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A 17-year-old female soccer player presents to clinic three days after a non-contact knee injury. She has a moderate effusion and protective hamstring guarding on examination. You wish to test ACL integrity. Which of the following physical examination tests is most sensitive for detecting an ACL tear in this awake, acutely injured patient?
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Prepare for the OR and rounds with anatomy, classifications, and surgical approaches.
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Revisit core orthopaedics across all 12 domains, from anatomy to treatment principles.
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Disruption of the anterior cruciate ligament — the primary restraint to anterior tibial translation and a secondary restraint to internal rotation and varus/valgus at the knee.
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Review indications, positioning, dissection, and structures at risk across 93 surgical approaches.
The deltopectoral approach is the workhorse anterior exposure of the glenohumeral joint and proximal humerus. It exploits the internervous interval between the deltoid and pectoralis major, using the cephalic vein as the surface marker. It is extensile, can be combined with osteotomy/release of structures distally, and provides access to the anterior glenoid, humeral head, lesser/greater tuberosities, and proximal humeral shaft.
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Here's the one idea that anchors everything about this ligament. The anterior cruciate ligament, the A-C-L, is the primary restraint to anterior tibial translation. Think of it as the leash that stops your shinbone from sliding forward out from under your thigh bone. It also does secondary work, resisting internal rotation and side-to-side varus and valgus stress at the knee.
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