When people buy a car, they don’t buy the first car they see. If they ask the dealer about the car’s gas mileage or how many miles the car will last, they wouldn’t accept answers like “pretty good” or “a lot.”
Yet athletes with ACL tears often accept the opinion of the first physician they see about how to treat their injury.
The consequences of buying the wrong car are far less severe than the consequences of not getting proper treatment for an ACL tear. “If you buy a car and don’t like it, you can buy another car,” says K. Donald Shelbourne, MD, orthopedic surgeon and founder of Shelbourne Knee Center. “If your knee surgery doesn’t work out, you can’t go back and try it again.”
50/50 Chance of a Good Outcome
Nationally, only about 50% of athletes who have ACL reconstruction have two normal knees after rehab and are able to return to sport at the same level. For the other 50%, the knee will be stable but not normal or equal to the non-injured knee. Functional limitations in daily life are also possible.
At Shelbourne Knee Center, 85–90% of athletes return to sport at the same level within a year. (1)
Dr. Shelbourne sees many patients who had poor results with their primary knee surgery. “We can make a bad outcome better, but we can never make the outcome as good as if the surgery had been done right the first time,” he says.
Not an Emergency
An ACL tear isn’t an emergency and it doesn’t require immediate surgery. In fact, Shelbourne Research Center research shows that the outcome is better when surgery is delayed to:
- Obtain full ROM
- Gain leg control
- Eliminate swelling. (2)
The Best Interest of the Athlete
The best outcomes occur when athletes are treated by orthopedic surgeons who are knee experts and who perform a high-volume of ACL reconstruction procedures.
Injured high school and college athletes and their parents tend to trust the opinion of the team’s athletic trainer and physician. Those opinions may not be in the athlete’s best interest, says Dr. Shelbourne.
Athletic trainers are often employees of a health system, and are required to refer patients to physicians in the health system. The team physician may be a newer physician chosen by the health system for this role to build his or her experience.
Evaluate Treatment Options
“The first physician the athlete sees is often not the best physician to treat the injury,” says Dr. Shelbourne. He advises athletes and their parents to evaluate their options before making a decision about treatment.
Due diligence includes asking for data on experience and outcomes, such as:
- Number of ACL reconstructions performed by the orthopedic surgeon
- Rate of return to sports at the same level
- Choice of graft
- Rehab process
Shelbourne Knee Center Experience and Outcomes
Dr. Shelbourne has performed more than 7,000 ACL reconstructions, with 85-90% of athletes returning to sport at the same level.(1) He uses a contralateral patellar tendon graft, which provides a predictable return to normal strength in both knees.
Shelbourne Knee Center’s specialized pre-op and post-op rehab program optimizes surgical outcomes: (2)
- Resolves swelling
- Restores normal knee range of motion (ROM).
Post-op rehab:
- Eliminates swelling by having patients lie down with the knee above the heart for the first five days instead of walking frequently
- Restores normal ROM before strengthening.
“When it comes to your knees you don’t get a second chance,” says Dr. Shelbourne. “It’s common sense to get a second opinion.”
For more information about second opinions or to refer a patient for a second opinion, please call 888-FIX-KNEE.
References:
- Unpublished data, 2018.
- Shelbourne DK. Thirty-five Years of ACL Reconstruction, presentation at Andrews University, February 2018.