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Anterior Cruciate Ligament Injuries

Anatomy & Biomechanics

  • completely intraarticular

  • anteromedial fibres - tight in flexion - limits anterior translation of tibia on femur

  • posterolateral fibres - tight in extension - limits anterior translation PLUS external rotation

  • ACL strength = 50% PCL strength

  • Load to failure = 1700N

  • strain rate plays a role in the location of ligament failure
    • midsubstance tears occurring at higher rates
    • bone ligament complex tears occurring at lower rates
  • Blood supply - middle genicular artery (post) & synovial vessels (ant)

  • Mechanoceptors with a proprioceptive role


Examination:

Mechanism of Injury:

  • substantial anterior tibial shear forces that stress ACL are produced from quadriceps contraction, esp in 0-30 deg of extension

  • Typically, the ACL is torn in a noncontact deceleration situation that produces a valgus twisting injury - when the athlete lands on the leg and quickly pivots in the opposite direction. 


Associated Injuries: ( Noyes, 1980 )



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Anterior Cruciate Ligament Injuries
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