NORMAL

When the hips and knees are bent

The leg can rotate inward

For example : while sitting, the right foot can be place on the left knees

But it cannot rotate outwardly.

Try sit on a chair and pull your foot directly sideway to putside.

It really cant bent that way.

THE SKIER ROUTINE

They are such in a sitting position

They face forces through :pounding through bumps,landing a jump on the tails,

Flexing the ankles, knees, and hips is the natural way for the body to manage these forces, and by itself, this does not cause injuries.

The problem happen when the skier receive certain forces at a moment that push the foot directly outward or twisted their legs.

The force usually come from the pull or push force to the ski.

If the force acts on the ski tip OR the tail, the ski will rotate around the skier’s boot heel, and the toe is likely to release from the twisting force.

However, if the force is at both the tail AND the tip, or if the force enters the ski at or near the heel (pushing the ski directly sideways), the forces do not twist the ski around the boot heel.

If this happens when the knees and hips are bent and the lower leg is pulled too far, a knee injury is likely occur.