Very cautious optimism in the interview with Leslie McDonald from WTVD. There is surgery scheduled for August 3rd but right now there are signs the torn ACL might not be as severe as first feared. McDonald said he is able to walk on it, there is minimal pain and swelling and he has full range of motion. That would explain why McDonald tweeted he was fine a few hours after it happened.
Since I am a blogger, not a doctor(Jim!) I am not sure if this means McDonald could come back in time to play this season or not. UNC has McDonald listed as out “indefinitely” which is the truth for the moment until a full timetable for recovery can be established. In the meantime we can hope for the best as it pertains to the coming season with the most important thing being McDonald recovering to 100% regardless of when that happens.
![[Bloglines]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/bloglines.png)
![[del.icio.us]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/delicious.png)
![[Digg]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/digg.png)
![[Facebook]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/facebook.png)
![[MySpace]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/myspace.png)
![[Technorati]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/technorati.png)
![[Windows Live]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/windowslive.png)
![[Yahoo!]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/yahoo.png)
![[Email]](http://www.tarheelblog.com/wp-content/plugins/bookmarkify/email.png)
count me as confused
I have not seen LMAC’s MRI nor am I an orthopedist. However, it is very common for folks with torn ACLs to walk and even do stuff like play golf. However, one cannot cut back and forth without ACL support in the knee very effectively.
Remember when Bobby Frasor torn his ACL? He walked off the court and everybody breathed a sigh of relief only to find out later he would be out until he was able to jump off balconies the next spring.
The walking is not the big deal here. The lack of swelling, pain and the fact he has full range of motion apparently surprised the medical staff, at least according to McDonald.
I think they key here is(please note I am not a doctor nor did I stay at a Holiday Inn last night) whether the damage is just the ACL or are there other concerns. Generally an ACL tear is a result of a severe twisting or hyperextending of the knee. In doing so there is other damage in and around the tear itself which also has to be dealt with in surgery and rehab. If we are talking about a clean tear of the ACL and no other damage to the knee, it might explain why the symptoms are different and could point to a faster recovery.
In general, players are never what they used to be after a major injury. That’s what we’ve got to be prepared for. Bobby Frasor and Farnold Degand (NCSU) blew out their ACLs at the same time and were never really back to normal. Jackie Manuel and Marcus Ginyard never really returned to form. Sean May (especially his NBA career) and Tracy Smith (NCSU) (who won’t have an NBA career now after his knee injury) were never quite the same, but as big men they could play with their backs to the basket and not have to run and cut as much. There’s no way to predict how a player will come back from this, especially if it’s a first major injury.
Degand and Frasor both lost a lot of lateral movement. Even if the tear isn’t as severe for MacDonald, he will probably be more limited than before.
This is just how sports are these days. Players push their bodies to the point of breakdown.
I tore my ACL in high school, playing soccer, and it was two months before we determined that it was torn. In the meantime, I was playing tennis and swimming with no pain whatsoever. The ACL tear makes the knee weak and more vulnerable to other injuries, so to play a sport that requires quick direction changes, it is usually recommended to have surgery to repair the ACL. And, as for coming back after the injury, I was never the same player, mentally or physically.
Obviously I’d love to see McDonald play for us this year if its possible. Even if he is physically limited as long as he is able to move around a screen (assuming we ever set one…), receive a pass and drain a three I’d love to see him be a part of our offense.
However, I suspect that Reggie Bullock tried to come back too early from the knee injury he suffered in high school, and we saw how that turned out. Therefore, I’d encourage LMAC to take whatever time he needs to get as healthy as possible.
While not a doctor, I do have personal experience with ACL tears, so lemme add my two cents:
1) did Leslie merely tear his ACL or rupture (rip the thing in half) the ligament? A torn ligament meants potential arthroscopic surgery – which sucks, but is not typically a 6-8 month rehab-worthy procedure. A ruptured ligament means a complete ligament replacement is necessary (either from the injured person’s hamstring or patellar tendon, although cadaver ligaments can be used), with screws placed in both leg bones to attach the new ligament, and a whole lot more rehab.
2) collateral damage – very rarely when one injures his knee is only one ligament affected. Typically, during the incident, while one ligament (in this case the ACL) suffers the most damage, often times the MCL, LCL and the meniscus are injured as well. Think Shaun Livingston for worst case scenario there. If the collateral damage was minimal, that can speed up recovery immensely if only one ligament needs to be repaired via surgery.
To sum up – as Heels Perspective said, without looking at an MRI, we don’t know diddly. However, if Leslie is cautiously optimistic then perhaps he is dealing with a tear, not a rupture, and luckily has minimal collateral damage. Which means he might be able to get by on arthroscopic surgery, leading to a much quicker rehab, ultimately resulting in him playing meaningful minutes in calendar year 2011.
“If we are talking about a clean tear of the ACL and no other damage to the knee, it might explain why the symptoms are different and could point to a faster recovery.”
This is what I had. ACL ruptured, but nothing else was damaged. Was walking within 20 minutes and pain free withing 24-48 hours. Still required reconstruction and 6 months of rehab. As far as I know, partial ACL tears are not treated surgically.
Not a doctor here, but I think the best we can hope for here for LMac is that he is back on the Court in January of 2012. If he can have surgery and begin rehab by early August, you’re looking at roughly 5 months until conference play starts. With a highly-conditioned athlete, that is possible if the knee is not terribly damaged. That would probably be a “best-case” scenario.
Very well put by Robuck. FYI and to continue the ACL primer: The typical sprain grading scale runs from 1-3, microscopic tear-partial tear-complete tear (rupture). Grade 2s (partials) *may* require surgical repair, which means fixing what’s left of the ACL; some heal on their own. A Grade 3 leads to a reconstruction, which essentially means having to provide the patient with a new one, as described in Robuck’s post. Reconstructions are done arthroscopically, so if we hear that Leslie is having “arthroscopic surgery” it isn’t necessarily a good (or bad) sign.
Until someone announces the exact degree of injury, which even given pre-op MRIs may not be clear until surgery, we can only guess about rehab time. When it comes right down to it, the type of surgery required will ultimately mean more than the type of injury, as far as rehab time is concerned. So now we need to go pace around or read a magazine in the waiting room. We can talk about how Roy should divide up the minutes at the two guard — that always distracts us — while we wait for the doctor to come out of the OR, take off his mask slowly to build the drama, and tell us how it went.
BP, PT
lmac wants to be part of something special. i am holding back judgement as to what happens here. I am OPEN.
BTW I am slowly getting into the mood for some Carolina FOOTBALL baby!!!!!
I am a surgeon.
It is easy to tell with a proper MRI what is injured. If the ACL is completely disrupted, the knee will be at least moderately unstable, often even for walking for most patients.
There is always some collateral injury with twisting and minor meniscus injury. The first part of the procedure to fix this is arthroscopy to evaluate and confirm the extent of injury. Then the ligament has to be replaced. It is not sewn back together. Meniscus injuries usually require nothing in this case. Sometimes a corner of the meniscus will be removed or repaired.
The exceptions to this are the few who struggle with no ACL. This can be done, but not at an elete athlete level.
So I wish the best for LMac, but he won’t be playing this year for UNC Men’s Basketball. Sorry.
It is really unfair to him to expect this to have less than a huge negative effect on his play in the future, especially with his playing style.
honestly give me a medical redshirt and an extra year of leslie down the road. We have enough on the wings and if he can recover from this he could be a real leader his (fifth) senior year