By vgreene, 9 January, 2015 Post-op: No post-op brace if isolated ACL [M]. Prevent future ACL tear via NM training<sup>17</sup> [M], not brace [L]. Initiate post-op PT<sup>18</sup> [M]. Return to play based on clinical judgment, not time/fxn criteria [L].
By vgreene, 9 January, 2015 If repairing ACL, also fix associated meniscal tear [L], esp. if locked knee [C], but not incomplete MCL tear [L]
By vgreene, 9 January, 2015 Possible initial operative mgmt, esp. if Δ laxity of IL vs CL knee<sup>15</sup> >5-7mm. Techniques: tibial-independent/transtibial approach [M], single/double bundle [S], autografts or allografts<sup>16</sup> OK [S]
By vgreene, 9 January, 2015 Initial conservative mgmt, esp. if Δ laxity of IL vs CL knee<sup>15</sup> <5-7 mm (if <50 h/yr of jumping/cutting sports) or <5 mm (if 50-199 h/yr) w/ delayed repair if recurrent instability [L], goal <5 mo postinjury [M]
By vgreene, 9 January, 2015 Image: AP/lateral XR knee 1st to r/o fx/dislocation [C], then MRI if needed to r/o internal knee pathology [S]
By vgreene, 9 January, 2015 Exam: neurovasc (esp. tibial/peroneal n.),<sup>13</sup> joint line tenderness, step-off/deformity, effusion, varus/valgus laxity @ 0° and 30° extension, AP/rotational laxity, Lachman test<sup>14</sup>
By vgreene, 9 January, 2015 Hx: injury mechanism, popping/locking/catching, swelling, ability to weight-bear/return to play.