Multifactorial physiotherapy and dynamic modeling of femoral head in post-contusion femoroacetabular impingement of knee joint (case report)

BACKGROUND: The growing number of patients requiring restoration of ligament function in the knee joint due to sports injuries highlights the relevance of developing non-pharmacological rehabilitation methods. The clinical profile of the patient (young age, complicated course of an unconfirmed sports-related injury), as well as the broader objective of improving national health and quality of life, underscore the relevance of systemic analysis in the training of medical personnel within the framework of professional development and scientific research on sports testing methodologies.

AIM: The work aimed to evaluate the efficiency of multifactorial physiotherapy (phonophoresis and optical irradiation) and physical exercises for dynamic modeling of knee joint structures and resolution of bone marrow edema of the medial femoral condyle, as detected by magnetic resonance imaging in a young football player.

METHODS: A case is described involving a 19-year-old male football player presenting with risk of aseptic necrosis of the femoral head, structural ligamentous changes in the knee joint, and joint effusion. The patient experienced sudden severe knee pain and inability to bear weight during intensive training. Assessment criteria were used to monitor outcomes before and after implementation of a personalized rehabilitation model.

RESULTS: New data were obtained on the combined use of four simultaneous modalities (therapeutic exercise, ultrasound and the Artra chondroprotector via phonophoresis, red and infrared spectra of non-coherent optical irradiation), which led to pain relief on the visual analog scale without pharmacological agents, resolution of bone marrow edema by day 7 of treatment, and full return to athletic activity within 3 months. Emphasis was placed on the stepwise application of autogravitational and post-isometric relaxation exercises in the developed multimodal rehabilitation protocol.

CONCLUSION: The integration of customized physical exercises and concurrent application of four physiotherapeutic factors constitutes a highly effective adaptive regimen. When initiated during the acute phase, it enhances clinical outcomes and reduces the risk of developing femoral head aseptic necrosis.