SPORTS INJURY I Dr.RAJAT JANGIR JAIPUR
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To Know more about ACL Injury, Click the links below:
1. ACL surgery 7 different Techniques we do at our center - "Not single technique best for all"
https://youtu.be/oWkIr8IXvr8
2. Everything about ACL Injury tear surgery in Hindi I
https://youtu.be/bqpjkAkwZ14
3. Best Screw for ACL tear surgery in Hindi
https://youtu.be/1LGpU1NHiIs
4. ACL Injury Tear Surgery Recovery : All your questions & queries solved by Dr.Rajat Jangir
https://youtu.be/SIAPWiMbOqs
5. Partial ACL Tear Surgery or not ! ACL आधा टूटा हो तो क्या करें ?
https://youtu.be/NEJRPKskJTI
6. 5 Symptoms of ACL Injury tear इंजरी के पांच लक्षण ?
https://youtu.be/EXpgy19Jxzw
7. PRP injection therapy in Partial ACL TEARs
https://youtu.be/qyG1EYgS87E
Dr.RAJAT JANGIR(Asso Prof.)
Senior Consultant Arthroscopy and Joint Replacement
(Specialist in Shoulder Knee Hip Surgery)
Ligament and Joints Clinic
67/34 Mansarovar Jaipur
Whatsapp: shorturl.at/gnAEP
Appointment: +91 8104855900
Email: ligamentsurgeon@gmail.com
Google Page: https://g.page/KNEE-Shoulder-SURGERY?...
Facebook: https://www.facebook.com/Ligamentandj...
* Vast experience and specialisation in the field of Arthroscopy and sports surgery.
* M.S. orthopaedics from BJ Medical College, Civil hospital, Ahmedabad
* Fellowship in Arthroscopy and Sports injury with Prof Joon Ho Wang at Samsung Medical Center, South Korea
* Diploma in Sports Medicine from InternationaI Olympic Committee
* Invited as Athlete Medical Doctor at Rio Olympic 2016
* Done Rajasthan's first "All Inside Physeal Preserving ACL reconstruction" in 13 year old Athlete
Dr.Rajat is rated as one of the best orthopedic surgeon with with excellence in Knee Shoulder Arthroscopy surgeries as replacements'
13. Pathophysiology
Repetitive microtrauma
in a relatively
hypovascular area.
Reparative process
unable to keep up
May be on the
background of a
degenerative tendon
14. Antecedent tendinitis/tendinosis in 15%
75% of sports-related ruptures happen
in patients between 30-40 years of
age.
Most ruptures occur in watershed area
4cm proximal to the calcaneal
insertion.
15.
16. History
Feels like being kicked in the leg
Case reports of fluoroquinolone use,
steroid injections
19. Prone patient with feet over edge of
bed
Palpation of entire length of muscle-
tendon unit during active and
passive ROM
Compare tendon width to other side
Note tenderness, crepitation,
warmth, swelling, nodularity,
palpable defects
24. Diagnostic Pitfalls
23% missed by Primary Physician (Inglis
& Sculco)
Tendon defect can be masked by hematoma
Plantar-flexion power of extrinsic foot flexors
retained
Thompson test can produce a false-negative
if accessory ankle flexors also squeezed
25. This lateral x-ray of the
calcaneus shows an
avulsion fracture at the
insertion of the Achilles
tendon, with marked
separation of fragments.
.
26. Inexpensive, fast, reproducable,
dynamic examination possible
Operator dependent
Best to measure thickness and gap
Good screening test for complete
rupture
27. Expensive, not dynamic
Better at detecting partial
ruptures and staging
degenerative changes,
(monitor healing)
29. cast with
plantarflexion q 2 wks2 wks
Allow progressive weight-
bearing in removable cast
Remove cast and walk with shoe
lift. Start with 2cm x 1 month,
then 1cm x1 month then D/C
4 weeks
Start physio for ROM
exercises
When WBAT and
foot is plantigrade
Start a strengthening
program
2- 4 weeks
30. Preserve anterior paratenon blood
supply
Beware of sural nerve
Debride and approximate tendon ends
Use 2-4 stranded locked suture
technique
May augment with absorbable suture
Close paratenon separately
31.
32. Acute case : usually end
to end repair is enough
Neglected case:
Advancement plasy (V-Y)
or reconstruction by
other tendons
33.
34.
35.
36. Assess strength of repair, tension and
ROM intra-op.
Apply long leg cast with ankle in the least
amount of planterflexion(gravity equinus)
& knee 60 degree flexion with window at
operated site.
Stitch removal after 2 wks.
Short leg cast after 3 wks with partial
equinus correction
37. 2 weekly plaster change with gradual equinus correction (4-6
episode ).
Walking with heel raised shoe & regular physiotherapy.
Reverse ankle stop brace up to 6 months.