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Physiotherapy Rehabilitation Management on Phase I of Post Operative Anterior Cruciate Ligament Reconstruction: A Case Report



Abstract

Background: An anterior cruciate ligament reconstruction (ACLR) phase I is critical for the patient to improve knee pain and range of motion (ROM), knee functions, and prevent excessive inflammation and muscle atrophy. This study aims to evaluate the physiotherapy interventions to improve the pain, ROM, muscle atrophy, and knee function following ACLR phase I.

Case Description: In July 2022, a 22-year-old female basketball athlete injured her right knee while running-pivoting movement during practice. The patient received ACLR on September 22, 2022, following an MRI and physiotherapy examinations. On October 14, 2022, the patient began receiving three times physiotherapy programs weekly. Until November 11, 2022, she complained of having trouble bending and straightening her knee. Although there was no increment in leg muscle circumference of 20 cm above the right patella (RP), there were increments in muscle circumferences of 1.3 cm at 10 cm above the RP, 1.1 cm at 5 cm above the RP, 1.2 cm at 10 cm below the RP, and 1.5 cm at 20 cm below the RP. After three times interventions, we found changes 5o of knee flexion, 2 points of tenderness VAS, 5-28 points of KOOS score, and 10 points of Lysholm’s score.

Conclusion: The physiotherapy interventions improved the pain, ROM, leg muscle circumference, and knee function in the ACLR phase I patient. This case report study could be a reference for further experimental study.

