Re: Torn Anterior Cruicate Ligament

[Guest guest]

I tore my ACL (70+%) about 20 years ago playing soccer as well. At that time,

the science was nowhere what it is now and my family and I made the decision

not to undergo any surgery. If your cousin wants to play at scholarship

level he's going to probably need surgical intervention since his knee

stability will be greatly decreased and he will constantly " nurse " his

knee for fear that it will happen again.

I recently went for a knee consult (20 years post injury during which time,

I've run fairly consistently and strength trained the knee at least 2x

weekly) and the ortho introduced me to the concept of a cadeavor tendon to

replace my existing torn ACL. He also showed me a clear screw that could be

used to attach the cadeavor to the existing ACL that disintegrates after

about a year post surgery. He also assured me about a 96% chance that I

would regain most of my stability without decreasing ROM. I'm going to wait

out the summer and then re-evaluate but this option is a heck of a lot better

than what was available 20 years ago.

Len Glassman

Personal Best Fitness & Wellness Studio

Garwood New Jersey

[Guest guest]

Hi Stuart!

About 30% of the population can function pretty well without an

anterior cruciate ligament (ACL). If your relative is among this minor

percantage of the population then he should work hard on rehab and see

how it goes. However if he continues to have instability problems as

most people in high demand activities such as soccer do, then he will

have to have his ACL reconstructed surgically. He should avail

himself of a competent sports othopaedic surgeon for futher advice.

Good luck!

Dan Wathen,

Youngstown (OH) State University

In Supertraining , " Stuart Wadley " <wadley@s...>

wrote:

> Dear Members

>

> Could you please give me some advice for my cousin. He is 22 years

old and has torn his anterior cruciate ligament while playing soccer.

>

> The doctor initially thought that the injury was damage to the

meniscus but upon exploratory surgery it was found that there was no

such damage and it was just a tear in the anterior cruciate ligament.

No action was therefore taken at that time.

>

> He is now awaiting the decision of the doctor as to what the next

course of action should be. He plays in midfield and has no previous

injuries. He has been offered a scholarship to play soccer in the USA

in September so is obviously desperate to get fit again as soon as

possible.

>

> Any advice from the members would be gratefully accepted. He wants

to be armed with as much information as possible so I told him I knew

some people who might be able to help.

>

> Many thanks

>

> Stuart Wadley

> Shetland, Scotland

[Guest guest]

Dan,

> 30% of the population can function pretty well without an ACL? <

I'm not sure how specific you were being, but a young athlete with a torn

ACL returning to a sport like soccer has a very low chance of success

without surgical intervention. As far as I am aware, the only studies looking

at this have shown that there are very strict inclusion criteria for non

operative rehab and even then, returning to a sport like soccer would be

very difficult. There are a few studies that have looked at very small

numbers of athletes who have returned to sport, but nothing I have seen would

lead me to consider there is any realistic chance of a high % of athletes

returning without an op ?

I may be wrong, please let me know? Where did you get the 30% from?

Kind regards

Steve Aspinall BSc (Hons) GSR

City Physio Sports Medicine

Manchester UK

[Guest guest]

Hi!

The ACL is not the only structure that provides stability. A lot of

people have torn ACL`s and don’t know it because of no adverse

effects on daily activities - including sports.

If he has a sense of " giving way " in his knee, surgery is necessary.

If he has the feeling that his knee is " unstable " and he doesn’t

trust it completely ,one should consider surgery.

Rehabilitation should focus on proprioceptive exercises and muscular

endurance-see the following article:

http://www.ptjournal.org/Feb00/public/v80n2p128-abs.cfm

The discussion by the 3 American PT- " Gurus " gives a lot of additional

information. I can send you both full-text articles if you like.

Bye

Matthias Weinberger

Physical Therapist

Regensburg, Germany

> Dear Members

>

> Could you please give me some advice for my cousin. He is 22 years

old and has torn his anterior cruciate ligament while playing soccer.

>

> The doctor initially thought that the injury was damage to the

meniscus but upon exploratory surgery it was found that there was no

such damage and it was just a tear in the anterior cruciate ligament.

No action was therefore taken at that time.

