Case Study ●Chief complaint is pain in the right knee ●A 16 year old female, was injured in soccer game with a blow to her right knee. ●Patient heard a pop in her knee, can not put pressure on knee ●Patient is not able to flex knee, hyperextension of the knee is present ●Sign of swelling, bruising and subtle sign of effusion in the knee ●X-ray came back negative for broken bones ●Lachman Test was performed with a positive result ●Patient sent for MRI ●MRI showed a torn anterior cruciate ligament ●Patient has no history of smoking, drugs or alcohol. ●Vitals are healthy blood pressure is 115/80, temperature is 98.6 degrees, pulse is 80. ●Personal History of playing soccer and basketball ●Family history of smoking, high blood pressure, obesity and high cholesterol
Discussion ●The patient’s injury was a result of the forceful impact of the knee. ●The patient’s MRI showed the torn ACL, following the diagnosis. ●Along with the MRI, the Lachman test determined the diagnosis. ●Risk factors include “an increased risk of early onset posttraumatic osteoarthritis,” (Smith, 2002). ●The patient is also at a high risk for reinjuring her knee, and recurrent episodes of the knee “giving way or feelings of an unstable knee, as well as a clear effusion,” (Matava, ). ●If the patient’s knee is injured again, the patient would have to go through physical therapy again, and upon opinion of the physician, may not be able to return to sports.
MRI of a torn ACL (Gamradt, MD).
Management/Treatment ●The patient will need surgery to correct her knee. ●The patient must attend physical therapy after therapy for about “7-9 months,” (Cluett, M.D.,2014). ●Her therapy will include many exercises including “cycling and elliptical training,” (Luks, M.D.,2014). ●The regimen of the therapy will be focused on strengthening her upper and lower muscles to prevent another injury ●She will have follow up appointments with her physician to discuss her progress. ●Once her physical therapy is completed she will be re-evaluated by her doctor. ●When the physician and therapist clears her she will be able to ease back into her physical activities. ●The patient will have to wear her brace while participating in her activities for a year.
Conclusion ●The patient’s injury will be corrected with surgery. ●The patient will participate in physical therapy. ●With surgery and physical therapy, the injury will be able to recover. ●Once the patient completes physical therapy, she must be cleared by physician to return to sports. ●The patient must wear a knee brace during all physical activities. ●After one year she will be able to engage in physical activities without the use of the knee brace.
References Works Cited Anterior Cruciate Ligament Tear. Film. https://www.youtube.com/watch?v=uuoj_HFG5Z0#t=11 Cluett, J., et al. (2014, June 2). How Long Does ACL Tear Rehab Take? Can ACL Rehab Be Accelerated?. (n.d.).About. Retrieved October 26, 2014 Knee Conditions: ACL Tear. By Seth Gamradt, MD. Luks, M.D., H. J. (2014). ACL Tears and ACL Injuries - Howard Luks MD. Howard J Luks MD. Retrieved October 26, 2014, from injuries/acl-tears/ Matava, M.J., R.W. Wright, and E.D. Ellis. "Natural History of ACL tears: From rupture toosteoarthritis." The Knee Joint Gewerbestrasse, Switzerland: Springer Paris, Print. Smith, H., Vacek, P., Johnson, R., Slauterbeck, J., Hashemi, J., Shultz, S., et al. (2002, July 5). Abstract. National Center for Biotechnology Information. Retrieved October 24, 2014, from