What Every Clinician Should Know About ACL Injury and Treatment
Presented by Terry Malone
Nonfinancial: Terry Malone has no competing nonfinancial interests or relationships with regard to the content presented in this course.
This course is a look at the last 50 years of ACL injury management. The course describes the challenges of identifying an optimal approach to management, which has evolved based on both clinical and basic science. This evolution involved numerous attempts at replicating the function of a native ACL and how to best rehabilitate the individual postoperatively. In the US today, individuals with noncontact ACL injuries are typically treated with a reconstruction with a strong graft that is properly positioned and fixated to enable early ROM and an active rehabilitative approach. Interestingly, the attempted early return to sport has become muted as registries have recognized that return before nine months is not ideal. This course provides the context of how we got to where we are and where we might be going.
Meet your instructor
Terry Malone
Dr. Terry Malone received his EdD and MSPT from Duke University in North Carolina and his BA from Bluffton College in Ohio. At Duke, he served as the initial sports physical therapist and was the coordinator of the Sports Medicine Clinic. He served as the initial chairperson of the Sports Specialization Council of the APTA…
Chapters & learning objectives
1. How and Why the ACL Gets Injured and Historical Development
The history of ACL injury is quite interesting, with numerous authors showing us that the ACL gets injured near extension and typically in a noncontact format. Younger patients who are very flexible are at greatest risk, and surgery is not a panacea.
2. ACL Surgery: Choices and Implications to Rehabilitation
Surgical management evolved with the introduction of antibiotics and the recognition of nonoperative management being unsuccessful for many (especially athletes wishing to return to cutting sports). Surgery has evolved from repairs to reconstructions using a strong graft that is properly positioned to better replicate native ACL function.
3. Rehabilitation and Outcomes
Evidence-based medicine has provided us with a pathway forward for guiding our rehabilitation following ACL reconstruction. The protocols have become graft-specific and ideally include a prevention program emphasis regarding return to play. Interestingly, most clinicians are accepting a nine-month schedule for return to play.
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