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Degenerative Healing of an ACL Tear – Case 5

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

52 years old, Japanese, female

Mechanism of injury:

On November 3, 2022, during a beach ball volleyball game, when she landed on his left foot after an attack, her ipsilateral left knee twisted and she collapsed.

Progress after injury:

After her injury, she received treatment including electrical therapy at another orthopedic clinic. She visited an orthopedic surgeon on November 21st, and X-rays were taken, but no fractures were found. At this time, she had her synovial fluid removed with an arthrocentesis. She had an MRI scan on November 26th, and she received the following diagnosis.

anterior cruciate ligament tear
The torn limb is unclear (Ihara classification IV)

Treatment plan:

She started online treatment with Jun Matsumoto on December 3rd and continued her Evo-Devo Exercise therapy three times daily at her home. She had a second MRI scan 4 months after starting treatment. She still did not wear her functional brace on a daily basis.

Follo-up and Outcomes

Her MRI images showed no clear connection between the stumps of her torn ACL. Her distal ACL stump was connected with the PCL. At this time, her doctor’s evaluation of the Lachman test was negative.

She then performed range of motion exercises and strength training, and her condition recovered to a level where she had no problems in her daily life. She gradually returned to playing beach ball in July of the same year. When she played, she twisted excessively to her left and felt instability in her knee, so she played with tape and a brace on.

On July 30th, while she was playing beach ball, she twisted her left knee again. Her knee was swollen for several days, so she was kept on bed rest.

On October 9th, Jun Matsumoto met with the patient and performed a manual examination. He had a pivot shift test (±) and a Lackman test (-).

On December 9th, her third MRI was performed. Her third MRI image showed no major changes compared to the second, suggesting that its morphology remained fixed as the degenerative healing.

Consideration:

In this case, the patient had been treated and supported for about a year, but the expected results were not obtained. I hypothesized that there were three causes that led to this deformity healing. The first is the removal of blood and edema by arthrocentesis. Second, she did not wear a functional orthosis on a daily basis. Third, the rupture pattern of the ACL was unclear, making it difficult for it to heal naturally. After this case, the later patients were instructed to wear a functional orthosis.

References:

Degenerative Healing of an ACL Tear – Case 4

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

33 year old, male, Malaysian

On July 21st, 2022, he was playing badminton. When he put his right foot forward to pick up the shuttlecock that was falling in front of him, he fell to his right side. He went to the hospital but was not referred for an MRI immediately. No joint fluid was extracted through knee arthrocentesis. He underwent acupuncture several times and participated in two weeks of physiotherapy, including knee extension. On September 8, he was scanned for the MRI and diagnosed as:

a complete ACL tear
(ruptured at the proximal part, classified as type I, in which the torn ends are facing each other)
MCL sprain
Lateral meniscus tear

Starting September 17, 2022, he engaged in Evo-Devo Exercises with Jun Matsumoto, continuing for three months without wearing a functional knee brace restricting the range of motion. On May 9, 2023, he was scanned for the second MRI.

MRI evaluation:

The torn ACL had degenerated and no clear continuity could be confirmed.

Consideration and reflection:

Even though the type of the ACL tear is easier to heal naturally, the expected healing failed. There are three possible causes. The first was that he did not wear a functional brace. Second, treatment started two months after the injury, which was relatively late. Third, before starting treatment, physical therapy with full knee extension was performed. Based on this failure, future treatment plans will likely be reconsidered.

References:

Natural Healing of an ACL tear – Healed but chose surgery – Case 31

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

  • Nationality: Russian
  • Gender: Male
  • Age: 16 years

Incident Description:

On April 4, 2022, the patient was playing football when he experienced a twisting and collapsing incident involving his right knee. An MRI was performed on the same day.

Diagnosis:

  • Primary Diagnosis: Complete tear of the Anterior Cruciate Ligament (ACL), specifically in the middle part, classified as Type 2.
  • Secondary Observations:
    • The meniscus showed no signs of damage.
    • A slight damage was noted in the Posterior Cruciate Ligament (PCL).

