Reconstruction Surgery and Rehabilitation Following Acute Anterior Cruciate Ligament Rupture in the Young Athlete

Abstract

As an athlete who has played on numerous teams and a supporter of so many others, I know intimately all the positive things that come along with being involved in sports--good friends, good competition, the hard work of striving toward a goal, and the satisfaction gained from achieving one. All of these things are wonderful, and are just a few of the many reasons people become involved in sports. Unfortunately, athletes run a high risk of being injured while they are training, practicing, or competing. I myself have been injured and have seen many others who have been hurt as well. It can be a devastating experience for someone who has a genuine love of their sport to discover that they cannot participate. The good news is that we have ways to help speed up recovery and even to return people, whose injuries would otherwise force them to retire, return to their sport. For my senior individualized project I chose to study just such an injury. An athlete who has torn their anterior cruciate ligament (ACL), a supporting structure within the knee joint, experiences joint instability which can make it impossible to play certain sports without some kind of intervention. Fortunately, surgeons can perform surgery to reconstruct the ACL. The surgery is followed by several months of hard work in rehabilitation, however the athlete is given the opportunity to return to their preinjury level of performance. For the committed athlete, this is often the treatment of choice. In order to gain an understanding of what anterior cruciate ligament reconstruction and rehabilitation entails, I worked with a number of individuals. I was fortunate enough to be able to observe an ACL reconstruction surgery performed by Dr. Mark Veenstra, MD at Borgess Hospital. It was particularly incredible to see all the equipment that is used in the procedure, to see the inside of a patient's knee on a monitor, and to watch Dr. Veenstra transplant a portion of the patient's patellar ligament into her knee joint. I was also able to watch a number of physical therapists work with individuals doing their rehabilitation following ACL reconstruction at both the Southwestern Medical Sportsmedicine Clinic and the Bronson Crosstown Parkway Outpatient Physical Therapy Center. I would like to give particular credit to Alan Colestock, PT, who told me a lot about how the rehabilitation worked and even let me try some of the high tech machines (like the Biodex) myself! I think one of the most valuable experiences was observing the physical therapy following ACL reconstruction occurred when I saw three patients at different stages of their rehabilitation in one room. One woman was being counseled prior to surgery, another was in her first week of therapy, while the other man had been in therapy for about a month. It was interesting to see and hear about how much progress each person had made, and how their rehabilitation experiences varied. These practical experiences in a clinical setting, in addition to a good amount of traditional research done in the library, have enabled me to gain a much more detailed understanding of how the anterior cruciate ligament functions, and how it can be repaired after injury. Additionally, I found this experience to be valuable because I was able to take a look at the more general principles of injury management. I found it interesting to see how the different spheres of athletic training, surgery, and physical therapy overlap and work together in order to meet the common goal of getting an athlete back to their sport.