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Abstract: The patient, a 33-year-old male, suffered a knee sprain due to an impact with another person during basketball, causing swelling and pain in the knee and other manifestations, and was diagnosed with an anterior cruciate ligament rupture by MRI after consultation. He was recommended to be hospitalized, and after arthroscopic ACL reconstruction surgery and rehabilitation exercises, the knee pain and swelling subsided, and flexibility and function improved significantly.
Basic information】Male, 33 years old
Type of disease】Ruptured anterior cruciate ligament
Hospital】Harbin First Hospital
Date of consultation】October 2021
Treatment plan】Arthroscopic ACL reconstruction surgery + rehabilitation exercises
Treatment Period】7 days of inpatient treatment, 1 month of outpatient follow-up
Results】Knee pain and swelling were relieved, and flexibility and function were significantly improved.
I. Initial consultation
The patient reported that he likes to play sports and regularly participates in basketball games in his neighborhood every week. During the game, he bumped into someone else and felt his knee twisted. It was considered that the ACL was ruptured due to excessive stretching of the ACL by twisting the knee during the basketball game, and it was confirmed that the continuity of the ACL was interrupted by MRI, thus confirming the diagnosis of ACL rupture. After detailed communication with the patient and his family about his condition, he agreed to be hospitalized.
II. Treatment process
After admission, the patient was first treated with ice and joint elevation and braking, and then arthroscopic ACL reconstruction surgery was performed to restore the function of the joint after the swelling of the knee had decreased. If only conservative treatment was used, the integrity of the ACL could not be restored, and the articular cartilage would be excessively worn out, accelerating the rate of degenerative changes in the joint, which would eventually affect the life of the knee. During the procedure, the ACL was confirmed to be completely torn, the torn ligament was cleaned, the superior and inferior ends of the ligament were identified, and a bone tract was created, and an autologous popliteal tendon was taken, braided and introduced into the bone tract and the joint cavity to reconstruct the ACL. No significant ligament loosening was observed under arthroscopic observation of knee flexion and extension activities, and the surgical incision was closed and fixed with a hinge support. The patient cooperated with rehabilitation exercises after surgery to restore knee range of motion and knee stability.
III. Treatment results
At the time of postoperative activities, the patient’s joint instability disappeared completely. 7 days after surgery, the pain and swelling were significantly relieved, and the patient was able to perform knee flexion and extension activities on his own, and he was able to leave the bed with the assistance of a double crutch, so he was discharged from the hospital. 1 month later, the outpatient review confirmed that the flexibility and function of the knee joint had improved significantly, and the front drawer test changed from positive before surgery to negative after surgery, suggesting that the stability of the knee joint had been restored.
IV. Notes
We are pleased that the patient has recovered knee function after surgical treatment. However, patients need to note that although joint stability was restored after arthroscopic ACL reconstruction, the affected limb should not be weight-bearing until the ACL is re-integrated with the bone tract, otherwise it will affect the healing of the ligament and bone, leading to excessive relaxation of the ACL, which will destroy the stability of the knee joint and eventually make the surgery fail. After discharge from the hospital, the patient should strengthen the quadriceps strength training to enhance joint stability, promote joint blood circulation, and speed up the fusion of the ligament with the bone tract. If symptoms such as joint fever, swelling, and severe pain occur after surgery, a follow-up visit to the orthopedic clinic is required to confirm the presence of serious conditions such as knee infection and rupture of reconstructed ligaments.
V. Personal insight
The rupture of the ACL is mainly related to knee sprain. After the arthroscopic ACL reconstruction surgery, it is necessary to pay attention to injury prevention when participating in sports in daily life. It is recommended to warm up sufficiently before exercise, avoid direct impact as much as possible during exercise, and wear a knee brace for protection if necessary. In addition, it is recommended that patients enhance the strength of the quadriceps muscle to improve knee stability and be able to fully protect the ACL and try to avoid rupture of the ACL.