Background: Anterior cruciate ligament injury is among the most common presentation amongst young adults, frequently associated with meniscal tears that also present with pain, instability, and functional loss of the knee. These are complex knee injuries consisting of the rupture of the ACL combined with medial and lateral meniscus tears. Surgical reconstruction should be followed by a structured physiotherapy rehabilitation to restore the knee's stability and function.

Aim: To assess the impact of a structured physiotherapy rehabilitation intervention on the following parameters: pain; range of motion; muscular strength; balance; gait; and overall function for a younger female with obesity following arthroscopic reconstruction of the ACL and repair of medial and lateral meniscus.

Case Presentation: A 19-year-old female complained of right knee pain/instability, which began during a twisting injury. MRI examination revealed a full-thickness ACL tear along with tears in the medial and lateral menisci. The right knee arthroscopic ACL reconstruction followed by arthroscopic surgery to treat the torn meniscus in the knee was carried out on the obese female. After surgery, the patient complained about the pain in the knee, generalized swelling, inability to extend her knee freely, quadriceps inhibition, reduced muscle strength in her lower limbs, impaired balance, and painful gait/weight-bearing movements.

Intervention: The patient underwent a structured, criterion-based postoperative physiotherapy rehabilitation program focusing on pain and edema management, gradual restoration of knee range of motion, and progressive strengthening of the quadriceps, hamstrings, and hip musculature. Recent physiotherapy advances, including neuromuscular electrical stimulation for early quadriceps activation, low-load progressive resistance training, blood flow restriction training, and neuromuscular and proprioceptive exercises, were incorporated in accordance with current evidence. Gait re-education and functional task progression were guided using patient-reported and performance-based outcome measures, as recommended in recent rehabilitation consensus and clinical trials.

Outcomes: After rehabilitation, the patient showed considerable improvement in IKDC Subjective Evaluation, KOOS Score, Lysholm Knee score, Tegner Activity Scale, Dynamic Gait Index, POMA, LEFS, NPRS, Single leg stance and timed up and go test in aspects such as reduction of pain, normal extension of the knee, improvement in knee flexion, improvement in muscle power, improvement in balancing skills, normalization of gait, and improvement in performance. There was marked improvement in aspects of patient-perceived outcome measures for knee function.

Results: The patient demonstrated significant improvement on all outcome measures with reductions in pain and improved levels of mobility and independence when engaged in daily activities.