16-Year Old Severe PCL Knee Sprain Corrected with Bone Marrow Aspirate

Abstract

This case report describes the successful treatment of a 16-year-old male basketball player with chronic instability and pain in his left knee following a grade 3 posterior cruciate ligament (PCL) sprain sustained during a trampoline accident. Initial conservative management and subsequent complete healing of the PCL did not alleviate the patient's symptoms of knee instability. After thorough evaluation, including physical exam, ultrasound, and MRI review, the patient opted for an unconventional treatment approach involving whole bone marrow aspiration and prolotherapy-based injections into multiple knee structures. The treatment protocol included injections into the PCL, quadriceps tendon, patellar tendon, patellofemoral ligaments, menisci, and Hoffa’s fat pad under ultrasound and X-ray guidance. This was followed by a regimen that included platelet-rich plasma (PRP) injections, high-dose vitamin C infusions, and adjunctive therapies such as red-light therapy and pulsed electromagnetic field therapy. The patient underwent six weeks of intensive physical therapy focusing on muscle strengthening and neuromuscular re-education. Within 2.5 months post-treatment, the patient demonstrated full stability of the knee without pain or swelling, allowing a return to basketball activities. Subsequent follow-ups at six months and one year revealed sustained improvement with no recurrence of symptoms, enabling unrestricted participation in competitive basketball. This case highlights the successful utilization of comprehensive regenerative medicine techniques and rehabilitation strategies in resolving chronic knee instability and facilitating return to sport in a young athlete.