A Case Study on the Effects of Performance Changes in a Patient with a Torn Anterior Cruciate Ligament (ACL) Injury Following Physical Therapy Intervention, from Pre-operative to Return to Normal Daily Living or Return to Sports, over a 3-Month Period
Keywords:
Torn Anterior Cruciate Ligament, ACL Reconstruction, Pre-habilitation Physical Therapy, Knee PerformanceAbstract
Purpose: To study of changes on the function of a patient undergoing Anterior Cruciate Ligament Reconstruction (ACLR) with concurrent medial meniscus repair.
Study design: Case Study.
Materials and Methods: The research focuses on the impact of continuous physical therapy interventions starting from the preoperative phase (Pre-habilitation) through a 3-month follow-up period. The case study involves a 25-year-old Thai male who sustained a sports-related injury. Performance was evaluated across three primary domains: knee Range of Motion (ROM), muscle strength symmetry (Limb Symmetry Index: LSI), and Patient-Reported Outcome Measures (PROMs), specifically using the IKDC Subjective Knee Form and KOOS scores. Assessments were conducted at three key intervals: T1 (pre-surgery), T2 (1-month post-surgery), and T3 (3 months post-surgery). Quantitative analysis included frequency, percentage, median, and range. Qualitative data were analyzed using content analysis based on information from 1) personal and clinical data records, and 2) clinical progress notes at each measurement point.
Main finding: The results demonstrated significant improvements in all measured dimensions. By the T3 interval, the patient achieved full range of motion (0° extension and 140° flexion). The Quadriceps muscle strength symmetry (LSI) improved from 80% at T1 to 95% at T3. Furthermore, the patient passed the Single-Leg Hop Test with an LSI of 92%. Regarding PROMs, the IKDC score increased from 45 to 90, while the KOOS ADL subscale reached 100, reflecting restored confidence and a return to normal quality of life.
Conclusion and recommendations: In conclusion, this study indicates that preoperative physical preparation and systematic, continuous rehabilitation during the first three months are critical factors in reducing performance deficits. These interventions accelerate the recovery of ACLR patients, enabling a safe return to activities of daily living and establishing a foundation for advanced sports-specific training.
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