ACL Online Therapy for natural healing
The case reports of ACL natural healing
Patient Information:
Age: 13 years
Gender: Female
Nationality: Japanese
Mechanism of Injury:
Date of Injury: June 10, 2023
Details: Twisted the left knee during a practice basketball game.
Progress after injury:
MRI Date: June 12, 2023
Diagnosis: Complete rupture of the left anterior cruciate ligament (ACL) with curved ends (Ihara Classification II).
Despite fresh trauma being confirmed by imaging, the patient had felt the knee dislocate several times over the past two years, but these symptoms quickly resolved each time. No joint fluid was aspirated during the examination. Post-injury, there were no knee collapses. Without undergoing hospital rehabilitation, the patient started our natural therapy on June 24, 2023, continuing for four months. A follow-up MRI was performed on October 25, 2023.
Results:
The second MRI showed no signs of natural healing of the ruptured ACL.
Discussion:
In this case, natural healing was not observed, and there was minimal deformity or adhesion to other structures like the posterior cruciate ligament. Despite having a tear pattern that typically allows for natural healing, the exact reasons for the failure remain unclear. Two potential reasons are:
1. Research indicates that younger females have a lower success rate of natural ligament healing compared to adults or males of the same age.
2. The issue of commuting to school. Although advised to avoid long-distance walking or cycling, family circumstances sometimes prevented this. Thus, the patient was not always able to avoid these activities.
Future improvements in treatment methods and living environments are necessary to enhance healing rates in younger patients.
References:
- Ihara H, Miwa M, Deya K, Torisu K. MRI of anterior cruciate ligament healing. J Comput Assist Tomogr. 1996 Mar-Apr;20(2):317-21. doi
- Ihara H, Kawano T. Influence of Age on Healing Capacity of Acute Tears of the Anterior Cruciate Ligament Based on Magnetic Resonance Imaging Assessment. J Comput Assist Tomogr. 2017 Mar/Apr;41(2):206-211. doi
- Pitsillides A, Stasinopoulos D, Giannakou K. Healing potential of the anterior cruciate ligament in terms of fiber continuity after a complete rupture: A systematic review. J Bodyw Mov Ther. 2021 Oct;28:246-254. doi
- Filbay, Stephanie R et al. “Healing of acute anterior cruciate ligament rupture on MRI and outcomes following non-surgical management with the Cross Bracing Protocol.” British journal of sports medicine, bjsports-202