- Author: Nick Wrenn
It has long been thought that an anterior cruciate ligament (ACL) rupture cannot heal without surgery. New evidence shows that this is incorrect and with a committed rehabilitation program, good healing can occur.
Case Study - ACL Rupture playing AFL football
One of our 21-year-old clients sustained a total rupture of his ACL while playing AFL football. The ACL rupture as well as injury to other knee structures was initially confirmed on MRI.
Initial Physiotherapy Consultation Showed
- clear instability with ligament stress testing
- decrease in knee range
A discussion involving the client, sports physician, and Nick (our physiotherapist) regarding the pros and cons of going for surgery or doing rehabilitation only with the potential for surgery later was made.
The outcome was that the client opted to go down the dedicated rehabilitation route.
Dedicated Rehabilitation Program Aims
- Decrease pain.
- Improve joint range.
- Improve joint stability.
- Improve joint function.
Rehabilitation Program
- Heavy weight training – graduated.
- Running, jumping and hopping drills – graduated.
Two Weeks later
- Full knee range was achieved and assessed by our physiotherapist.
- Client reported feeling more “stable” in the knee.
Five Months Later
- Client reported that his knee is feeling “great”.
- Client reported that he is now wanting to return to AFL football.
- Ligament stress tests indicate minimal (if any) joint instability.
- A follow-up MRI is organised
Follow-Up MRI Results
- the previously fully ruptured ACL had re-attached itself and showed good healing
- other injured knee structures also demonstrated good healing.
Outcome
With continuing to gradually increase the rehabilitation program, we hope to get our client back to his first AFL game in April 2022 – nine months after the initial injury.
The above scenario won’t apply in all cases and a big commitment to the rehabilitation program is required.
A recent study conducted in Sweden found 56% of patients who underwent rehabilitation alone had a healed ACL at the 2-year follow-up.1 It is now apparent that a structured rehabilitation program in a person with a ruptured ACL may result in avoiding surgery altogether.
It’s important that all surgical vs non-surgical options for ruptured ACL management are a shared decision involving the client, physiotherapist, and doctors/surgeon.
In the last six months, we have had two cases at Physiotherapy West where a tailored rehabilitation program as a non-surgical option for an ACL rupture has resulted in a self-healed ACL – great results from our dedicated team!
Talk to our experienced team
All physiotherapists at Physiotherapy West have undergone Professional Development for delayed ACL surgery rehabilitation and can talk you through your options.
