An Athlete’s Worst Nightmare: Tearing the ACL
By Ty Endean, D.O.
Bryce was playing the game of his life in his senior season…his team was winning in the fourth quarter when he ran across the middle of the field catching a pass only to be hit hard by the safety and the cornerback. He made the catch but something was just not right in his leg. As he fell to the ground he felt a “pop” and had a giving way sensation. While laying on the field and being attended to by the trainers, his college scholarship opportunities ran through his mind. “Will Rutgers still offer me my scholarship? Will Michigan honor their offer of a scholarship?” He came off the field with the assistance of the trainers only to be told by the team doctor that he felt he had torn his ACL.
The ACL or anterior cruciate ligament is one of four ligaments in the knee. These ligaments work together to stabilize the knee. Unfortunately, tears of the ACL are common with twisting activities (skiing, basketball, and soccer) and direct blow injuries (football, rugby and wrestling). When athletes tear their ACL it is usually a sudden event and it has no significant capability of healing, thus the ligament function is lost, an athlete’s worst nightmare.
Most people with a torn ACL will experience instability, which will usually lead to additional damage. Most athletes with a torn ACL are unwilling to give up their sporting activities and also have a strong desire to prevent further damage. Therefore, most athletes elect to “reconstruct” their ACL.
Patients must choose between using an auto graft (tissue taken from one’s own body) or allograft (cadaver tissue) for the procedure. Drawbacks to auto graft use are that it causes additional damage to the knee and takes a long time to heal. The donor site can become a source of pain, scarring, weakness, and can even permanently reduce motion.
Allografts are advantageous because they do not cause additional damage to the knee and stronger grafts can be used. Donors are screened extensively by tissue banks and are tested for bacteria, fungus and infectious diseases. However, there is a slight risk of disease transmission through allografts. Current sterilization technology is available to avoid these risks.
Using sterilized tissues for your procedure is a good way to assure the safest, quickest recovery process possible. One example is the Clearant Process, a unique sterilization method that safely inactivates bacteria and viruses to virtually eliminate the risk of infection while preserving functional viability of the graft.
As an orthopedic surgeon who specializes in ACL reconstruction, I encourage you to ask your treating physician several questions: What are my treatment options? What are my graft choices? If you choose allograft where do you get your tissues from? Do you use sterilized tissue? How often do you treat ACL injuries? What is your complication rate? (Less than 5% is industry standards) Are you fellowship trained in arthroscopic procedures? When can I return to play?#
Ty Endean, D.O., Orthopedic Surgeon, Sports Institute of Tucson serves as the team physician for the Arizona Heat, a professional female fast pitch league, and as a medical consultant for the United States Rugby Team. He also treats both high school and professional athletes, in his Tucson-based practice.
