00:00This is the Injury Report, presented by NYU Langone Health.
00:05Giants fans got a tough blow this week as they found out Brian Burns suffered a major injury tearing his
00:12ACL.
00:13We're going to talk all about that and what that means this week on Injury Report.
00:17And I'm joined to break it all down by Andrew B., a doctor, sports orthopedic surgeon with NYU Langone, who
00:23joins me now.
00:23Dr. B., how's it going?
00:26It's going good, man. Thanks for having me.
00:28No, glad to have you.
00:30And hopefully we can explain things a little bit better to the Giants fans out there.
00:34We've seen the play where Burns tore his ACL.
00:38And walk us through this play if you can, because we've seen many ACLs get torn in a variety of
00:43ways.
00:43But what happened to Burns' ACL in the play where he tore it?
00:47Yeah, it's tough to watch.
00:49You see Burns kind of coming off the edge.
00:52And he's met by, you know, the center, the pulling center meets him.
00:55But it's not really a contact injury.
00:58You see him planting his right foot, trying to turn that corner to get to Cam Ward.
01:03And you can see his knee does a very classic valgus and tibial rotation, internal rotation injury.
01:09And what that means is the knee bends inwards, and his tibia or shin bone kind of plants and twists
01:16inwards, which puts an enormous amount of strain on the ACL.
01:19And that's a very classic way that the ACL tears.
01:21So this is, you know, even though it looks like he's being met by that pulling center, this is like
01:24a pretty classic non-contact pivoting injury with the ACL.
01:27Yeah, it's a tough one to watch indeed.
01:30Now, when you talk about the ACL, recovery time is not what it used to be.
01:34You know, you talk to other NFL players.
01:36They'll say, you know, years ago it took a long time for guys to come back.
01:39They now come back faster.
01:41How aggressive can you be on the rehab of an ACL for a guy like Brian Burns at 6'5",
01:45250 pounds?
01:46How aggressive can you rehab that ACL injury?
01:50Yeah, we've really come a long way in a revolutionizing kind of return to sport after ACL, and techniques have
01:55gotten better.
01:56Surgical techniques have gotten better.
01:57Rehab techniques have gotten better.
01:58You know, Pat Mahomes is playing basically nine months after his surgery, and he's doing it, and he's crushing it.
02:04So, you know, of course you have to meet all the metrics of return to sport, but these NFL athletes,
02:10they have such an immense access to these rehabilitation centers
02:14and athletic trainers and sports performance that they can get their muscles and their dynamic stabilizers of the knee ready
02:19to go.
02:20Now, that nine-month mark is kind of like a hard cutoff in the sand for a lot of surgeons
02:24because what we know from many years of data is that return to sport before nine months
02:29kind of risks that re-tear the ACL, but as long as you're ready to go by that nine-month
02:33mark, a lot of us are letting our patients play.
02:36Very interesting stuff there.
02:37Now, we talked about the size of Brian Burns.
02:39He's also known as Spider-Man.
02:41He is a freak athlete.
02:42We talked about a 6'5", 250-pound frame that he has, and he's got all the athleticism, and that
02:48is his superpower.
02:49And I think the thing that fans are going to worry about, Dr. B, is should they be concerned about
02:53any limitations with him
02:55or loss of athleticism when he does get back to the field?
03:00Yeah, I mean, he's a freak of nature.
03:02You don't get, like, 16 sacks without being a pure athlete.
03:04And, you know, a lot of people do worry about that after ACL injuries, but the nice thing about ACL
03:10surgery and ACL reconstruction and recovery is that once you are fully rehabbed, the expectation is that you can get
03:15back to your full explosiveness.
03:17You know, I think, you know, patient zero, the best example is Adrian Peterson, ACL and MCL in 2011.
03:22When he came back, he was an absolute athletic marvel still, you know, an absolute beast.
03:26So as long as you recover well on those setbacks after a successful ACL reconstruction and return to sport, we
03:33all hope that Brian Burns gets back to his full athletic ability.
03:35And that is the key indeed, no setbacks.
03:38And we've talked about before here on Injury Report with the great folks here at NYU Langone how you would
03:42treat an ACL to one of your patients.
03:45But what if the patient is maybe on the, you know, larger size of size, like Burns is, we talked
03:50about him being 6'5 and 250 pounds, they might not be a professional athlete, but would their rehab and
03:56recovery time differ because of their size?
04:00Yeah, I mean, that's a great point and something that we don't talk about enough with, you know, surgery and
04:03rehab.
04:04You know, a 6'5, 250 pound patient is not the same as a 5 foot, 100 pound soaking wet
04:09patient.
04:10You know, everything is different.
04:11The sizes are different.
04:12And so you can do some things in surgery to mitigate that, whether you take a little bit of a
04:15bigger graft for your ACL reconstruction.
04:18For someone as high level of an athlete as Brian Burns, an ACL reconstruction, a lot of us would recommend
04:23probably adding what you call an LAT procedure, or that's an IT band tenodesis on the outside of the knee
04:30to add even extra stability.
04:31And good data shows that it reduces your rate of re-injuring the ACL by half, okay?
04:36It does not slow down your rehab or your return to sport.
04:39So a lot of things that you can do, you can kind of mitigate the risk factors and get these
04:42extra-large, extra-special athletes back to play as fast as possible.
04:47Got you on that.
04:48Well, Giants fans are hoping that Brian Burns can get back onto the field and still have that athleticism as
04:53soon as possible.
04:55We will see.
04:55It is an injury that is very painful, but Brian Burns, we've seen other players come back from it before
05:01in the sport of football.
05:03That is Dr. B with NYU Langone, a fantastic orthopedic surgeon there.
05:08Dr. B, appreciate you coming on and talking with me about Burns' injury here on Injury Report.
05:13It's my pleasure.
05:14Thanks for having me.
05:15Thanks for having me.
05:17Thanks for having me.
05:18Thanks for having me.
05:18Thanks for having me.
05:18Thanks for having me.
05:18Thanks for having me.
05:19Thanks for having me.
05:19You
