Anterior Cruciate Ligament Reconstruction of a College Student with a Prosthetic Limb: A Disablement Model Case Study


  • Scott Lawrance Purdue University
  • Sara Zilvetti Purdue University
  • Amanda Young Purdue University
  • Jeff Stein Purdue University



ACL, BKA, Prosthetic Limb


This case examines a 19-year-old male college student with a left anterior cruciate ligament reconstruction (ACLR) secondary to a motor vehicle accident (MVA). The accident caused numerous severe injuries to both lower limbs including untreatable right lower leg injuries, leading to a right below knee amputation, and a left ACL tear. Before the accident, the patient was a varsity cross country and track athlete expecting to continue in college. Six weeks following surgical reconstruction, the patient reported to the rehabilitation clinic for standard ACLR rehabilitation practices including lower leg and proximal hip strengthening, attaining full knee ROM, and balance exercises. Gait training was essential due to an antalgic gait and complicated by the presence of the right leg prosthesis. He progressed as expected with balance and strengthening exercises; but progress was inhibited by many factors including global left knee swelling, his inability to achieve or maintain full left knee extension ROM, intense end-range pain with left knee extension, and a leg length discrepancy (LLD) between his remaining limb and daily prosthesis. Psychological factors from rehabilitation fatigue may have hindered progress and contributed to higher pain sensations and frustration levels. Four months after surgery, the patient was showing improvement in pain reduction and extension ROM, but care was discontinued secondary to the COVID-19 global pandemic when the patient declined to continue formal rehabilitation in an online format. One year post ACLR the patient achieved normative scores for the LEFS and IKDC. This case exhibits the impact of a prosthetic limb on the overall healing time of a patient and highlights how factors that can be easily overlooked such as LLDs, psychological stressors, and kinetic chain disruptions can greatly impact a patient's rehabilitation. By looking holistically at our patients, we can make connections to improve the patient’s rehabilitation and healing.

Author Biographies

Sara Zilvetti, Purdue University

Sara is a senior at Purdue University and a candidate for a Bachelor of Science degree in Health and Kinesiology with a major in Athletic Training.  Her future interests include pursuing advanced professional school education to provide rehabilitation services to a variety of orthopedic patients.

Amanda Young, Purdue University

Dr. Amanda Young has been a physical therapist at Purdue University Student Hospital since the fall of 2014 where she specializes in orthopedic and sport-specific conditions.  A MDT Certified therapist, Dr. Young graduated from Indiana University with her Doctorate of Physical Therapy degree and from Purdue University with a Bachelor of Science degree in Movement and Sports Science.

Jeff Stein, Purdue University

Dr. Jeff Stein is a physical therapist and athletic trainer currently serving as the Director of Physical Therapy at Purdue University Student Hospital since May 2015.  He has extensive experience providing rehabilitation services to collegiate and professional athletes.  Dr. Stein graduated from Northwestern University with his Doctor of Physical Therapy degree, Illinois State University with a Master of Science in Athletic Training and from Illinois Wesleyan University with a Bachelor of Arts degree in Biology.






Disablement Model Case Study