Treatment:

The patient commenced online sessions with Jun Matsumoto on May 10, 2022. The treatment plan involved a specific set of exercises known as “Evo-Devo Exercises.” During this therapy, the patient was instructed not to engage in any other forms of exercise. Additionally, he did not use a knee brace during the course of his treatment. After three months of the treatment, he took the next MRI.

MRI evaluation:

In the patient’s subsequent MRI, the healing of the ACL fibers did not progress as anticipated. The fibers appeared thin, and the condition was classified as Grade III. (Ihara’s ACL healing classification) During the Lachman test, the knee’s instability was rated as 2 out of 3. However, there was a positive note in that the quadriceps muscle showed signs of recovery. Given these mixed results, it was decided to continue with the conservative therapy approach.

Accident:

On November 8, 2022, despite his father’s advice against it, the patient began playing basketball. Approximately 15 minutes into the game, he suddenly heard a clicking sound in his knee, followed by severe pain, which led him to stop playing immediately. Subsequently, his knee became swollen. An MRI taken on November 27 showed that there was no complete tear of the ACL, and no significant changes were observed from the previous MRI results.

ACLR surgery:

Given the patient’s young age, the remaining instability in the knee, and the fear of reinjury, the decision was ultimately made to proceed with ACL reconstruction surgery. This choice was influenced by the need for a more stable and definitive solution to ensure the patient’s long-term knee health and functionality.

Consideration and reflection:

The approach of not using a knee brace during treatment raises questions about its impact on the healing process. Additionally, the patient’s early return to playing basketball, which resulted in the accident, suggests the need for a more cautious approach to resuming sports activities post-injury. These aspects highlight the necessity for further study and evaluation of treatment protocols.

References:

Quick Natural Healing of an ACL partial tear – Healed Case 30

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

Japanese, female, 40 years old
On Nov.12th, 2022, she did a jumping kick during kickboxing practice and twisted when she landed on her left foot. She continued her practice for about an hour right after that. She felt her knees give way.

On Nov.21st, she took the first MRI, but the old MRI didn’t show the good resolution for diagnosis. On Dec.6th, she took the second MRI, and it indicates:

Partial tear of ACL

She didn’t feel any problem in having the normal daily activities. She didn’t feel giving way on the knee. However, the injured knee was a bit loose through the anterior drawer test. Therefore, she stopped not only practicing kickboxing but also stopped any other form of exercise. Not only that, but she stopped fully extending her knees.

Starting Dec. 7th, she initiated online therapy with Jun Matsumoto and continued Evo-Devo Exercises for five weeks. On Jan. 16th, 2023, the third MRI scan was performed.

MRI indicates:

The fibers, which had become sagging due to partial rupture, regained their tautness and straightness.

Future Prospects and Considerations:

Despite only five weeks of treatment, her injured anterior cruciate ligament achieved spontaneous healing. The reason was that the anterior cruciate ligament was partially torn, not completely torn. Another reason may be that the injured ligaments were not separated from each other. With proper treatment, patients with partial anterior cruciate ligament rupture are likely to be able to return to normal daily activities or return to sport earlier than cases with complete rupture.

References:

Natural Healing of an ACL tear – Healed Case 29

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient Information:

Japanese female, 41 years old. On July 5th, 2022, she experienced a sensation of her right knee dislocating while exerting force on her right leg during a basketball game, rendering her immobile. Although she was able to walk later, she visited a hospital two days after the incident. No joint fluid was aspirated during the examination. An MRI scan was performed on July 12th, revealing the following diagnosis:

Complete right Anterior Cruciate Ligament (ACL) tear (proximal 1/3)
No meniscal damage.

According to the Ihara’s ACL tear classification of ACL injuries, it was classified as a type 2, which is the torn and disrupted type. After the injury, no giving way of the knee was reported. She did not undergo any physiotherapy involving knee extension post-injury. She had a history of a left Achilles tendon rupture surgery 13 years prior.

Starting July 28th, she initiated online therapy with Jun Matsumoto and continued Evo-Devo Exercises for five months. On December 12th, 2022, a second MRI scan was performed.

