Clean evidence in ACL smoothly

Aug 6th, 2022
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How to Clean evidence in ACL

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Hello again. In this online course, we have already discussed a lot of factors how to deal with ACL injury ACL reconstruction across the whole rehabilitation continuum. The aim of this screencast is to summarize the key aspects why we may fail to achieve optimal results after ACL injury and/ or ACL reconstruction. Note that this summary is not meant to blame anyone. But just to make sure we can do better in the future. The first limitation we are currently dealing with is that there are only a limited amount or there is a lack of clinically applicable guidelines for rehabilitation after ACL injury and ACL reconstruction. Some guidelines have been published but these guidelines remain very general and non-specific. Secondly, there is clearly a gap between what we know from research and what is typically done in clinical practice. This can be due to many reasons. For example for many of us physical therapists, It can be very challenging to keep up to date. Given the fact that a lot of r

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0:13 1:16 Lachman Test | Anterior Cruciate Ligament (ACL) Rupture Knee YouTube Start of suggested clip End of suggested clip Our next test is lockmans test thats a way to assess the anterior cruciate ligament. So to do thatMoreOur next test is lockmans test thats a way to assess the anterior cruciate ligament. So to do that we need to stabilize the thigh we need to make sure martins nice and relaxed.
Diagnostic value of MRI The accuracy was good for ACL injuries (87.6%) and PCL injuries (84.5%), moderate for MCL injuries (69.1%) and LCL injuries (66.9%), low for the meniscus injuries (45.4%).
Data for the physical examination are summarized in Table 1. A positive Lachman test or pivot test is strong evidence of an existing anterior cruciate ligament (ACL) tear, and a negative Lachman test is fairly good evidence against that injury.
Occasionally, theyll have been misdiagnosed with a knee sprain when the issue is far more serious. Unfortunately, ACL injuries are rather good at disguising their true nature, and that can present real problems.
ACL tears are also often misdiagnosed as collateral ligament knee strains. With that being said, when a trained musculoskeletal radiologist is reading the case, an ACL tear or other abnormality is rarely missed. This is why a radiologist with subspecialty training is recommended to look at your MRI.
In our study, 159 cases of ACL tear were detected on MRI. Out of these 154 cases were confirmed on arthroscopy (true positive), and 5 cases were found to be false positive. Out of the 51 cases which had no ACL tear on MRI, 47 were confirmed on arthroscopy (true negative), and 4 cases were found to be false negative.
Contrary, accuracy of MRI for knee articular cartilage lesions is more controversial with several reports showing sensitivity as low as 15% and as high as 60% depending on the depth of the lesion [13,14,15]. Only few studies were designed to identify factors associated with false negative MRI.
Conclusions: MRI appearance of ACL healing after ACL rupture occurred in one in three adults randomised to initial rehabilitation and one in two who did not cross-over to delayed ACLR and was associated with favourable outcomes.

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