ACL Case Report #54: Successful Natural Healing via Evo-Devo Exercise for a 28-Year-Old Canadian Female

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ACL Case Report #54: Successful Natural Healing with Continuity Preserved Through Evo-Devo Exercise — Return to Functional Lifestyle for a 28-Year-Old Canadian Female

Summary:

The patient sustained a left knee ACL rupture while playing soccer for leisure. Based on a strict consensus of three independent specialists, the initial MRI was classified as Ihara Type III (tear with displaced stumps). She chose to pursue non-surgical natural healing by initiating online therapy with Matsumoto Jun Sekkotsuin, employing Evo-Devo Exercise. She strictly adhered to a rigorous management environment, including a brace restriction of 0–30° extension, a walking limit of ≤3,000 steps per day, and a home program of Evo-Devo Exercise three times daily. After 4 months, the final MRI evaluation revealed successful morphological healing, with all specialists confirming structural continuity matching ACLOAS Grade 2 (thinning/elongation with continuity preserved). Following continuous rehabilitation, she successfully returned to her activities of daily living, although she has reportedly given up returning to competitive soccer.

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Patient Information

Age / Nationality: 28-year-old female, Canadian
Injured side: Left knee

Mechanism of Injury

Date of injury: 14 June 2023
Context: Sustained an injury while playing soccer as a hobby, twisting her left knee. She explicitly noticed a distinct “popping sound” at the moment of injury. On the following day, June 15, an X-ray examination was performed, which revealed no abnormalities or fractures.

Initial Evaluation (MRI #1)

Date: 23 June 2023
Diagnosis: Left knee complete ACL rupture
Ihara classification: III (Grade 3) — Unanimously confirmed by 3 independent specialists (tear with displaced stumps)

[Ihara classification notes]

I = linear/straight tear; II = curved tear; III = tear with displaced stumps; IV = indistinct/unclear stumps.

Initial Policy & Start of Therapy

Start date: 3 July 2023
Format: Online guidance; initiation of non-surgical management via Matsumoto Jun Sekkotsuin
Brace management: Knee extension restricted to 0–30°
Activity: Walking strictly restricted to ≤3,000 steps/day
Home program: Evo-Devo Exercise performed 3 times daily

Final MRI Evaluation (~4 months)

Date: October 2023 (4 months post-injury)
Assessment: ACLOAS Grade 2 (thinning/elongation with continuity preserved) — Unanimously confirmed by 3 independent specialists
Clinical Finding: The final imaging evaluation objectively confirmed the structural recovery and continuity of the tissue. Following consecutive structural healing, the patient engaged in progressive rehabilitation and successfully restored stability for daily functional life.

[ACLOAS (native ACL) notes]

0 = normal; 1 = thickening/intra-ligament high signal with shape and continuity preserved; 2 = thinning/elongation with continuity preserved; 3 = discontinuity.

Results

Initial: Ihara III (unanimous consensus)
Final: ACLOAS Grade 2 (successful morphological healing with continuity preserved)
Clinical status: Satisfactory functional recovery achieving successful reintegration into daily life; competitive soccer activities have been discontinued.

Summary

Injury (2023/06/14): Left knee complete ACL rupture during recreational soccer with an audible pop.
Management: Strict range of motion restriction (0–30° extension), walking limit of 3,000 steps per day, and Evo-Devo Exercise 3 times daily.
Objective Evidence: Successful natural healing with structural continuity restored (ACLOAS Grade 2), confirmed by a strict consensus of three independent readers.