 The ACL originates from the deep within the notch of the distal femur.  Its proximal fibers fan out along the medial wall of the lateral femoral condyle.. There are two bundles of ACL which is anteromedial and posterolateral named according to where the bundles insert into the tibial plateu.  The ACL attaches in front of the intercondyloid eminence of the tibia, being fused with the anterior horn of the medial meniscus.

Present history: History of twisting the knee when playing a futsal on 2/6/2013. Patient went to hospital for the MRI on 7/6/2013. Then dr diagnosed as ACL tear. Past history: Nil Medical history: Nil Surgical history: Nil Personal history: Non smoking and alcoholic Socioeconomic history: Stable financial status Pain history: :- Duration of pain: Intermittent :- Types of pain: Dull, aching :- Side : Right :- Site: Anterior aspect of knee :- Aggravating factor: Bend knee and squatting :- Relieving factor: Rest :- 24 hours: More in morning :- VAS Scale: 6/10

On observation: Built of patient: Mesomorphic Gait: Normal External appliances: Nil Deformity: Non abnormality detected Scar: Right and left knee On palpation: Edema: Nil Mild warmth at right knee No tenderness No swelling

On examination:  Range of motion KneeRightLeft Flexion ⁰ AFROM ExtensionAFROM

 Muscle power KneeRightLeft Flexion4/55/5 Extension4/55/5  Limb girth measurement (supine) KneeRightLeftDifference 5cm42.5cm 0cm 10cm45.0 cm45.6cm0.6cm 15cm49cm48.5cm0.5cm

Problem listing: pain during bending the knee and do squatting Pain due to ligament tear at the right knee Reduced range of motion at the right knee Short term goals: Reducing pain Improve range of motion Long term goals: Maintaining functional activity Prevent 2 nd complications

Treatment plans: Ultrasound ( 5mins )(0.9w/cm2)( 1 Mhz) Faradic stimulation ( 15 min) ( 20ms) (pulsed mode) TENS ( 15 mins) SLR exercise ( 10 reps) Static quadriceps exercise (10 reps)