Dr. Joshua Alpert is an orthopedic surgeon and sports medicine specialist on staff at Sherman Hospital. He is the team physician for Judson University, Dundee Crown High School as well as Larkin High School, and commonly performs ACL reconstruction surgery.
Derrick Rose had reconstructive ACL surgery on May 12th, 2012 and as of May 6th 2013, he is still not back to playing in the NBA. His Chicago Bulls are in the midst of a remarkable playoff run considering all the injuries and illnesses that have sidelined key players. Consequently, there has been a lot of speculation regarding Rose’s possible return to action.
Dr. Alpert is an expert on ACL injury, treatment, and rehabilitation, and has provided some fascinating information below.
What is the ACL?
The ACL is a ligament in the middle of the knee joint that attaches the femur bone (thigh) to the tibia bone (leg). It acts as one of the main stabilizers of the knee and prevents the tibia from moving forward on the femur.
What causes the ACL to tear?
ACL injuries usually occur from a non-contact twisting injury to the knee with the foot planted. It commonly occurs in sports such as soccer, football, skiing and basketball. These injuries are more 2-4 times more common in women.
What are the symptoms associated with an ACL tear?
When the ACL is torn, an athlete usually twists his or her knee, hears a pop and is unable to bear weight. Swelling rapidly develops in the knee and patients feel a sense of instability where the knee feels like it’s going to “give out.”
How is an ACL tear diagnosed?
An ACL tear is diagnosed from a detailed history of the injury, a complete physical exam, and confirmed with radiographs such as XRAYS and an MRI (Rose’s was confirmed with MRI). There are certain physical exam tests that can test for “looseness” or “instability” of the knee that occur with ACL injury. An MRI will not only confirm if the ACL is intact or torn, but also evaluate for other associated damage in the knee such as meniscus or cartilage damage.
What is the treatment for an ACL tear? How was Derrick Rose’s treated?
The ACL, when torn, does not heal on its own. In a young active patient, a torn ACL should be treated with surgery to reconstruct the torn ligament. ACL tears are fixed via a minimally invasive arthroscopic technique using a camera to look into the knee joint. A graft is used to replace the ACL. There are a variety of graft options. Most commonly, the middle third of the patellar tendon or hamstring tendons are used because they have a similar strength as the normal ACL. The surgery is done on an outpatient basis. Derrick Rose’s ACL reconstruction was done using his own patellar tendon as graft.
What is the typical rehabilitation after ACL surgery?
Physical therapy is a long and difficult process after ACL reconstruction. Patients will get knee range of motion back in 6 weeks, full strength back in 3 months, and be back to cutting and pivoting sports such as basketball in about 6 months. It takes 6-12 months before an athlete is back to competitive sports at a high level.
What would cause an athlete to take over one year to return to professional sports after ACL surgery?
Patients are usually cleared to return to sports within 6-12 months after ACL reconstruction. For many elite athletes, especially NBA basketball players, it can take up to two years until they return to sports at an extremely high level. It takes that extra time for the quadriceps and hamstrings to regain the strength and stamina needed for intense cutting, pivoting, jumping, and high intensity sports specific activities. The risk of returning too early is a re-tear of the ACL and needing further surgery. After being cleared by the medical team, it is ultimately up to the athlete to decide when they are ready to return to high level competitive sports.
Midwest Bone & Joint Institute: A Patient’s Guide to ACL Injuries
SportsMed: The Injured ACL
Joshua Alpert, M.D. is a board certified orthopedic surgeon, fellowship trained in sports medicine and arthroscopy at Massachusetts General Hospital/Harvard. As an active member of the American Orthopedic Society for Sports Medicine, Dr. Alpert treats individuals of all ages. He is a physician with the Midwest Bone & Joint Institute, which has served the Chicago area for over 30 years. He may be reached at 847-931-5300.