Knee instability after ACL surgery

✅ Clinical Case:

Knee instability after ACL surgery

Patient: Male, 25 years old, amateur football player in 3rd division

History:

Anterior cruciate ligament (ACL) reconstruction 2 years ago using hamstring graft (semitendinosus and semimembranosus). Rehabilitation included insurance-covered therapy, private physiotherapy, and personal training.

🤕 Persistent symptoms

• Sensation of instability and overload after training or matches

• Episodes of swelling, joint warmth, and mild numbness in the operated knee

• Recovery after 2–3 days of rest, but persistent feeling that the knee is “not completely right”

🔎 Clinical and neuromuscular evaluation

• Orthopedic knee stability tests: negative (knee stable)

• Graft harvest site (hamstrings) with reduced sensitivity and local discomfort

• Applied kinesiology test: marked weakness in hamstring muscles on the operated side, although general strength appeared normal

💡 Specific treatment

• High-power laser therapy (15W) applied to the graft scar during 4 sessions

• Result: full recovery of adaptive muscle strength in the affected muscle group

⚽️ Functional outcome

• Patient returned to regular training and competition

• No pain, no overload, and no subjective instability after exertion

🧠 Conclusion

In ACL surgery cases, persistent symptoms may not be related to the joint itself but rather to scars affecting muscle function. Advanced neuromuscular assessment and treatments such as high-power laser therapy can make a decisive difference in the complete recovery of athletes.