Keywords
Health Care Competency, Disablement Model Case Study
Abstract
This case examines a 19-year-old female Division I collegiate soccer player who underwent anterior cruciate ligament (ACL) reconstruction with medial and lateral meniscal repairs. Though meniscal tears often occur in conjunction with ACL injury, incidence of concurrent medial and lateral tears with presence of a displaced bucket-handle lesion is rare. This patient attempted to tackle an oncoming opponent in which contact caused forceful trunk rotation away from her planted right foot. Sideline evaluation revealed medial and posterior knee pain with active knee range of motion deficits. Further evaluation revealed apprehension and muscle guarding during Lachman’s, anterior drawer, and valgus stress tests. Immediate care consisted of immobilization and referral to the team physician. Upon evaluation, an MRI was prescribed which revealed a severe grade 2 ACL sprain with anterior tibial translation, displaced bucket-handle tear of the lateral meniscus, and a curvilinear non-displaced tear of the medial meniscus. Five days later, the patient underwent arthroscopic ACL reconstruction with a bone-patellar tendon-bone autograft and repairs to the lateral and medial menisci. Due to the displaced meniscus, the patient was unable to regain range of motion (ROM) through rehabilitation prior to surgery. During the initial stages of rehabilitation, the patient showed apprehension to pain and difficulty exhibiting intrinsic motivation, which led to a delay in regaining ROM. Consequently, the sports medicine team utilized feedback from patient outcome measures and adjusted the traditional rehabilitation program and implemented strategies to build trust, develop mental resilience, and provide extrinsic motivation. Following these concentrated efforts, the patient showed improved knee flexion and was able to avoid a second surgery. For cases in which pre-surgical rehabilitation efforts are limited, it’s important that clinicians identify their patient’s intrinsic and extrinsic challenges early during post-surgical rehabilitation, so that targeted strategies can be implemented and patient centered care is prioritized.
Recommended Citation
Perry, Rebecca L.; Alicea, Angelica; Welch, Jeanette; White, Carl; Hildebrand, Emily E.; and Lisman, Peter
(2025)
"Concurrent ACL and Medial/Lateral Meniscal Repair in a Collegiate Soccer Player: Disablement Model Case Study,"
Clinical Practice in Athletic Training: Vol. 8:
Iss.
2, Article 7.
Available at:
https://scholars.indianastate.edu/clinat/vol8/iss2/7
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