Degenerative Healing of an ACL Tear – Case 4

注目

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

注目

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:

Natural Healing of an ACL tear – Healed Case 29

注目

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

注目

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

注目

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

注目

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

注目

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:

Spontaneous Healing of a Complete ACL Rupture even after the meniscus repair surgery– Case 23

注目

ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

59 years old, Male, Japanese
On Dec.28, 2021, he injured his right knee during skiing. On the same day, he was taken to the hospital, and there was no fracture through x-ray. On Jan.13, he was taken to the MRI scanning and diagnoses as:

Complete ACL tear
Buckling of medial meniscus

On Jan.17, he had a surgery for repairing the meniscus, and his knee was immobilized by the cast for three weeks. After the cast was removed, he visited Jun Matsumoto, and he started the Evo-Devo EX. for natural healing of ACL tear. He continued the therapy through face-to-face and online sessions for six months. On August 4, he took the next MRI.

The MRI indicates:

Continuity of ACL fibres

Future prospects and considerations:

In my experience, this is the first case of natural healing of ACL tear after the meniscus repair surgery. I assumed that natural healing would be immpossible, becasue the knee was immobilized for three weeks. Actually, it took a long time to recover the range of motion due to the contracture after the immobilization. Contrary to my assumption, the torn ACL has successfully healed naturally after 6 months of the Evo-Devo EX.. After the natural healing was observed through the second MRI, he started strength trainning as well as Evo-Devo EX. to return to skiing. In October, he already has the normal dialy activities without problem and continues the rehab exercises every day.

References:

Spontaneous Healing of a Complete ACL Tear – Case 22

注目

ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

45 years old, Male, Japanese
He injured her right knee during skiing on February 5th, 2022. On February 10th, she went to the MRI scanning, and the diagnosis was:

Complete ACL tear
MCL tear grade2

On February 21, 2022, he started the online therapy for the natural healing of the ACL tear with Jun Matsumoto. He continued doing Evo-Devo Exercises for six months, and he took the next MRI on August 17th, 2022.

The MRI indicates:

Visible continuity of the ACL

Future prospects and considerations:

According to the new MRI, the visible continuity of the ACL can be seen, even though it is not the perfectly clear one. This morphological healing is classified as the type II of Ihara’s classification, and the healed ACL is the straight band with partial thinning. The patient has healed functionally very well, and he doesn’t feel any pain in the daily activities so far. He will continue the Evo-Devo Exercises and the some strength exercises until he can return to skiing.

References:

Natural Healing of a Complete ACL Tear – Case 21

注目

ACL Online Therapy for natural healing

ACL tears heal without surgery

Patient information:

41 years old, Female, American
She injured her left knee during skiing on February 4th, 2022. On February 10th, she went to the MRI scanning, and the diagnosis was:

Complete ACL tear

On February 27, 2022, she started the online therapy for the natural healing of the ACL tear with Jun Matsumoto. She continued doing Evo-Devo Exercises for four months, and she took the next MRI on July 5th, 2022.

MRI reports:

Modest signs of suffering are detectable in the anterior cruciate ligament which appears slightly reduced in thickness in the middle-distal III with an inhomogeneous signal that tends to be hyperintense in the T2-weighted sequences for slight edematous imbibition with characteristics compatible with the outcomes of a “strain” suffering with probable parcel laceration and persistence of a tenuous edematous suffering of the residual ligament; the ligamentous structure however remains clearly visible along its entire course with modest surrounding synovial thickening and periligamentous liquid layer in the distal insertion tract.

Future prospects:

According to the report above, the torn ACL starts healing naturally, and it will take a while until healing process ends. Jun Matsumoto permitted her to practice the full range of motion of the affecyed knee and start strengthen the quadriceps muscles. Even though she still feels weakness on the affected knee, there is no othere complication in her daily life activities. Further more, she will contines the Evo-Devo Exercises and strength exercises until she gets ready to return to skiing.

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