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.
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.