Patient Information and Mechanism of Injury
39 years old, male, Japanese, Occupation: Military officer
On December 2, 2021, he twisted his left knee during a martial arts practice. He had an MRI scan two weeks later and he was diagnosed as follows:
Left knee anterior cruciate ligament tear
medial meniscus tear
As for the patient’s symptoms, there is discomfort in walking due to limited range of motion. It hurts in complete flexion and twisting his knee. When he moves vigorously, his knee becomes giving way.
From December 20, 2021, he started the online therapy for the natural healing of the ACL tear with Jun Matsumoto. He continued doing the Evo-Devo Exercises for five months, and he took the next MRI on May 9, 2022.
Both the tibial and femoral stumps of the torn anterior cruciate ligament appear to be fused with the posterior cruciate ligament. In this case, the anterior cruciate ligament stumps did not fuse together, but the knee regained stability through the fusion with the posterior cruciate ligament. In the medial meniscus, damage to the inner edge only spread to the outer edge and reached the red zone with high blood flow, so natural healing can be expected in the future.
Future prospects and considerations
The patient was interviewed online approximately 8 months after injury. He resumed his sports activities, and his subjective evaluation showed that he had recovered to about 90% of the pre-injury level. In this case, the ruptured anterior cruciate ligament did not normally heal spontaneously and was healed by fusion with the posterior cruciate ligament. Instability of the knee does not remain and achieves sufficient functional recovery.
The reason why normal natural healing did not occur this time is still unclear, but I would like to describe the points that caught my attention. One was that he experienced several knee collapses after performing vigorous exercise several times immediately after the injury. Second, about two months after the start of treatment, he once felt some severe pain when going up and down stairs. In the future, when there is a case of degenerative healing, we will leave such points of concern as data as comparison material.
Crain EH, Fithian DC, Paxton EW, Luetzow WF. Variation in anterior cruciate ligament scar pattern: does the scar pattern affect anterior laxity in anterior cruciate ligament-deficient knees? Arthroscopy. 2005 Jan;21(1):19-24. doi: 10.1016