MRI indicates:

The evaluation of the MRI images indicated that the ruptured anterior cruciate ligament had restored continuity and healed naturally. According to Ihara’s ACL healing classification, it was classified as grade 3, which is thinned healed fiber.

Future Prospects and Considerations:

Having confirmed natural healing through MRI, she initiated full knee extension training and strength training. By the six-month mark post-injury, she had recovered to a level where she faced no issues in daily life. She is currently undergoing further rehabilitation with the aim of returning to recreational-level sports.

References:

ACL Healing without surgery – Healed Case 28

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

37 years old, Female, Kazakh living in the U.S.
On February 26th, 2022, he twisted her left knee during skiing. She went through the MRI scan, and the diagnosis was:

Complete ACL tear

According to the Ihara’s classification, this type of ACL tear is classified as disrupted or unclear type. And, this type has been reported as the most difficult type to heal spontaneously.

After the injury, she had been doing some rehabilitation exercises such as strengthening the muscles and 10 min stationary bike under the supervision by a physiotherapist.

On April 29th, she started the Evo-Devo Exercises through the online sessions with Jun Matsumoto, and continued the sessions only for two months. During these months, she stopped doing any strength trainning and focused on the Evo-Devo EXercises. After doing two momths, she started strength training again.

On November 18th, she took the second MRI as poseted below.

MRI indicates:

The MRI shows the clear continuity of the ACL. This healing type can be classified as grade I of the Ihara’s classification, and it is the taut and straight band type of healing.

Future prospects and considerations:

Even though this type of ACL tear has been reported as the most difficult type to heal spontaneously, it has heald upto the best type of healing.

References:

ACL Healing without surgery – Healed Case 27

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

25 years old, Male, Indian
On April 13th,2022, he twisted this right knee during playing soccer. On April 15th, he went through the MRI scan, and the diagnosis was:

complete ACL tear
tear of the anterior root of the lateral meniscus
mild grade1 tear of the body of the medial meniscus
sprain of the mecial and lateral collateral ligaments

complete ACL tear
medial meniscus tear
anterior root tear of the lateral meniscus

On May 24, he started the Evo-Devo Exercises through the online session with Jun Matsumoto. He had four online sessions in a month, and after that he continued the Evo-Devo EX by himself for three months. On October 2nd, he took the second MRI.

healing into the taut and striaight band
medial meniscus tear remains
anterior root of lateral meniscus remains

MRI indicates:

It can be seen that the completely torn ACL grows into the taut and straight band. And, this morphological type of healing is classified as the type 1 by Ihara’s classification. Although the ACL has been healing into the best morphology, the meniscus tears still remain and have even deteriorated further.

Future prospects and considerations:

Regarding to horizontal tear of meniscus, it could be asymptomatic in many cases. However, it is, of course, better to be healed than not to be healed. There is a need to improve existing treatments to make it heal the unhealed meniscus tears.

References:

Natural Healing of ACL tear 26 – Degenerative healing – case 3

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ACL Online Therapy for natural healing

The case reports of ACL natural healing

Patient information:

55 years old, female, Japanese
On March 7th, 2022, she fell in the snow while skiing. And, then her right ski stuck in the snow, and her body was pushed forward. She was immedeately taken to the hospital and scanned for x-ray, but there was no fracture. At that time, the blood and the fluid in the right knee were extracted by the doctor. One week later, she was scanned for MRI, and the diagnosis was:

Complete ACL tear
No other ligament tear
Bone contusion on posterior tibia

On April 18, she started the Evo-Devo Exercises through the online session with Jun Matsumoto. Since the injury, she did not experienced knee giving way. She continued the Evo-Devo EX. for four months, and she took the second MRI.

The second MRI did not show the clear natural healing of the torn ACL even though she did not feel the instability of the knee any more. She continued the exercises and took the third MRI at the different hospital to have more various pictures.

