ACL Tear — NPTE Cheat Sheet

  • What it is:
  • ACL failure from excessive anterior tibial translation — basically the tibia tries to run off and the ACL can’t hold the line.
  • Classic signs:
  • Pop
  • Immediate swelling (1–2 hours)
  • Pivot / cutting mechanism
  • Instability
  • Difficulty weight-bearing
  • Rule-in test:
  • Lachman test — NPTE’s #1.
  • Rule-out clues:
  • Slow swelling → Meniscus
  • Posterior sag → PCL
  • Medial pain → MCL
  • NPTE trap:
  • Delayed swelling means NOT ACL.
  • Best treatment:
  • Early ROM, quads, swelling control, gait normalized.
  • Mock question included: Yes — test yourself before you move on.

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