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Conservative treatment has poor outcomes in ACL injury, since the ACL is unable to form a fibrous clot, as it receives most of its nutrients from synovial fluid; this washes away the reparative cells, making the formation of fibrous tissue difficult. The two most common sources for tissue are the patellar ligament and the hamstrings tendon. [10]
Relative to the femur, the ACL keeps the tibia from slipping forward and the PCL keeps the tibia from slipping backward. Another structure of this type in human anatomy is the cruciate ligament of the dens of the atlas vertebra, also called "cruciform ligament of the atlas", a ligament in the neck forming part of the atlanto-axial joint. [2]
Anterior Cruciate Ligament Reconstruction (ACL) surgery is a common intervention. 1 in every 3,000 American ruptures their ACL and between 100,000 and 300,000 reconstruction surgeries will be performed each year in the United States.
Female athletes are two to eight times more likely to strain their ACL in sports that involve cutting and jumping as compared to men who play the same particular sports. [12] NCAA data has found relative rates of injury per 1000 athlete exposures as follows: [citation needed] Men's basketball 0.07, women's basketball 0.23
Acute injury to the medial meniscus frequently accompanies an injury to the ACL (anterior cruciate ligament) or MCL (medial collateral ligament). A person occasionally injures the medial meniscus without harming the ligaments. Healing of the medial meniscus is generally not possible unless the patient is very young, usually <15 years old.
An increased amount of anterior tibial translation compared with the opposite limb or lack of a firm end-point may indicate either a sprain of the anteromedial bundle or complete tear of the ACL. [2] If the tibia pulls forward or backward more than normal, the test is considered positive.
Originally described by Dr. Paul Segond in 1879 [6] [7] after a series of cadaveric experiments, the Segond fracture occurs in association with tears of the anterior cruciate ligament (ACL) (75–100%) and injury to the medial meniscus (66–75%), lateral capsular ligament (now known as the Anterolateral ligament, or ALL), as well as injury to the structures behind the knee.
The PCL is located within the knee joint where it stabilizes the articulating bones, particularly the femur and the tibia, during movement.It originates from the lateral edge of the medial femoral condyle and the roof of the intercondyle notch [2] then stretches, at a posterior and lateral angle, toward the posterior of the tibia just below its articular surface.