HISTORY: A 16-year-old, amateur female basketball player sustained a non-contact injury on her left knee during a game (sudden cutting movement combined with a dynamic valgus collapse).
PHYSICAL EXAMINATION: The acute clinical examination (signs of swelling, tenderness, or instability) did not indicate any signs of an anterior cruciate ligament (ACL) tear. Three days later, a magnetic resonance imaging (MRI) revealed a complete ACL tear. The orthopedic doctor recommended reconstructive surgery, and subsequent KT-2000 arthrometer tests revealed an anterior tibial translation (ATT) consistent with an 80% tear of the ACL. However, the player opted to seek a second opinion and consulted another orthopedic doctor ten days later. He conducted a new MRI revealing a partial ACL tear, and another KT-2000 test indicating a 20% tear.
- Complete ACL tear
- Partial ACL tear
- Meniscus tear, collateral ligament injury, patellar dislocation
- Knee osteoarthritis/bursitis
TEST AND RESULTS:
- Clinical examination: No signs of ACL tear of the left knee
- MRI (initial): Complete ACL tear
- KT-2000 (initial): 80% ACL tear
- MRI (second): Partial ACL tear
- KT-2000 (second): 20% ACL tear
FINAL / WORKING DIAGNOSIS:
Partial ACL tear of the left knee
TREATMENT AND OUTCOMES:
- 6-month abstinence from basketball for conservative treatment
- Clinical guidance from trainer and sports medicine doctor for identified risk factors: anterior-posterior knee laxity, narrow notch (<17mm), impaired hamstring ability, and gluteus maximus fatigue
- During first game back, player injured right knee (complete ACL tear) due to dynamic knee valgus while protecting left knee
- ACL surgery of the right knee followed by 8 months off court
- Perform strengthening/proprioception exercises 3 times a week on both knees
Stillwell, Koree; Gravvanis, Nikolaos; Hayes, Brett; and Stamatis, Andreas FACSM
"Bilateral ACL Tear — Basketball,"
International Journal of Exercise Science: Conference Proceedings: Vol. 15:
2, Article 6.
Available at: https://digitalcommons.wku.edu/ijesab/vol15/iss2/6