Degenerative Healing of an ACL Tear – Case 9

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

30 years old, male, Hong Kong resident

Injury Mechanism:

On August 20, 2023, during a soccer match, while dodging an opponent’s tackle while dribbling, he twisted his left knee. At that moment, he heard a tearing sound.

Post-Injury Course:

The next day, he visited a family doctor and it was determined that an MRI was necessary. He underwent an MRI on September 12, receiving the following diagnosis:

ACL complete Tear (proximal tear with retraction of the ends (Ihara classification III)
Grade I MCL injury
Grade I LCL injury

After the MRI, he continued functional recovery training instructed by a physical therapist for eight days. The prescribed exercises included an exercise bike, knee extension exercises, and squats. From September 23, he began the online therapy online with Jun Matsumoto. On December 27, he had his second MRI scan.

Based on the MRI images, the torn ends had adhered to the PCL. On December 28, he had an in-person consultation in Hong Kong where both the Lachman test and pivot shift test were both negative. Subsequent MRIs were performed on February 2 and April 27 of the following year.

According to the radiologist’s opinion on the MRI from April 27, the torn ACL displayed a loose and weakened structure with ligament fiber reconstruction. On May 4, the patient resumed playing soccer but heard a painless tearing sound when he slipped during play.

Discussion:

The outcome of this case was deformity healing with adhesion to the PCL. Two possible causes for the deformity healing are proposed. One is that not only were the torn ends separated, but they were also unclear. The other is that rehabilitation for surgery had already been implemented before starting the natural healing therapy. Exercises involving full knee extension are considered to hinder natural healing. In the future, we plan to compare the healing results between groups that performed full knee extension exercises and those that did not.

References:

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