Complex Knee Injury Rehabilitation – Case Study
Background
Katie is a 45yr old Dancer, normally fit and well.
She sustained a twisting injury to her knee whilst skiing. Following an MRI scan, it was confirmed she had a bucket handle tear of her lateral meniscus and a complete ACL rupture.
She initially had a Lateral Meniscus repair and was put in a hinged knee brace for six weeks and partial weight bearing on 2 crutches. After this we progressed her back to full weight bearing and weaned her off her crutches. We then worked hard with manual therapy and exercise to regain as much of her range of movement as possible and strengthen her leg ahead of an ACL reconstruction using a hamstring graft 5 months later.
Rehabilitation
Following Katie’s second surgery we had to work very hard to regain her range of movement, base levels of muscle activation, confidence to load the leg and everyday function.
We focused on activation of her quads and reduction of swelling to improve knee terminal extension, and this took several months. We progressively built up her hamstring strength to help stabilise the knee and offload the ACL graft.
At the appropriate time we introduced impact and rotational exercises. Due to the severity of the initial injury and phased operative intervention, Katie struggled to progress through her stages of rehabilitation and recovery, with various back and hip issues. This was mainly due to muscle guarding that had developed following such a long period on crutches and in the brace. However, with regular manual therapy and movement re-education techniques we were able to overcome each set back. She was a regular in the treatment rooms and in our rehabilitation gym. It required significant mental strength and dedication from her side and plenty of reassurance and education on why these setbacks were occurring from us. She maintained a positive, determined attitude throughout, and this was most certainly required to achieve such a positive outcome.
Outcome
Following a lengthy and intensive rehabilitation process, Katie has made a near full recovery and will continue to improve back to full function over the coming months with her ongoing rehabilitation programme. She has been able to return to running, gym classes and has started dancing again. She has decided against future skiing, but should she have a change of heart we would be able to fit her with an Ossur or Donjoy ACL Brace to prevent future injury to her graft. Following this process Katie gave Shepherds’ Health a heartfelt review:
“It’s certainly been a long journey, but it’s been made so much easier to deal with and understand with Jon and James by my side. I couldn’t have wished for a kinder team who understood and fixed me through every little worry, both mentally and physically. Thank you!”