ACL TEAR

Made By
Rashmi Jain
A1106616090
Subjective Information
Demographic details:
Name: Shilpi Yadav
Age: 30 years

Gender: Female
Occupation: Housewife
IP No.- P233623
Chief complaint: Patient feels pain and weakness in the
left leg while walking
History:
 Present History: Patient experienced pain and weakness
in left leg.
 Past History: History of road traffic accident on Nov’
2020 (2-3 months back). Patient had twisting of knee
while falling. Patient had complete ACL tear as per MRI
readings. Conservative treatment such as medication and
bracing was advised to the patient for few weeks.
 Medical History: N/A
 Surgical History: History of lower section caesarean
section 6 years back
 History of Abortion in 2018 and March 2020
Medications: Vitamin sachet
 Tab. Covalium D3
 Tab. Signoflam

Pain history
 Onset: sudden
 Site: Medial side of knee

Aggravating factor: prolonged walking

Relieving factor: rest
NPRS: 6
Objective Information
Observation-
 Body build: Mesomorphic
 Oedema: Absent
 Any scar: Absent
 Gait: Limping gait
 Deformities: Absent
 Posture: Mild flexion of knee

On palpation:
 Tenderness: Present over medial side of knee
 Temperature of skin: Normal
On examination
 Range of motion:

Joint Movement left right

knee Flexion 0-133 0-135

extension 133-0 135-0

 Manual muscle testing:

Joint Muscle groups Grade (left) Grade (right)

knee flexors 3+/5 4/5

extensors 3+/5 4/5
Investigations – MRI suggestive of suspicious
subchondral fracture of tibial plateau with total ACL
tear.(Nov’ 20)
Special tests-
 Lachman test – Positive
 Mc Murray test - Negative
 Valgus/varus stress test - Negative

Provisional diagnosis- Left ACL tear

Treatment-
Short term goal: To reduce pain
 
Long term goal: To strengthen muscles
To be able to do ADLs
Electrotherapy Modalities:
 Hot pack x left knee x 15 minutes
 IFT x Classical Interferential x left knee x 15.8 mA x
80 Hz x 15 minutes
Exercise programme:
Ankle toe pumps x 10 repetitions
Isometric Quadriceps exercise x 10 repetitions
Vastus Medialis Oblique exercise x 10 repetitions
SLR x 10 repetitions
Dynamic Quads x 10 repetitions
 
After 2 days
Hamstring curls x 10 repetitions
Prone SLR x 10 repetitions
Side SLR x 10 repetitions
Isometric Quadriceps exercise x 1 kg weight x 10 repetitions
Vastus Medialis Oblique exercise x 1 kg weight x 7 repetitions
SLR x 1 kg weight x 7 repetitions
Dynamic Quads x 1 kg wt. x 7 repetitions

Next Week
Chief Complaint: Pain is reduced in the left knee and is able
to perform some ADLs without any problem.
Observation and Palpation:
Gait: Normal
Oedema: Absent
Tenderness: Mild
Temperature: Normal
NPRS: 4
ROM: Within normal limits
Examination:
MMT: Knee Flexors 4 -/5
Extensors 4/5
PT Advice:
Isometric Quadriceps exercise x 2 kg weight x 10
repetitions
Vastus Medialis Oblique exercise x 2 kg weight x 10
repetitions
SLR x 2 kg weight x 10 repetitions
Dynamic Quads x 1 kg weight x 10 repetitions
Addition of Exercises
Hamstring curls x 1 kg weight x 10 repetitions
Prone SLR x 1 kg weight x 10 repetitions
Side SLR x 1kg wt. x 10 repetitions

After 2 days
Continuation of above exercises
Partial lunges x 10 repetitions
Wobble board exercises (lateral and anterior
direction) with support
Step ups and step downs x 10 repetitions
Wall slides x 10 repetitions
Next week
Observation and Palpation:
 Gait: Normal
 Oedema: Absent
 Tenderness: Absent
 Temperature: Normal

NPRS: 2
 Examination:
MMT: Knee Flexors 4/5
Extensors 4/5
PT Advice:
Hamstring curls x 2 kg x 10 repetitions
Dynamic Quadriceps x 2kg x 5-7 repetitions
Prone SLR x 2kg x 5 repetitions
Side SLR x 2kg x 7 repetitions
Wall slides x 15 repetitions
Single leg standing(with support)
Step ups and step downs x 15 reps
Static cycling
 
THANK YOU