Rehabilitation of Tibial Plateau Fracture Following Anterior Cruciate Ligament Reconstruction: A Case Report

Objective: The purpose of this case report was to describe the management of a tibial plateau fracture in a patient who had undergone anterior cruciate ligament (ACL) reconstruction 3.5 years earlier. Clinical Features: A 36-year-old man presented with pain and edema following a fall from a height of approximately 2 m while skateboarding. The patient reported having undergone arthroscopic ACL reconstruction with allograft and bioabsorbable screws 3.5 years earlier. Computed tomography scan revealed a comminuted fracture extending through the graft tunnel, as well as evidence of tunnel widening and incomplete bone resorption and generation within the tibial tunnel. Intervention and Outcome: A trauma surgeon repaired the plateau fracture with internal fixation. The patient was non-weight bearing for 8 weeks while undergoing rehabilitation in a chiropractic clinic (spinal manipulation, physiotherapy, nutritional support) twice per week and returned to full activity within 3 months. Conclusions: The patient responded favorably to the treatment protocol, which included rehabilitation by a doctor of chiropractic and co-management with a trauma surgeon.