Keywords: ACLR Phase I Physiotherapy Rehabilitation Sports Injury
Section

References

  1. Wijayasurya S, Setiadi TH. Cedera Ligamen Krusiatum Anterior. J Muara Med dan Psikol Klin. 2021;1(1):98-104.
  2. Correira Fonseca M. Biomechanical Simulation of the Damage on the ACL in Injury Related Movements. 2020;(June).
  3. Ombregt L. A System of Orthopaedic Medicine. Third Edit. Elsevier Ltd; 2013. https://books.google.co.id/books?hl=en&lr=&id=YaFsAAAAQBAJ&oi=fnd&pg=PP1&dq=Ombregt,+L&ots=g6E7kBWt6U&sig=4HwQurPOQXbkEMS8KDn7RmZPy5M&redir_esc=y#v=onepage&q=Ombregt%2C L&f=false
  4. Flandry F, Hommel G. Normal anatomy and biomechanics of the knee. Sports Med Arthrosc. 2011;19(2):82-92. doi:10.1097/JSA.0b013e318210c0aa
  5. Khalid K, Anwar N, Saqulain G, Afzal MF. Neuromuscular Training following Anterior Cruciate Ligament reconstruction – Pain, Function, Strength, Power & Quality of Life Perspective: A Randomized Control Trial. Pakistan J Med Sci. 2022;38(8):2175-2181. doi:10.12669/pjms.38.8.5730
  6. Santoso I, Sari IDK, Noviana M, Pahlawi R. Penatalaksanaan Fisioterapi Pada Post Op Rekonstruksi Anterior Cruciate Ligament Sinistra Grade III Akibat Ruptur Di RSPAD Gatot Soebroto. J Vokasi Indones. 2018;6(1).
  7. Maralisa AD, Lesmana SI, Fisioterapi D, et al. Penatalaksanaan Fisioterapi Rekonstruksi Acl Knee Dextra Hamstring. Indones J Physiother Res Educ. 2020;1(1):4-17.
  8. Blahd W. Anterior Cruciate Ligament (ACL) Reconstruction Surgery. WebMD Med Ref. Published online 2016:1-13.
  9. Dhammi IK, Rehan-Ul-Haq, Kumar S. Graft choices for anterior cruciate ligament reconstruction. Indian J Orthop. 2015;49(2):127-128. doi:10.4103/0019-5413.152393
  10. Mayeda, N. L., Komalasari, D. R., & Rohayani I. Penatalaksanaan Fisioterapi Paska Rekontruksi Anterior Cruciate Ligament Pattelar Autograft: Studi Kasus. Physiotherapy Health Science (PhysioHS). Physiother Heal Sci. 2022;4(4(1)):11-17.
  11. Yao S, Fu BSC, Yung PSH. Graft healing after anterior cruciate ligament reconstruction (ACLR). Asia-Pacific J Sport Med Arthrosc Rehabil Technol. 2021;25:8-15. doi:10.1016/j.asmart.2021.03.003
  12. Hauser RA. Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. Open Rehabil J. 2013;6(1):1-20. doi:10.2174/1874943701306010001
  13. Adhitya IPGS, Manuaba IBAP, Suprawesta L, Mauludina YS, Marufa SA. Patient characteristics of non-operative anterior cruciate ligament injury associated with poor knee functions on activities of daily living: a cross-sectional study. Bali Medical Journal. 2020;9(3):710-5.
  14. Jennifer Evans, Jeffery l. Nielson. Anterior Cruciate Ligament Knee Injuries. Published May 5, 2022. Accessed July 20, 2022. https://www.ncbi.nlm.nih.gov/books/NBK499848/
  15. Logan CA, Beaulieu-Jones BR, Sanchez G, et al. Posterior Cruciate Ligament Injuries of the Knee at the National Football League Combine: An Imaging and Epidemiology Study. Arthrosc - J Arthrosc Relat Surg. 2018;34(3):681-686. doi:10.1016/j.arthro.2017.08.304
  16. Herzog MM, Marshall SW, Lund JL, Pate V, Mack CD, Spang JT. Trends in Incidence of ACL Reconstruction and Concomitant Procedures Among Commercially Insured Individuals in the United States, 2002-2014. Sports Health. 2018;10(6):523-531. doi:10.1177/1941738118803616
  17. Owesen C, Aas E, Årøen A. Surgical Reconstruction is a Cost-Efficient Treatment Option for Isolated PCL Injuries. Knee Surgery, Sport Traumatol Arthrosc. 2018;26(4):1053-1058. doi:10.1007/s00167-017-4632-5
  18. Mather RC, Hettrich CM, Dunn WR, et al. Cost-Effectiveness Analysis of Early Reconstruction versus Rehabilitation and Delayed Reconstruction for Anterior Cruciate Ligament Tears. Am J Sports Med. 2014;42(7):1583-1591. doi:10.1177/0363546514530866
  19. Bieler T, Aue Sobol N, Andersen LL, et al. The effects of high-intensity versus low-intensity resistance training on leg extensor power and recovery of knee function after ACL-reconstruction. Biomed Res Int. 2014;2014. doi:10.1155/2014/278512
  20. Gupta R, Rana S, Kapoor A, Patil B, Sachdeva V, Masih GD. Better and early recovery in ACL reconstructed elite players with addition of core stability exercises in postoperative rehabilitation program. Sport Sci Health. 2021;17(2):357-362. doi:10.1007/s11332-020-00696-6
  21. Jones D, Rutherford O, Parker D. Physiological changes in skeletal muscle as a result of strength training. Quarterly Journal of Experimental Physiology: Translation and Integration. 1989;74(3):233-56.
  22. Kraemer WJ, Deschenes MR, Fleck SJ. Physiological adaptations to resistance exercise. Sports medicine. 1988;6(4):246-56.
  23. Benner RW, Shelbourne KD, Bauman SN, Norris A, Gray T. Knee osteoarthritis: alternative range of motion treatment. Orthopedic Clinics. 2019;50(4):425-32.
  24. Kami K, Tajima F, Senba E. Exercise-induced hypoalgesia: potential mechanisms in animal models of neuropathic pain. Anatomical Science International. 2017;92(1): 79-90.
  25. Secrist ES, Freedman KB, Ciccotti MG, Mazur DW, Hammoud S. Pain management after outpatient anterior cruciate ligament reconstruction: a systematic review of randomized controlled trials. The American Journal of Sports Medicine. 2016; 44(9): 2435-2447.
  26. Roos EM, Roos HP, Ekdahl C, Lohmander LS. Knee injury and Osteoarthritis Outcome Score (KOOS)‐validation of a Swedish version. Scandinavian Journal of Medicine & Science in Sports. 1998; 8(6): 439-448.
  27. Lepley LK, Grooms DR, Burland JP, Davi SM, Mosher JL, Cormier ML, Lepley AS. Eccentric cross-exercise after anterior cruciate ligament reconstruction: novel case series to enhance neuroplasticity. Physical Therapy in Sport. 2018;34: 55-65.

How to Cite

Adhitya, I. P. G. S., Ari Wibawa, Abdurrasyid, I Gusti Ngurah Wien Aryana, Muhammad Adrian Putra Rachman, Ni Luh Veni Rahayu, Ni Komang Mega Junianti, Emily Devina Kartawijaya, & Tabita Febyola Wijaya. (2022). Physiotherapy Rehabilitation Management on Phase I of Post Operative Anterior Cruciate Ligament Reconstruction: A Case Report. Indonesia Journal of Biomedical Science, 16(2), 132–139. https://doi.org/10.15562/ijbs.v16i2.435
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I Putu Gde Surya Adhitya
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Ari Wibawa
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Abdurrasyid
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I Gusti Ngurah Wien Aryana
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Muhammad Adrian Putra Rachman
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Ni Komang Mega Junianti
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Emily Devina Kartawijaya
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Tabita Febyola Wijaya
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