title: Criteria-based management of an acute multistructure knee injury in a professional football player: a case report.
abstract: METHODS
  Case report.
  
  
  BACKGROUND
  Joint stiffness, also called arthrofibrosis, remains the primary complication following any reconstructive knee surgery. Acute anterior cruciate ligament surgery, performed with concomitant multiple ligamentous repair and/or reconstruction, further increases the likelihood of developing impaired knee motion following surgery. The purpose of this case report is to present a criteria-based approach to the postoperative management of a multiligament knee injury.
  
  
  METHODS
  A 25-year-old male professional football player sustained a contact injury to his right knee while making a tackle during a regular season game in 2007. He underwent an acute anterior cruciate ligament reconstruction, with concomitant posterolateral corner repair, biceps femoris/iliotibial band repair, lateral collateral ligament repair, and a medial meniscocapsular junction repair. He completed 17 weeks of a multiphased rehabilitation program that emphasized immediate range of motion, low-load long-duration stretching, therapeutic exercise, neuromuscular reeducation/perturbation training, plyometrics, and sport-specific functional drills. Electrical neurostimulation was implemented during the early stages of rehabilitation to control postoperative pain and to promote a steady progression of therapeutic exercise activity.
  
  
  RESULTS
  The patient was cleared to begin sport-specific activity 7 months after major multistructure reconstructive knee surgery. He began the 2008 season on the physically-unable-to-perform list, but was activated midseason and played in every game thereafter. During the 2009 and 2010 seasons, he played all regular season games and all playoff games as a starter, and continues to start as a defensive cornerback in the National Football League.
  
  
  CONCLUSIONS
  This case report highlights the clinical decision-making process and management involved in an acute multiple ligamentous knee injury/reconstruction.
  
  
  METHODS
  Therapy, level 4.
authors: A J
authors: AJ
authors: Yenchak
authors: Kevin E
authors: KE
authors: Wilk
authors: Christopher A
authors: CA
authors: Arrigo
authors: Charles D
authors: CD
authors: Simpson
authors: James R
authors: JR
authors: Andrews
mesh_terms: D000208:Acute Disease; D000328:Adult; D016118:Anterior Cruciate Ligament / Q000503:physiopathology / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods / Q000534:rehabilitation*; D017885:Collateral Ligaments / Q000293:injuries / Q000503:physiopathology / Q000601:surgery; D005081:Exercise Therapy / Q000379:methods*; D005538:Football / Q000293:injuries*; D006801:Humans; D007593:Joint Instability / Q000534:rehabilitation / Q000601:surgery; D007718:Knee Injuries / Q000534:rehabilitation* / Q000601:surgery; D008297:Male; D016059:Range of Motion, Articular; D012720:Severity of Illness Index; D016896:Treatment Outcome