Through progressive and supervised rehabilitation, I managed to progress to 90° sidestep cutting manoeuvres at 66 days, returned to training at 150 days, and full basketball at 200 days postinjury. 4 Previous study showed that early MRI (≤6 weeks) was less accurate than that late MRI group (>6 weeks) in diagnosing ACL injuries, with a particular tendency to overrate the injury severity. Probably, the ACL was only partially torn, and the residual continuous fibres could not be shown because of the oedema in the acute inflammation phase. Compared with the distorted and broken fibres in the MRI of the sixth day, the MRI demonstrated that the intensity signal of the ACL was much improved with fibres in continuity at the thirty-five days after injury. Thirty-three days after injury, I was able to get back on the basketball court practising shooting with a heavy knee brace. This focused on pain/inflammation control, gaining range of motion (ROM), strength, and ultimately, return to play. 1–3 Considering my busy academic schedule and good joint stability, I decided to take the conservative treatment route.Įarly rehabilitation is particularly important in conservative treatment and Dr Jiwu Chen and the sports medicine team of Huashan Hospital customised a detailed rehabilitation protocol for me.
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I encountered articles reporting that results did not differ between rehabilitation plus early ACL reconstruction, vs rehabilitation plus optional delayed ACL reconstruction. I read a lot about acute ACL injury, and I learned that current treatment options are still controversial. Dr Chen (an expert in sports medicine) gave me some practical suggestions, including wearing a knee brace immediately and using crutches to avoid any secondary injuries ( figure 1).ĭecision time: early ACL reconstruction or conservative management?
However, an MRI scan taken at day 6 postinjury indicated that my ACL was torn, although, luckily meniscus was intact. My teacher and mentor, Dr Jiwu Chen, performed a physical examination for me and confirmed that the stability in my injured knee was good (with negative tests for Lachman’s, anterior drawer and pivot-shift). I wore a knee brace and used crutches to avoid weight bearing on my injured knee.īased on my professional knowledge, I thought the anterior cruciate ligament (ACL) might be torn but I still hoped for the best outcome. My injured knee was extremely effused, and I was unable to bend or straighten it. The morning after the injury, the pain was severe. I immediately iced the knee, wore a knee pad, and raised the injured leg with a pillow to reduce swelling before going to bed. On the night of the injury, the pain was not severe.
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