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The simultaneous ACL and patellar tendon during a skiing accident, is a rare lesion. The initial diagnosis is often difficult and there is no consensus on treatment. We present 2 patients who experienced ACL injuries, patellar tendon and meniscus following a skiing accident
The first case was a 43-year-old suffered a skiing accident with injury in his right knee. The diagnosis was initially posed a serious knee sprain with isolated ACL tear. The initial treatment was orthopedic. In the absence of clinical improvement, the patient took a second opinion. Clinical examination was difficult with a knee inexaminable, widespread pain and a large hematoma. MRI (done at 28 days) showed a complete rupture of LCAE, a laceration of the patellar tendon, peripheral avulsion internal and external meniscus. The patient was operated on urgently: repair and suturing of the patellar tendon, exploration knee arthroscopy, excision of ACL fibers and bi-meniscal suturing. After rehabilitation and consolidation, a second procedure was performed 8 months later with type hamstring ligament. The postoperative protocol and rehabilitation were the same as for an isolated LCAE. A 3 year follow-up, the patient has recovered a normal knee.
The second case was almost identical after a skiing accident in a woman of 24 years. The initial diagnosis was also an isolated lesion LCAE. The MRI done at 10 days showed a lesion LCAE associated with a laceration of the patella tendon, a double meniscal tear and damage LLI. The treatment took place in 2 stages with repair of the patellar tendon and suture the two menisci in emergency then type hamstring ligament in 6 months. At last follow 2 years she has a good functional outcome.
The simultaneous rupture of the patellar tendon and LCAE is very rare and poorly known. There are very few cases in the published literature. The initial diagnosis is often not made and requires urgent MRI. The operating program should be in two stages to prevent fibrosis and postoperative stiffness after complex knee surgery. In these 2 patients supported their have given satisfactory results.
Partial ACL tear
Isolated ruptures of the anterior cruciate ligament (ACL) injuries are the most frequent ligament of the knee. These breaks may be complete or partial. In partial tears, clinical diagnosis is more difficult because the clinical presentation is variable. The diagnosis, evolution in time and treatment its partial tears are still subject to much controversy. The purpose of this article is to clarify the definitions, clinical diagnosis and therapeutic strategies to these partial ACL tears. (read more ...)
Women have four to eight times more likely than men to have a ruptured anterior cruciate ligament (ACL). This risk seems more important during the pre-ovulatory phase of the menstrual cycle than during the post-ovulatory phase. The main objective of the study was to describe the distribution of ACL injuries during the menstrual cycle in a large recreational skiers population.
The main goal of this study Was to compare the results of the GNRB arthrometer To Those of Telos TM in the diagnosis of partial thickness tears of the anterior cru- ciate ligament (ACL). A prospective study Performed January- December 2011 included all patients presenting with a partial or full-thickness tears ACL without ACL recon- struction and with a healthy contralateral knee. Anterior laxity Was Measured in all patients by the Telos TM and GNRB├ĺ devices.
It is necessary to distinguish:
- The fracture lesions which are always found with certainty notion traumatic (new or old)
- Chronic lesions with onset of osteonecrosis subchondral more or less extensive, described in the literature under different terminologies (osteochondrosis, osteochondritis, osteonecrosis).
This distinction seems to us essential because etiology, radiographic appearance, treatment and prognosis of such lesions are sometimes totally different.