‘SEVEN-MONTH RECOVERY’ THE NEXT FRONTIER FOR KNEE RECONSTRUCTIONS
THE NEXT frontier in the treatment of serious knee injuries could see AFL players returning within seven months of a traditional reconstruction.
Leading surgeon Julian Feller, who is credited with saving the careers of some of the game’s biggest stars, believes clubs could eventually take a less conservative approach with knee injuries and move into line with overseas sports.
The AFL is funding a research project that will be conducted by a group of top surgeons to audit all serious knee injuries in the past 10 years and establish recovery trends.
A traditional knee reconstruction is seen by clubs as a 12-month injury, but Feller believes players could wipe four to five months off that timeline.
“I don’t think it’ll come back to being a six-month recovery, but it might come back to a situation where nine to 10 months doesn’t seem unusual, and seven or eight seems feasible,” Feller told AFL.com.au.
“Australia traditionally has been a little bit more conservative than other countries, and we would argue that maybe our game puts greater demands on the knee.
“So I think that will take time for people to be confident to do that.”
Looking at players who suffered ACL injuries in 2013 and didn’t have setbacks in their recovery, Adelaide captain Taylor Walker, Fremantle ruckman Jonathon Griffin and Hawthorn’s Ryan Schoenmakers all returned exactly 12 months on.
Collingwood defender Alan Toovey and GWS forward Jonathon Patton, who has since suffered a repeat injury, both shaved a few weeks off their recovery so they could return in round one, 2014.
Young Magpie Matt Scharenberg ruptured his ACL on August 22 last year, but the 19-year-old is ready to return this weekend, eight months after his injury.
Feller, the surgeon of choice for most Victorian clubs, said he had found most players who targeted an early return were getting away with it.
“We’ve had some really early returns from ACL reconstructions, which then gives you confidence about treating subsequent players,” he said.
“I think having the confidence to let players do more early on has probably helped them in their comeback.
“We’ve got much more baseline data and we know what someone was like at the start of the season when they’re as fit as they should be.
“So then when you’re doing their rehab you want to get them back to all of those levels. That’s made a big difference.”
The AFL’s most recent injury report, covering the 2013 season, found that eight of the 23 ACL reconstructions that season were re-injuries due to graft failure.
This represented a high failure rate that the League said warranted further analysis.
Feller said surgeons had become better at recreating the anatomy of a player’s knee in the reconstruction, but this also put the player at more risk of re-injury if he had started with a loose knee.
Some players will now undergo an additional operation called an extra-articular lateral tenodesis, which was commonplace in the early 1990s.
“There’s a few players now who have had that done and they’re all in the process of coming back, but we think that provides a bit more stability,” Feller said.
“In some ways it’s back to the future, because that’s how I was taught to do the operation originally back in 1990 and then we dropped one part of the operation.
“It gives you, if you like, an external anterior cruciate ligament, which helps protect the real one inside.”
Among the players returning from knee reconstructions this season are Andy Otten (Adelaide), Nathan Vardy (Geelong), Trent West (Brisbane Lions), Brent Macaffer (Collingwood) and Clay Smith (Western Bulldogs).
Geelong’s Daniel Menzel is recovering from his fourth knee reconstruction, while Swan Alex Johnson and Fremantle’s Anthony Morabito have each suffered complications getting back from their third reconstructions.
Seven players have suffered ACL injuries this year – Christian Petracca (Melbourne), Tom Liberatore (Western Bulldogs), Michael Close (Brisbane Lions), Daniel Nielson (North Melbourne), Nathan Drummond (Richmond) and Eric Mackenzie and Mitch Brown (West Coast).
Gold Coast star Jaeger O’Meara has been ruled out for the season after rupturing his patella tendon.
FIVE FAST RETURNS FROM KNEE RECONSTRUCTIONS
1995: David Schwarz (11 weeks)
Suffered his first ACL tear early in 1995 and returned inside three months only to re-injure the knee in his second game back. The following season he suffered yet another tear. The Melbourne forward’s struggles are the main reason clubs adopted a conservative approach.
1998: Tony Liberatore (18 weeks)
The Brownlow medallist holds the AFL record for the fastest successful return from a knee reconstruction, returning from his second operation in just four-and-a-half months. His surgeon, David Young, operated on son Tom this year after the young Bulldog tore his ACL.
2008: Nick Malceski (12 weeks)
The ‘bionic man’ was the first player to undergo a LARS reconstruction in 2008, opting for a synthetic ligament in his second reconstruction. He opted for the same operation in 2011 when he re-injured his right knee, returning even quicker to the NEAFL in just 73 days.
2014: Tim Mohr (35 weeks)
A quick return by conservative modern standards, Mohr was back with Greater Western Sydney’s reserves in the NEAFL early this season after tearing the ACL in his left knee in July last year. He has said the knee is feeling stronger than before he suffered the injury.
2014: Matthew Scharenberg (33 weeks)
Another example of a modern player pushing the boundaries following a traditional reconstruction, Scharenberg could play his first match this weekend in the VFL. The Magpies have still been conservative with the 19-year-old, who was physically ready to play three weeks ago.
[ AFL – Australian Football League ]