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Anterior Cruciate Ligament Injuries

Anatomy of ACL

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What is the blood supply of the ACL?

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What are the 2 bundles and their function?

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Where do the 2 bundles attach to on the femur and tibia?

ACL injuries

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What are the gender risk factors of an ACL tear?

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What is the usual mechanism of an ACL injury?

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Which meniscus is more commonly torn with an acute ACL injury?

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Which meniscus is more prone to injury in a chronic ACL-deficient knee? Why?

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What is the O'Donoghue unhappy triad? Is it still applicable?

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What is the natural history of a patient with an ACL tear? Do all patients need surgery?

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What are the special associated X-ray findings?

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What is the MRI pattern of bone bruising?

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What are the chances of returning to sport after ACL reconstruction?

CONSERVATIVE MANAGEMENT OF ACL

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Does ACL reconstruction reduce the rates of secondary osteoarthritis?

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What evidence supports non-operative management of ACL injuries?

CONSIDERATIONS for RECONSTRUCTION

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What is the ideal timing for an ACL reconstruction?

Graft Choice Question

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Young ACL. Would you use an allograft or autograft?

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What if patient still wants an allograft for the advantage of no donor site morbidity?

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Any difference among the various autografts in terms of Basic Science properties?

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Any difference among the various autografts in terms of Outcomes?

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Any difference among the various autografts in terms of Retear Rates?

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What is the contemporary popularity of grafts?

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What is your choice?

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What is an ideal graft size?

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What technique will you use?

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What is the evidence comparing transtibial vs transportal ACL reconstruction techniques?

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What is the evidence between single bundle vs double bundle reconstruction?

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What options of ACL graft fixation are you aware of?

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What is the basic science involved in ACL graft preparation?

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What will you do if your assistant drops the ACL graft while preparing it?

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What augmentation techniques are you familiar with?

Postoperative Considerations

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Describe the stages of graft incorporation:

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How does bone block in BPTB graft integrate?

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What is your post-operative rehabilitation protocol?

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What are the outcomes of ACL reconstruction?

Complications of ACL Reconstruction

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What are common complications of ACL reconstruction?

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Patient had ACL reconstruction and now knee is stiff. How will you approach?

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What happens to ACL reconstruction if you don't repair the meniscus?

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What are the consequences of incorrect tunnel positioning?

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For the Lord gives wisdom; from his mouth come knowledge and understanding. Proverbs 2:6