Degenerative Healing of an ACL Tear – Case 6

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投稿日時: 2024年4月22日投稿者: ivanivankov

Patient information:

46 years old, female, Hungarian

Mechanism of injury:

On January 6, 2023, while skiing downhill, she fell on an ice slope and fell down. She was unable to stand up and she was rescued by rescue teams.

Progress after injury:

She returned to Hungary from Slovakia, where she consulted an orthopedic surgeon. She had her joint fluid removed by arthrocentesis. She had an MRI done on January 9th, and she received the following diagnosis.

Complete ACL tear (displaced stump (Ihara classification III))
Medial collateral ligament injury
Lateral collateral ligament injury

On January 16th, she visited the orthopedic surgeon again. The Lachman test was positive. She then began range of motion exercises, including full knee extension.

On January 20th, she started online therapy with Jun Matsumoto and began Evo-Devo Exercises.

On February 17th, she had another MRI scan. The images were taken with the knee fully extended. The latest MRI images did not confirm her spontaneous recovery. In fact, the distance between the stumps had widened and worsened. The tibial stump remained in a displaced position and had not improved.

After that, she continued Evo-Devo Exercises and had a third MRI scan on May 18th.

Spontaneous recovery was not confirmed in this MRI scan, but the Lachman test conducted by the doctor showed negative result. She then discontinued Evo-Devo Exercises and started physical therapy in Hungary. On September 18th, her fourth MRI was performed.

This MRI showed no major changes. The patient had limited range of motion in his right knee and had residual knee dysfunction. He is continuing exercise therapy to improve his functional impairment. The fifth MRI was performed on February 27, 2024.

The diagnostic imaging specialist’s report determined that the ACL was torn, but that some of the fibers were still connected. Although the patient is able to lead a normal daily life, she still has limited range of motion in his right knee and is currently undergoing physical therapy.

Consideration:

In this case, not only did the torn ACL not heal well, but there was still clear functional impairment, and natural healing could be said to have failed. There are four possible causes of failure. The first is that the distal end of the stum had turned over, making it difficult for it to heal naturally. Second, blood had been removed by arthrocentesis. Third, physical therapy including full extension was performed early after the injury. Fourth, a second MRI was taken in the fully extended position early after the injury. Based on these results, we would like to strive to improve future treatment methods.

References:

Degenerative Healing of an ACL Tear – Case 5

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投稿日時: 2024年3月28日投稿者: ivanivankov

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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:

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

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投稿日時: 2023年9月11日投稿者: ivanivankov

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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:

ACL Healing without surgery – Healed Case 28

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投稿日時: 2023年3月16日投稿者: ivanivankov

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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:

Spontaneous Healing of a Complete ACL Rupture – Case 17

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投稿日時: 2022年6月26日投稿者: ivanivankov

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ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

37 year old, male, Australian living in Austria
He injured left knee while rock climbing on the 3rd November 2021. He fell akwardly from a very low height and his weight went on my knee in a bad direction. Two weeks later, he went to the MRI scanning, and the diagnosis was:

Complete ACL Tear
Medial meniscus tear
Lateral meniscus tear

On December 8th,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 four months, and he took the next MRIs on April 25,2022.

The MRI report indicates:

“Regular positioning of the patella in the femoropatellar compartment, the retropetallar cartilage shows a deep cartilage ulceration at the medial facet, which is slightly increasing compared to the previous examination, reaching the cartilage-bone lamella.
The trochlear cartilage is continuous. The medial and lateral retinaculum patellae are unremarkable.

Infrapatellar fat body in regular formation. In the lateral femorotibial compartment ubiquitous cartilage cover, the lateral meniscus shows a circumscribed linearity at the posterior horn IMA 8-27, this was already present in the previous examination, but currently appears somewhat expanded and reaches the tibial meniscus surface.

In the medial femorotibial compartment there is a cartilage cover throughout, the medial meniscus at the posterior horn appears clearly more elevated than in the previous examination, but there is no evidence of a dislocated meniscus fragment.

The posterior cruciate ligament is continuous. After rupture of the anterior cruciate ligament, the latter is still edematised, but individual fibrous strands show signs of continuity.

Significant decrease in knee joint swelling. Angelegte Baker-Zyste. Baker’s cyst in place. Typical flow-void popliteal.”

Future prospects

Even though the meniscus tears still remain unhealed, the torn ACL is successfully healing naturally. Jun Matsumoto ordered him to start strengthening the leg muscles, and agreed to follow-up the further prognosis.

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
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

Non-Surgical Treatment of a Complete ACL Tear – case 16

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投稿日時: 2022年4月20日投稿者: ivanivankov

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ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

31 year old, male, Japanese
On September 20th, 2021, he was playing badminton, and when he landed on his left knee from jumping, he twisted it. Two weeks later, he went to the MRI scanning, and the diagnosis was:

Complete ACL tear
Tear of the posterior segment of the Medial Meniscus
Tear of the posterior segment of the Lateral Meniscus

On October 28th,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 four months, and he took the next MRIs on February 25,2022.