MRI indicates:

The MRI above doesn’t show the clear continuity of the ACL, however, the middle one shows the clear continuity. It is not the clear and beautiful natural healing, but it is sure that the torn ACL acquired the continuity to stabilize the knee. The MRI below is the one of the coronal slices taken on the same day 2022/11/11. It shows that the ACL is morphologically deformed and does not adhere to the original position. That may be the reason why the MRI in sagital plane does not project the clear continuity.

Future prospects and considerations:

Even though the MRI does not show the expected beautiful healing, the torn ACL finally acquired the continuity. She will try the PRP injection to expect the further natural healing. If the platelet contains the self-healing substances, the blood and the fluid in the knee should not be extracted by injection just after the injury. This ridiculous treatment might have interrupted the natural healing. In the functional meaning, her right knee healed well without feeling any instability, and she already has the normal daily activities.

After PRP injections:

She tried the PRP injections for three times and took the MRI again on Aug.31st, 2023. The slight progress of the ACL healing can be seen on the sagittal plane. At this time, Lachman test was performed, and the result was negative. Her prognosis is relatively good, and she is having a normal daily life.

References:

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

Kittani M, Haviv B, Shemesh S, Yaari L, Yassin M, Rath-Wolfson L. Morphological and Histological Changes in the Human Anterior Cruciate Ligament after Rupture. Isr Med Assoc J. 2021 Jan;23(1):33-37.

Spontaneous Healing of a Complete ACL Tear – Case 25

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ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

44 years old, Male, Japanese
On April 9th,2022, he was practicing Judo and trying to throw the opponent. Then, his left knee was twisted internally, and he collopsed down to the ground. He went to the hospital, and Lackman’s test was positive. When he turned the direction, he had gaving way syndrome. He took the MRI on April 19th, and the diagnosis was:

Complete ACL tear
MCL tear

He didn’t want to have a surgery, and he was searching the alternative treatment. He found the Natural Healing Therapy by Jun Matsumoto, and he started the online therapy with him from May 24th, 2022. He had the weekly sessions with Jun and continued doing the Evo-Devo Exercises for five momths. He took the second MRI on October 18th.

The MRI indicates:

The MRI shows the continuity of the ACL. His doctor diagnosed this case as the spontaneous healing of the ACL tear. There was still some signal intensity on the MCL.

Future prospects and considerations:

Jun Matsumoto allowed him to start doing more intense exercises such as squatting and lunge. On November 17th, he got drunk and twisted the left knee again. he says that it wasn’t a serious inury though. Let’s see and follow his prognosis from now on.

References:

Natural Healing of a Complete ACL Tear in Children – Case 24

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ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

8 years old, Male, Japanese
On Nov.30, 2021, he injured his left knee by his own movement during playing soccer. On the same day, he was taken to the hospital and scanned through the x-ray. On Dec.11, 2021, he was taken through the MRI scanning, and the diagnosis was:

ACL Tear
Suspected Avulsion Fracture of tibial spine

His doctor said that he was too young to have the ACL reconstruction as there is a high risk of interfering the bone growth. On Jan.18, he and his family visited Jun Matsumoto and started the Evo-Devo EX. for natural healing of the ACL tear. The Lackman’s test was positive. He continued the Evo-Devo EX. through the face-to-face and online sessions. The next MRI was taken on Mar.30.

Even though the MRI pictures don’t show the clear continuity of the ACL, the Lackman’s test was negative at that time. After continuing the Evo-Devo EX. furthermore, he took the third MRI on Aug.17.

The MRI indicates:

Even though the T1 pictures don’t show the clear appearance of the natural healing, the T2 picture(the first one pf 08/17) shows the continuity of the ACL.

Future prospects and considerations:

Due to the poor resolution of the 1.5T MRI, it is difficult to have the exact diagnosis from these MRI. However, from the results of MRI and Lachman’s test, it can be inferred that the ACL healed spontaneously. Around 10 months from the injury, he already recovered the full range of motion of the knee, and started attending the physical education class at school. After one year from the injury, he plans to return to playing soccer.

References:

Tsuchida S et al. Knee ligament injuries in a seven year old child. The Journal of Kansai Arthroscopy and Knee Scociety. 2008.vol.20.no.1.