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Tutorial

This document discusses injuries to two tendons: the anterior cruciate ligament (ACL) and the Achilles tendon. It provides information on the anatomy of each tendon, common causes of injury, symptoms of injury, diagnostic tests, and treatment options both non-operatively and operatively. ACL tears are common in sports and may cause a popping sound and knee instability. Achilles tendon ruptures typically occur in adults aged 40-50 during athletic activities and cause a snap in the heel. Treatment options discussed include casting, bracing, and open or percutaneous surgical repair.

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28 views13 pages

Tutorial

This document discusses injuries to two tendons: the anterior cruciate ligament (ACL) and the Achilles tendon. It provides information on the anatomy of each tendon, common causes of injury, symptoms of injury, diagnostic tests, and treatment options both non-operatively and operatively. ACL tears are common in sports and may cause a popping sound and knee instability. Achilles tendon ruptures typically occur in adults aged 40-50 during athletic activities and cause a snap in the heel. Treatment options discussed include casting, bracing, and open or percutaneous surgical repair.

Uploaded by

Nova Suryati
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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INJURY LIGAMENT

Anterior Cruciate Ligament


Tears
Can withstand approximately 400 pounds
of force
Common injury particularly in sports (3%
of all athletic injuries)
May hear a pop sound and feel the knee
give away

Types of ACL Tears

Causes of ACL Injuries


Cutting (rotation)
Hyperextension

Straight knee landing


When the knee is extended, the ACL is at its
maximal length putting it at an increased risk
of tearing

Acute Achilles Tendon


Rupture
Largest, most powerful tendon in
body
Formed by gastrocnemius and soleus
Incidence of rupture 18:100,000
Incidence is increasing
As demonstrated by population based
studies in Finland, Canada, Scotland and
Sweden

Adults 40-50 y.o. primarily affected


(M>F)
Athletic activities, usually with
sudden starting or stopping
Snap in heel with pain, which may
subside quickly

25% of patients have previous


symptoms of Achilles inflammation
Leppilahti et al. Clin Orthop 1998

Associated conditions:
Ochronosis
Steroid use
Quinolones
Inflammatory arthritis

DIAGNOSIS
Weakness in plantarflexion
Gap in tendon
Positive Thompson test

IMAGING
X-rays
Indicated if fracture or avulsion fracture
suspected

Ultrasound or MRI
Reveal tendon degeneration, if present

TREATMENT
Non-operative versus operative
treatment controversial
Several methods described for each

NON OPERATIF
Cast immobilization
Traditional recommendation is 8 weeks of
immobilization
Wallace recommended patellar tendon bearing
orthosis for weeks 4-8
Functional brace with semi-rigid tape and
polypropylene orthoses for duration of
treatment also described

Rerupture rate 8-39% reported

OPERATIVE
Open repair
Locking stitch, +/- augmentation with
plantaris or mesh
Post-op care = Casting for 6-8 weeks
Risks: Infection (4-21%), Rerupture (15%)

Percutaneous
Bunnell stitch
Weaker than open repair (Rerupture 017%)
Risk of sural nerve injury (0-13%)
Decreased infection risk

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