The MRI report indicates:

Partial ACL tear

By comparing the MRIs of 2021/10/05 and 2022/02/25, the torn ACL starts healing spontaneously and growing intact. The torn ACL is still in healing process. However, the both meniscii tears remain unhealed yet at this moment. Jun Matsumoto ordered him to continue doing he Evo-Devo EX until the continuation of the ACL becomes more firm. The patient recovered the full range of motion of the left knee, and he doesn’t feel any instability of the knee. He can walk normally and have the normal daily activities so far.

Reference

Natural Healing, Re-rupture,and PRP Trial Story – case 10

注目

投稿日時: 2021年9月21日投稿者: ivanivankov

ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

16-year old, Male, Japanese
On March 21st, 2021, he twisted his left knee by his own movement during playing the handball. Next day, he was taken to the hospital, and his left knee was scanned for the MRI. The diagnosis was:

ACL complete tear
Medial meniscus tear

He visited Jun Matsumoto`s Natural Therapy Office, and started the evo-devo exercises for the natural healing of the ACL tear. He has visited there once a week for 4 months and has continued the exercises every day at home. He took the MRI at the different hospital on September 4th, and it was found that the torn ACL was healing naturally. Jun Matsumoto permitted him to do jogging and start the more intense exercises. In next 3 months, he will return to playing the handball in athletic level.

When he was running on September 28th, he twisted my left knee again. On the same day, he underwent an MRI scan at the hospital and was diagnosed with anterior cruciate ligament rupture. After several days of rest, he resumed spontaneous healing of the re-ruptured anterior cruciate ligament.

Evo-Devo Exercise was performed for another 3 months, and MRI imaging was taken again.

The continuity of the anterior cruciate ligament, as confirmed by MRI on September 4, 2021, could not be clearly confirmed. It was confirmed that the tibial stump of the anterior cruciate ligament adhered to the posterior cruciate ligament. The patient had no symptoms such as knee collapse and was functionally recovering satisfactorily, so he agreed to continue conservative therapy. The exercise intensity was gradually increased, and MRI imaging was performed again on March 5, two months later.

Unfortunately, the continuity of the anterior cruciate ligament was not confirmed this time either. In the future, he agreed to further increase his exercise intensity and observe the progress while aiming to return to the competition.

Consideration:

Although he healed naturally once from his anterior cruciate ligament rupture, he suffered a re-rupture and his spontaneous healing of the re-rupture was unsuccessful. The cause of his re-rupture cannot be clearly pointed out, but there were two points of concern. One was that the start of spontaneous healing therapy was late, 7 weeks after the injury. During that period, the range of motion was restricted by the orthotic device and supporters, so that the flexion restriction remained even during the period from the start of treatment to the spontaneous healing.

The second is that the MRI, which confirmed the spontaneous healing on September 4, did not indicate a beautiful natural healing yet, and that it was a deformed healing that seems to have adhered to the posterior cruciate ligament. My personal impression is that ligament adhesions may have occurred in an environment with limited range of motion during the 7 weeks leading up to the start of treatment. Even if the anterior cruciate ligament rupture heals spontaneously, there is a possibility of re-rupture after that, and how to prevent it is a future proposition.

PRP Injection trials

After the failure of the natural healing from the re-rupture of the healed ACL, he tried the first PRP injections in September 2022 to expect the natural healing again. Totally, he tried the injections four times. The function of his knee was recovering well, and he was practicing Handball in intense level. He attended the official game without having any problem. Moreover, Lackman’s test during that time was negative. He took the next MRI on Jan.16th, 2023.

MRI findings and Considerations:

Even though he tried the four-times PRP injections, expected natural healing did not succeed well. However, it looks that the scar tissues were enhanced to stabilize the knee joint. The remnants of the tprn ACL were adhering to the PCL more tightly.

Can an ACL Tear Heal without Surgery? – case 5

注目

投稿日時: 2021年1月25日投稿者: ivanivankov

ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

38 year old, male, Brazilian, living in Germany
On August 12, 2020, he got injured his left knee during playing the squash. The MRI pictures were taken on August 17, and the diagnosis was:

Complete ACL tear
Complete MCL tear
Lateral meniscus tear(radial tear of posterior horn)

He started the Online Therapy with Jun Matsumoto from September 1, 2020 and continued Jun’s special rehab. exercises for 4 months.

MRI indicates:

After 5 months from his injury, he took the new MRI pictures, and those show that the torn ACL was healing naturally. At this time, he can already have the normal daily activities, and he still continues the rehab. exercises to return to sports.