Work

Non‐Operative Management of a Complete ACL Rupture With the Cross‐Bracing Protocol in an Elite Australian Rules Football Athlete

Year: 2026

Type: article

Abstract: Anterior cruciate ligament (ACL) injuries are traditionally managed with surgical reconstruction, but the ACL's healing capacity continues to be explored. Non-operative management strategies have emerged as viable alternatives for ACL-injured patients either via rehabilitation alone or approaches like the Cross-Bracing Protocol (CBP). We report the case of a female Australian rules football (AFL) athlete with a complete ACL rupture sustained through a non-contact hyperextension mechanism. The athlete was treated with the 12-week CBP, and the serial MRI examinations at 3-, 6-, 12-, and 36-month post-injury are presented, demonstrating progression from a complete ACL rupture to a contiguous ACL with normal thickness, volume, trajectory, and signal intensity. Patient-reported outcome measures (PROMS) were collected at 3-, 6-, 12-, and 36-month post-injury. The athlete successfully returned to elite-level AFL sport one year post-injury and reported no re-rupture at 3 years post-injury. This case demonstrates the potential utility of the CBP to restore normal ACL anatomy and result in stability of the knee following non-surgical management.

Source: Clinical Case Reports

DOI: 10.1002/ccr3.72818

Authors: Keiley Mead, Matthew Dowsett, Zoe Cass, Stephanie Filbay

Institutions: The University of Sydney, University of Cambridge, Addenbrooke's Hospital, The University of Melbourne

Language: English

Topic: Knee injuries and reconstruction techniques

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,820