Lechman's test is most commonly used by trainers and examiners because it does not force the knee into the painful 90-degree position but tests it at a more comfortable 20 to 30 degrees. Another reason for its popularity is that it reduces the contraction of the hamstring muscles.When an athlete has injured his/her ACL the initial treatment involves splinting the knee, ice treatment to help reduce swelling, elevation of the joint (just above the heart) and administration of anti-inflammatory drugs. The athlete also needs to limit physical activity. A non-athletic person can live with the injury using rehabilitation and bracing. When the Anterior Cruciate Ligament is torn the guide wire of the knee is gone, creating instability. Without the stabilizing actions of the ligament, there is increased wear on the top of the tibia, meniscal cartliges tear and the articular cartilage erodes. The erosion will result in degenerative arthritis with grinding and pain when climbing stairs, running, or jumping. But for the active athletic person reconstructive ACL surgery is the only solution.Repair of the ACL by surgery can be done by open or arthroscopic techniques. Recent advances in surgical techniques have made ACL much more predictable and lees traumatic to the athlete. Techniques in arthroscopic surgery now allow surgeons to reconstruct the ligament through smaller incisions and several smaller "stab wounds" leaving less scarring. Techniques involve using the athlete's torn ligament strands and incorporating them into a primary repair of the ligament usually backed up by a portion of the athlete's patellar tendon. The patellar middle one-third is used with a block of bone from the patella and from the tibia. The graft is then passed through two tunnels drilled into the tibia and then the femur. The bony portions of the graft are anchored using specially designed screws, giving a solid fix to the graft. The graft recreates the ACL and allows e...
