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Hey everyone,
One of the students in our clinic has been treating an 11 y/o s/p ACL reconstruction who has had persistent limitations in knee extension. They recently did an arthroscopic surgery and found that he had developed a Cyclops lesion. While researching a little more about failed ACL reconstructions, I found the attached article that discussed the multifactorial nature of patients with persistent instability, pain, or stiffness following ACLR.
I’m curious to know what you are looking for subjectively and objectively with your post-ACLR patients when determining whether to accelerate their protocol and when to hold them back. Also, at what point would you be considering sending them back to their surgeon?
Looking forward to seeing everyone (again) this weekend!
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Hey Tyler, a lot of questions come to mind with post ACL patients. I think it’s important to consider graft type (allograft, autograft), is this a revision or primary ACL reconstruction? how long after their injury did they wait to have surgery and were there associated injuries (meniscus, MCL, LCL, PCL, PLC)? Have they had prior injuries to the knee? I like to see them get full extension pretty quickly over the first month, while managing edema and pain levels to help facilitate quad. If they are not getting full extension, then I really start to question why and may give the doctor a call (is it associated with high pain levels? how is patellar mobility? edema?). Just curious – what type of graft did he have? The last pediatric ACLR I treated was a iliotibial band autograft.
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