Date of Award

2007

Document Type

Scholarly Project

Degree Name

Doctor of Physical Therapy (DPT)

Department

Physical Therapy

First Advisor

David Relling

Keywords

Anterior Cruciate Ligament -- surgery; Knee Injuries -- rehabilitation

Abstract

Background/purpose: Anterior cruciate ligament (ACL) rupture is reported to be one of the most common and most serious injuries among physically active individuals, There are a multitude of articles addressing rehabilitation following ACL reconstruction, but there is no clear "best method' identified in the evidence, Subjects with a combination of ACL rupture and degenerative joint disease are less frequent in occurrence, and also lack evidence to identify the most appropriate rehabilitation method.

Description: This case study provides the details of the first 8 weeks of rehabilitation for a 49 year old male subject who underwent anterior cruciate ligament reconstruction of one knee with moderate to severe degenerative joint disease of the contralateral knee.

Outcome: The subject was able to recover full range of motion of the anterior cruciate ligament reconstructed knee and was able to gain 10 degrees of flexion in the knee with degenerative joint disease within 4 weeks of right knee ACL reconstructive surgery, The subject was able to perform all ADL activities to include stairs without discomfort at 6 weeks post-op, Thigh girth at 15 cm above the medial joint line was equal at 8 weeks post-op, KT-1000 score indicated less than I mm difference at 8 weeks postop.

Discussion: The rehabilitation program for this patients' ACL reconstructed knee followed a traditional, evidence based approach with modifications for patients age and presence of degenerative joint disease in the contralateral knee. A combination of closed chain exercise, neuromuscular re-education and open chain exercises were used with this patient. The short-term results appear to be encouraging related to range of motion and muscle function. However, in this patients' case-as well as for other patients undergoing this procedure, the long-term (5 -10 years) outcome is most important.

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