00:00This is the Injury Report, presented by NYU Langone Health.
00:05Olympic medalist Lindsey Vonn is known as the Iron Woman of alpine skiing,
00:10but just days ago, she completely ruptured her ACL in her left knee,
00:14along with a lot of bone bruising and meniscal damage.
00:17So in today's Injury Report, we're talking to Dr. Leith Jazrawi,
00:22sports orthopedic surgeon at NYU Langone,
00:24because Lindsey basically said a busted knee is not going to keep her out of the Olympics.
00:31Doc, that was just my paraphrase, and thanks for coming back on.
00:34Long time no see.
00:36So let's break this down, because a completely ruptured ACL,
00:41bone bruising, and meniscus damage,
00:43it was serious enough to where you can see in this video,
00:46she had to be airlifted by a helicopter.
00:49When I think of ACL injuries, it's usually like basketball and football players.
00:55So what happened to Lindsey's knee in that fall, and how bad was it?
01:01Well, look, it's ski season, right?
01:04Here, it's winter here in New York City.
01:07We've got a ton of ACLs coming in.
01:10So really, that idea that we see it just in basketball and football players is wrong.
01:16The most common ACL-injured patient that comes into my office is anywhere from a novice skier
01:24to an advanced skier now, depending on how aggressive they are on the slopes.
01:30And the bottom line is that, just think about it, you've got these two sticks,
01:34you're riding down the slopes, and in sometimes icy conditions,
01:39your knee could give, twist, and that's how you tear your ACL.
01:42In the case of Lindsey, as she was going down, if you look closely at the video,
01:48she doesn't have the classic, real big twisting injury that you would see in some of the ACL tears.
01:56It's more, she comes down, she almost hyper-flexes the knee,
02:01and it looks like it goes right there on the left side.
02:04Now, that would point to a potentially lower-grade ACL injury without all the other ligaments that could be torn
02:14that make it much more challenging to actually compete.
02:20An isolated ACL tear in the past, there were a group of patients that would be able to compete with a brace on
02:27and do so at a high level.
02:29She may be one of them.
02:31They're probably going to brace her.
02:32The ACL tear is probably in isolation with some of the meniscus pathology
02:36without any other concurrent ligament damage, which she can do it.
02:42You know, her quads are strong.
02:44She's an elite athlete.
02:45There's a chance.
02:46What about the non-professional athletes out there?
02:49What about us regular New Yorkers who feel like we've got to ski to get through our cars,
02:54through all this snow, and get down the sidewalk?
02:56If someone was to tear their ACL and they're not a professional athlete,
03:01how would you treat the patient with this injury?
03:05It's a great question.
03:06Look, you need your ACL if you're younger and want to do some type of pivoting or cutting sport,
03:12like basketball, even tennis.
03:15You know, you need that ACL.
03:17But the idea is that most patients will come in and complain that they feel like their knee is slipping
03:24if they start to pivot.
03:26Dancers, same thing.
03:27As they're twisting, they feel that.
03:29Now, there are certain patients, and it's rare, that don't feel like that.
03:34And certainly when I examine the knee and I don't get a sense of tremendous looseness,
03:39there's an opportunity for that patient to delay their surgery a little bit.
03:43But even if you don't feel that looseness, under those extreme stresses of pivoting the knee,
03:49patients will feel it.
03:50And that's always the challenge.
03:52And that's why, for the most part, in the United States,
03:55most patients, 99% are getting their ACL reconstructed after they tear it.
04:00They want to be active.
04:01They want to go and continue their sports that they're playing.
04:04Now, there are a few isolated cases in just joggers
04:07or people that want to do very limited in-line type of activities.
04:13And sometimes there's a role for non-operative treatment, but it's very rare.
Comments