The quarterback for the St. Louis Rams, Sam Bradford, tore his Anterior Cruciate Ligament (ACL) this past weekend, ending his current season. Unfortunately, ACL tears are a common injury in sports like football that have significant pivoting and change of direction as part of the game. They can occur as part of a traumatic injury (where the knee is put in an unnatural position and the ligament tears due to excessive force applied to the knee) or as part of a non-contact pivoting injury, which is actually the most common mechanism of injury.
Sam Bradford’s injury means his season is over because his injured knee will not be able to withstand the stress upon it during attempts at change of direction. The ACL is the main stabilizer in keeping the lower part of the leg (the tibia) from not excessively moving forward and rotating from the thigh bone (the femur).
Often, ACL injuries occur at the same time as other injuries – such as other ligament tears, meniscal tears and cartilage injuries. If other injuries are sustained, the surgery required will be more complex. Meniscus tears, if possible, should be treated with repair rather than simply removing the damaged tissue to allow the meniscus to perform its job which is to act as a cushioning between the shin bone (the tibia) and the thigh bone (the femur). This allows the cartilage to see less stress and have a lower chance of injury over time.
There are many choices of graft alternatives for reconstructing an ACL. One can decide to use a patient’s own hamstring or patellar tendon. There are pros and cons with each option. The gold standard in the NFL is the use of the patellar tendon, but we treat each patient on a case by case basis and determine the proper graft choice based upon the circumstances.
Rehabilitation following surgical ACL reconstruction is very important and will last at least 6 months for most patients. I believe in therapy that involves great communication between the physician, patient and the therapist. Each patient is different and protocols, although great, sometimes requires tweaking to allow for the best results.
Assuming Sam Bradford’s injury is an isolated ACL tear, with the proper treatment he has a good chance of being fully recovered and ready for the start of next season.
Dr. B. Christian Balldin is an orthopaedic surgeon, fellowship trained in sports medicine, with The San Antonio Orthopaedic Group. He treats all sports-related injuries as well as other shoulder, hip, and knee conditions for patients aged 3 years and up. His special interests include ACL reconstruction and cartilage restoration procedures. To schedule an appointment with Dr. Balldin, please call 210.281.9595.
