Use of knee extension device during rehabilitation for Type 3 Arthrofibrosis after ACL Reconstruction: Case Report

North American Journal of Sports Physical Therapy, Aug 2006, Vol 1, No 3

Study Design: Case report

Background: Arthrofibrosis is a frequent complication following anterior cruciate ligament ( ACL ) reconstruction. While prevention is the best form of treatment there is little information within the literature outlining the treatment of patients with arthrofibrosis and even less regarding the rehabilitation intervention. In this case report we describe a perioperative rehabilitation program in the management of a patient with arthrofibrosis.

Case Description: The patient was an 18-year-old female who sustained an ACL and medial collateral ligament ( MCL ) injury in a basketball game and underwent an ACL reconstruction with an ipsilateral patellar tendon graft. The patient developed arthrofibrosis and despite traditional physical therapy of therapeutic exercise and manual therapy, the patient continued to complain of pain, stiffness, limited activities of daily living and the inability to participate in competitive sports. This patient used a knee extension device as part of her perioperative rehabilitation program.

Outcomes: The patient was able to obtain knee extension and flexion equal to her opposite normal knee. Upon completion of the rehabilitation program, she returned to full activities of daily living and competitive sports.

Discussion: Increasing and maintaining knee extension that is equal to the opposite normal knee is an important component in the successful outcome after ACL reconstruction. The use of a knee extension device may provide an effective rehabilitation intervention in the treatment of arthrofibrosis.