Today I had a new patient arrive for an initial Physio session to assess and commence treatment on his recently injured knee. He hurt his knee in the last few minutes of his soccer match a couple weekends ago. From description, there was no major collision or external force that caused the injury… he was simply running, attempted to slow down and change direction to beat a defender, and suddenly felt a pop and twist sensation in his knee.
The injury turned out to be a rupture of his anterior cruciate ligament (ACL). His MRI results (thankfully) did not reveal any damage to other structures within the knee. In the old days, it’s likely that this patient would be shipped off for reconstructive surgery asap. But these days, there’s emerging evidence that ACL injuries can heal without surgery, and that the injured knee has a good chance of regaining its pre-injury function with non-surgical rehabilitation. This patient seems keen to explore this management route.
We had a good chat today about the pros and cons of the various options available to him. It’s possible that with a non-surgical route, the knee may not regain satisfactory function, and he may end up having surgery anyway. We chatted about how this might feel like a waste of time (compared with just getting the surgery done immediately). But he seemed to appreciate the perspective that if there is a non-surgical option on the table, it will carry less risk than any surgical option. And at the very least, any non surgical rehabilitation efforts made, would certainly help his knee get a better pre-operative baseline, should surgery eventually prove necessary. So while I think he is leaning more towards a non-surgery route, we will keep the lines of communication open and get a trusted knee surgeon to throw his 2 cents in too.
I’m really looking forward to seeing how he progresses over the coming weeks.