>

> He is now awaiting the decision of the doctor as to what the next

course of action should be. He plays in midfield and has no previous

injuries. He has been offered a scholarship to play soccer in the USA

in September so is obviously desperate to get fit again as soon as

possible.

>

> Any advice from the members would be gratefully accepted. He wants

to be armed with as much information as possible so I told him I knew

some people who might be able to help.

>

> Many thanks

>

> Stuart Wadley

> Shetland, Scotland

[Guest guest]

Why would you want to use a cadaver graph instead of a hamstring or

patellar tendon graph? There are more complications associated with using

a cadaver graph.

Trevor Cottrell

Kingston, ON

At 09:56 PM 5/18/2003 -0400, you wrote:

>I recently went for a knee consult (20 years post injury during which time,

>I've run fairly consistently and strength trained the knee at least 2x

>weekly) and the ortho introduced me to the concept of a cadeavor tendon to

>replace my existing torn ACL.

[Guest guest]

Hi Steve!

The figure of 30% which I quoted, is from a study by Dr. Noyes

which appeared in the Journal of Bone and Joint Surgery 65A:163-174.

1983. Dr. Noyes gave figures up to 60% in one series of patients who

were able to function pretty well with rehab alone.

I concur with your and others statements concerning having a

reconstructive procedure done on young athletes in high demand sports.

We generally reserve conservative care for those at the end of their

playing careers who will lose their last year of playing eligibility

if surgery is performed. I would advise any athlete who is at the

initial stages of his college career to have the procedure done. No

matter if the figure is 10, 20, 30, or even 70% for conservative care

the odds are better with surgical intervention.

Best wishes!

Dan Wathen,

Youngstown State University

In Supertraining , " Steve Aspinall "

<aspinallsteve@h...> wrote:

> Dan,

>

> > 30% of the population can function pretty well without an ACL? <

>

> I'm not sure how specific you were being, but a young athlete with a

torn

> ACL returning to a sport like soccer has a very low chance of

success

> without surgical intervention. As far as I am aware, the only

studies looking

> at this have shown that there are very strict inclusion criteria for

non

> operative rehab and even then, returning to a sport like soccer

would be

> very difficult. There are a few studies that have looked at very

small

> numbers of athletes who have returned to sport, but nothing I have

seen would

> lead me to consider there is any realistic chance of a high % of

athletes

> returning without an op ?

>

> I may be wrong, please let me know? Where did you get the 30% from?

>

> Kind regards

>

> Steve Aspinall BSc (Hons) GSR

> City Physio Sports Medicine

> Manchester UK

[Guest guest]

But Hines Ward is very much the exception rather than the rule. He is a superb

athlete, not to say that the gentleman with the ACL injury in question is not a

fine athlete himself. Hines Ward also has a very extensive staff of highly

qualified and paid medical personnel taking care of him. It is also his job to

be an all-pro wide receiver, even without an ACL.

Furthermore soccer is a completely different sport that American Football in

many ways, not least that fact that tackling occurs a majority of the time below

the knee, therefore placing most of the force absorption duties on the soft

tissues of the knee and ankle joints.

As a former college soccer player and recipient of a patella tendon graph for a

ruptured ACL over 12 years ago, my opinion for this young man is to seek medical

evaluation from an orthopedic specialist preferably one who only deals with the

knee joint and who performs this surgical procedure.

Good luck and be sure to keep us all informed of the outcome and his

rehabilitation.

Condron

NY,NY,USA

[Guest guest]

But Hines Ward is very much the exception rather than the rule. He is a superb

athlete, not to say that the gentleman with the ACL injury in question is not a

fine athlete himself. Hines Ward also has a very extensive staff of highly

qualified and paid medical personnel taking care of him. It is also his job to

be an all-pro wide receiver, even without an ACL.

Furthermore soccer is a completely different sport that American Football in

many ways, not least that fact that tackling occurs a majority of the time below

the knee, therefore placing most of the force absorption duties on the soft

tissues of the knee and ankle joints.

As a former college soccer player and recipient of a patella tendon graph for a

ruptured ACL over 12 years ago, my opinion for this young man is to seek medical

evaluation from an orthopedic specialist preferably one who only deals with the

knee joint and who performs this surgical procedure.

Good luck and be sure to keep us all informed of the outcome and his

rehabilitation.

Condron

NY,NY,USA