Discussion femoral tunnel tibial tunnel: isometric placement of ACL refers to the concept that a full range of knee can be achieved w/o causing long-term ligament deformation; isometry can not exist because, during ROM, there is no one point on femur that maintains a fixed distance from a single point on tibia; elongation always will … Read more
– Discussion: – anatomy of ACL; – ACL biomechanics; – graft tunnel sites / isometry: – hamstring ACL reconstruction is an alternative to bone patellar bone graft fixation; – size and strength of graft: – double looped hamstring graft is more than twice as … Read more
Discussion AC joint is situated between the clavicle and acromion; acromion has two ossification centers which fuse at age 22 yrs; it permits motion in three planes: AP gliding of acromion during protraction & retraction of scapula; tilting of acromion during abduction & adduction of arm; rotation of the clavicle; rotation occurs during abduction & … Read more
(see also: Achilles Tendonitis) Discussion ruptures typically occur after age 30, more often in people beyond middle age; rupture at musculous tendinous junction occurs most often in young people, but ruptures near the calcaneus also occur; inciting event may be related to atrophy of the soleus muscle, and commonly occur in weekend athletes; in 5-33% … Read more
note that active plantarflexion may occur due to activity of tibialis posterior, peroneals, and long toe flexors; diagnosis is clinched w/ one of two tests; hyper-dorsiflexion sign the patient is placed in the prone position, and the knees are flexed to 90 deg; the examiner then passively dorsiflexes both feet maximally and compares the injured … Read more
(see also: Pseudoachondroplasia) Discussion autosomal dominant disorder; arises due to a point mutation for the gene encoding a fibroblast growth factor (Fibroblast growth factor receptor 3) over 80% of all persons with this disorder are born to parents who are not achondroplastic, & such parents rarely have second achondroplastic child; it is presumed in these … Read more
– Normal Hip Development: (limb development and pediatric anteversion); – at 4 to 6 gestational weeks, the hip joint develops from the cartilaginous anlage; – by 7 weeks a cleft develops between precartilagenous cells which are programmed to form the femoral head and acetabulum; – by 11 weeks, the hip … Read more
optimal graft angle the report by Howell SM, et al, the authors studied the angle of the tibial tunnel to graft function; 5 surgeons treated 119 subjects by reconstructing a torn ACL using a double-looped semitendinosus and gracilis graft and a standardized technique; radiographs were analyzed for tibial tunnel placement and a clinical evaluation was … Read more
optimal graft angle: in the report by Howell SM, et al, the authors studied the angle of the tibial tunnel to graft function; 5 surgeons treated 119 subjects by reconstructing a torn ACL using a double-looped semitendinosus and gracilis graft and a standardized technique; radiographs were analyzed for tibial tunnel placement and a clinical evaluation … Read more
– Graft Entry Point: – because the slope of the intercondylar notch will vary from 26 to 44 deg, the tibial tunnel should be accordingly positioned between the anterior third and the midpoint of the saggital length of the tibia; – referenced off the PCL: – this … Read more