Derrick Rose and Anterior Cruciate Ligament Tears: Decision Making

Derrick Rose Tears His ACL:

Any avid basketball fan now knows that Derrick Rose has torn his Anterior Cruciate Ligament — or ACL.  ACL or Anterior cruciate ligament injuries are very common.

Derrick Rose Tears His ACL:

Any avid basketball fan now knows that Derrick Rose has torn his Anterior Cruciate Ligament — or ACL.  ACL or Anterior cruciate ligament injuries are very common.  Let’s learn a bit more about  them…. using Derrick Rose’s ACL injury as an example.  

What is the Anterior Cruciate Ligament:

ACL Tear

When Derrick Rose hit the court last night, his knee was “stable” and held together by four strong ligaments.  The ACL is one of the four major ligaments inside the knee that is responsible for maintaining stability of the knee during certain activities.  The ACL or anterior cruciate ligament is necessary for most people to participate in sports involving.

• cutting
• pivoting
• turning or
• twisting

How did Derrick Rose tear his ACL? 

Most ACL tears occur as the result of a non-contact injury.  As you can see on the video, Derrick Rose’s ACL tear occurred when he came down on his leg at an unusual angle, twisted the knee and heard a pop as his leg gave way.   Most patients in my office with an ACL tear will note that they pivoted, twisted, or tried to rapidly change direction and then felt a pop. 

How do I know if I tore my ACL? 

75% of people who present with a painful swollen knee, after a pivoting or rotational injury will have an ACL tear.  Most people who tear their ACL – or Anterior Cruciate Ligament will experience a pop or a snap after a fall, sharp turn, etc.  They will be unable to continue their activity and within an hour or so, significant swelling will usually occur.  Many people who tear their ACL will notice that their knee feels loose or unstable as the swelling starts to subside.    

Does Derrick Rose need surgery to repair his ACL tear?

Not everyone who tears their ACL requires a reconstruction to put a new ligament in the knee.   Elite athletes, or even weekend warriors who have a persistent feeling of instability — a sense that the knee is loose — will either require an ACL reconstruction or they will need to try a brace or simply give up the activity that leads to the feeling of instability.   

Derrick Rose has a complete ACL tear… but partial tears of the ACL occur fairly often.  Sometimes enough of the ligament remain that you will not experience instability symptoms — but unfortunately many of you will have a feeling that the knee is loose, despite the fact that the ligament is only partially torn.   Most orthopedists will rehabilitate a partial tear patient aggressively before  considering if an ACL surgery is necessary.   In partial tears, many of us are capable of simply reconstructing or fixing the torn portion —leaving the normal portion of the ACL untouched.  

Are all ACL  tears Repaired or Reconstructed?

There’s no question that Derrick Rose will have his ACL reconstructed.   Other adults have choices as I mentioned above.  What about children ?  As our children become more and more active, we are seeing more and more ACL tears in them.  A parent’s notion is to avoid surgery if their youngster tears their ACL.   Recent scientific studies show that children are at very high risk of developing secondary injuries such as meniscus tears .

ACL Reconstruction: For Derrick Rose … and you too.

Holes drilled to prep for new ACL

The way we perform ACL reconstructions or surgery to repair the Anterior Cruciate Ligament today is far different from the methods utilized in the past.    The procedure we perform today is called an Anatomical ACL Reconstruction — from a surgical prospective it is very different than the procedure we performed for decades.  The goal of the surgery today is to reconstruct your ACL so that is placed in exactly the same position your old one was.   An important caveat …. if you are considering ACL surgery, make sure your surgeon is well versed in the Anatomical Technique.  

How long will it take Derrick Rose to recover from his ACL surgery?

We wish Derrick Rose a speedy recovery.  Ultimately it will be nearly a year before  Derrick Rose can return to basketball after his ACL surgery.   Why do we make you wait so long for an ACL to heal?  Initially the pain and weakness in the leg will prevent any meaningful activity.  After a month or two Derrick Rose will likely feel good.  That’s when the surgeon becomes the “bad guy” —where you feel good and want to return to sports and we keep saying no. Why do we do that? 

The ACL that we placed in your knee will go through a process of regeneration or reorganization that will cause it to be very weak compared to a normal ACL.  That weakness will persist for at least 8-12 months or longer.   The longer you wait before returning to sports, the less likelihood there is that you will suffer a new tear .  

So while we wish Derrick Rose a speedy recovery following his ACL surgery… we know it will be a while until we see his skills demonstrated on a basketball court. 

Recommended Reading:

Anterior Cruciate Ligament Tears

Partial ACL Tears

ACL Tears in Children

Meniscus Tears