I had an anterior cruciate ligament reconstruction four weeks ago, and now my question is, how harmful is it if the Lachman test is done four weeks after surgery?
Nick
Mark Chen, physiotherapist
Hey Nick,
Hopefully your surgery went well and you are on your way to rebuilding your agility and strength! To answer your question directly:
I see no good reason to have the Lachman test done during that period and it could indeed be harmful.
First of all, if all goes well, the reconstruction has gone well if the orthopedist has reported nothing special after the operation. If there are any doubts, I would discuss them with your therapist and orthopedist before attempting a clinical test of the cruciate ligament.
After four weeks, the knee may still be quite tender and a large percentage of patients still have fluid in the knee. Even if it is not visible from the outside, it may still be present in excess in the joint and this affects the reliability of the test. And this while the test in itself does not provide reliable information about how the cruciate ligament is doing.
But here’s the main reason I wouldn’t have it done: Assuming you’ve had a classic ACL reconstruction, the new ligament is secured with a dissolvable screw. This screw holds the new ligament in place in the bone until your body makes new bone to “grow” with it. At four weeks this is not yet the case and pulling forces on this “anchor” could cause irritations or problems. In short, the value you can get from the test is simply not worth the risks.
I hope this helps, if you have any other questions, don’t hesitate to send them in!
Good luck with your rehabilitation.
Mark
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Mark Chen is a physiotherapist and NASM trained personal trainer. Since August 2014 he has been working in Phnom Penh, Cambodia. His expertise lies in analyzing and optimizing movement patterns. Dry needling and medical taping are an important part of his vision and training predominates.
