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Spontaneous Healing Of A Tear Of An Anterior Cruciate Ligament Graft: A Case Report

Ng, N. Y. Y. 2017Other/Unknown

Ng, N. Y. Y., Tan, B. W. L., & Krishna, L. (2017). spontaneous healing of a tear of an anterior cruciate ligament graft: A case report. The Knee, 24(6), 1504–1507. https://doi.org/10.1016/j.knee.2017.09.002

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Case Details

Disease Location

Left knee

Personal Characteristics

24-year old full-time military conscripatient WHO sustained pivoting injury to his left knee during basketball

Clinical Characteristics

Immediate swelling, pain and instability; examination 4 weeks after injury showed effusion, positive lachman and anterior drawer test with negligible end point, range of motion of the affected knee was 0-120 degrees, MRI showed full-thickness mid-substance tear of the acl with a grade 2 medial collateral ligament sprain; examination during operating 4 months after injury showed complete acl tear without meniscal injury; patient re-tore acl during basketball game 7 months after reconstruction surgery, experienced pain and swelling (opatiented for no surgery and conservative treatment)

Remission Characteristics

8 months after re-injury, patient was asymptomatic for pain, swelling and instability, demonstrated full range of motion and no tenderness, anterior drawer, lackman and pivot shift testing showed no acl instability, MRI showed interval near-complete healing of acl graft

Treatment & Mechanisms

Proposed Remission Mechanisms

Higher cellular response in hamstring tenocytes to injury-induced growth factors as compared to that of acl tenocytes (graft was from hamstring); may not have been a full tear of acl during re-injury

Clinical Treatment

Four months after injury the pateint underwent acl reconstruction with gracilis and semitendinosus autograft; patient underwent the institution's acl reconstruction rehabilitation protocol and showed no symptoms of pain or instability at one-week, six-week, three- months and six- months post-operative follow-ups

Non-Clinical Treatment

None reported discussed