The document discusses injuries and treatments to the ACL, PCL, and MCL ligaments in the knee. It describes the anatomy of the knee and mechanisms of injury for each ligament, including being hit on the side of the knee or twisting motions. Treatment options are outlined depending on the severity of each ligament tear, ranging from RICE therapy for mild injuries to surgery and bracing for complete tears. The rehabilitation process after ACL surgery is also summarized, focusing on regaining strength and mobility over several months.

1. Injuries and Treatments to the ACL, PCL, and MCL Sulema S. Suarez BIO141-0903A-16 Phase 3 Individual Project 7/23/2009

2. Anatomy of the Knee Femur Patella Distal femoral condyle Tibial collateral ligament Anterior cruciate ligament Medial meniscus Fibular collateral ligament Lateral meniscus Posterior cruciate ligament Tibia Fibula

3. Posterior Cruciate Ligament Mechanism of injury Can tear if shinbone is hit just below the knee Most common is auto accidents and contact sports Bending or extending knee past normal position Getting hit on side of knee while leg is twisted Other structures of the knee are usually damaged with the PCL (Mayo Clinic, 2009)

4. Treatments for PCL Mild to moderate P.R.I.C.E. Protection, rest, ice, compression, and elevation Physical therapy Moderate to severe Joint aspiration Removes fluid from joint using a syringe Surgery If severe, and is accompanied with damage to other structures, joint may need to be reconstructed (Mayo Clinic, 2009)

5. Medial Cruciate Ligament Mechanism of injury Can be injured when struck on the outside of the knee joint Stretches the ligament and can cause injuries on different scales Grade I MCL Tear Incomplete tear Grade II MCL Tear Larger tear but still considered incomplete tear Grade III MCL Tear Complete tear

6. Treatment for MCL Injuries Treatment Grade I MCL Tear Rest and icing the injury Anti-inflammatory medications 1-2 weeks recovery time Grade II MCL Tear Hinged knee brace 3-4 weeks recovery time Grade III MCL Tear Knee immobilizer Crutches Knee brace (after knee is able to bend) Regain strength in quadriceps 3-4 months recovery time Surgery is generally not preferred for MCL injuries (Cluett, M.D., Jonathan, 2008)

7. ACL Injuries Mechanism of injury Ligament tears when you slow down suddenly, cut, or pivot while foot is firmly planted Causes twisting and overextending of the knee (Mayo Clinic, 2009)

8. Surgery for ACL Surgery is performed at least one month after injury Can be preformed as same day surgery Surgery lasts one and a half to two hours Regional or general anesthesia may be used ACL must be completely removed and replaced with a segment of a larger ligament Patellar ligament Hamstring tendons Allograft (donor tissue) About one third of the ligament is used to secure the femur to the tibia (Cluett, M.D., Jonathan, 2008)

9. Rehabilitation after surgery Will need to use crutches and a knee brace for one to three weeks A CPM (continuous passive motion)machine may be used in the days following surgery Swelling should be controlled Joint should be flexed Muscles around the knee should be strengthened to improve stability of the joint Normal activities can be resumed after tow to four months High demand activities can be resumed after six to seven months (Cluett, M.D., Jonathan, 2008)

10. References Cluett, M.D., Jonathan. January 1, 2008. Anterior cruciate ligament surgery. Retrieved July 23, 2009, from: http://orthopedics.about.com/cs/aclrepain/a/acl_3.htm Mayo Clinic. Copyright 1998-2009. Knee Pain. Retrieved July 24, 2009 from: http://www.mayoclinic.com/health/knee-pain/ds00555/dsection=symptoms Touch of Life Technologies. Copyright 2009. VH Dissector. Retrieved July 24, 2009