Event Title

Conservative Anterior Cruciate Ligament Rehabilitation Without Imaging in an Outpatient Facility: A Retrospective Case Report

Author/ Authors/ Presenter/ Presenters/ Panelists:

Alex Parker, Governors State UniversityFollow

Start Date

4-12-2019 4:00 PM

End Date

4-12-2019 6:00 PM

Abstract

Background/purpose: Anterior cruciate ligament (ACL) injury can be devastating and result in a sequalae of complications. Arthroscopic surgery remains the gold standard for diagnosing an ACL rupture but is invasive, costly, and time consuming for arriving at a diagnosis. Physical examinations are quick, noninvasive, and inexpensive exams. Magnetic resonance imaging is a valid and noninvasive diagnostic method but remains costly. The purpose of this case study will examine a common knee injury, an ACL tear, and the management of conservative treatment for 6 weeks without imaging to confirm the ACL tear diagnosis.

Case Description: A 33-year-old Caucasian male with no significant past medical history, surgeries, medications, or imaging results underwent a noncontact hyperextension moment in his right knee. The patient presented to physical therapy unable to achieve terminal knee extension, lacked active knee flexion, reported knee instability, and exhibited suprapatellar swelling; all signs and symptoms of a likely ACL tear with meniscus involvement. A conservative approach was incorporated to reduce the likelihood of surgery and return to a fast-paced work environment.

Outcomes: Throughout the 6 weeks of treatment, improvements were documented in knee and hip strength, knee range of motion, and decreased pain. At discharge, the patient also reported he felt steady in his right knee when ambulating at a comfortable pace, and could manage full work days. The patient also reported decreased pain levels via the NPRS from 7 to 3.

Discussion: This case report illustrates the effectiveness of a conservative approach to a potential ACL and meniscal tear in an adult patient in the outpatient setting. The results in this case report are consistent with similar studies regarding conservative treatment of an ACL tear. Additional research should be conducted to focus on conservative treatment rather than surgery to contribute to future clinical practice guidelines, and to provide more options to patients who elect not to undergo surgical repair.

Description of Program

ACL hyperextension injury

Faculty / Staff Sponsor

Dr. Dale Schuit

Presentation File

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Apr 12th, 4:00 PM Apr 12th, 6:00 PM

Conservative Anterior Cruciate Ligament Rehabilitation Without Imaging in an Outpatient Facility: A Retrospective Case Report

Background/purpose: Anterior cruciate ligament (ACL) injury can be devastating and result in a sequalae of complications. Arthroscopic surgery remains the gold standard for diagnosing an ACL rupture but is invasive, costly, and time consuming for arriving at a diagnosis. Physical examinations are quick, noninvasive, and inexpensive exams. Magnetic resonance imaging is a valid and noninvasive diagnostic method but remains costly. The purpose of this case study will examine a common knee injury, an ACL tear, and the management of conservative treatment for 6 weeks without imaging to confirm the ACL tear diagnosis.

Case Description: A 33-year-old Caucasian male with no significant past medical history, surgeries, medications, or imaging results underwent a noncontact hyperextension moment in his right knee. The patient presented to physical therapy unable to achieve terminal knee extension, lacked active knee flexion, reported knee instability, and exhibited suprapatellar swelling; all signs and symptoms of a likely ACL tear with meniscus involvement. A conservative approach was incorporated to reduce the likelihood of surgery and return to a fast-paced work environment.

Outcomes: Throughout the 6 weeks of treatment, improvements were documented in knee and hip strength, knee range of motion, and decreased pain. At discharge, the patient also reported he felt steady in his right knee when ambulating at a comfortable pace, and could manage full work days. The patient also reported decreased pain levels via the NPRS from 7 to 3.

Discussion: This case report illustrates the effectiveness of a conservative approach to a potential ACL and meniscal tear in an adult patient in the outpatient setting. The results in this case report are consistent with similar studies regarding conservative treatment of an ACL tear. Additional research should be conducted to focus on conservative treatment rather than surgery to contribute to future clinical practice guidelines, and to provide more options to patients who elect not to undergo surgical repair.