Geno Atkins tore his ACL at the end of October 2013 and had surgery roughly three weeks later. Some Orthopedic surgeons believe that the knee needs about this much time for swelling (hemarthrosis) to decrease before performing surgery. In other cases i.e. Adrian Peterson, the surgery was done just seven days after the injury which doesn’t usually happen. When you have arguably the best sports knee surgeon in the world in Dr. Andrews it’s likely you can’t go wrong. Or can you? Robert Griffin III had surgery just three days after his injury to his LCL and ACL in Janurary 2013 by Dr. Andrews. We all saw how long it took RGIII to look decent in his mobility during the season even with the knee brace. Compare that to Adrian Peterson being a contributing playmaker at the beginning of training camp just nine months after surgery and eventually having the best season of his career in 2012.
This early surgery process may have to deal with tricking the body’s own healing mechanisms. When we have an injury certain things take place in our bodies that protect us from further injury. In the case of a knee ligament injury our body is believed to begin muscle atrophy to your quadriceps muscle in order to decrease anterior displacement of the tibia on the femur. Practitioners previously believed that rapid quad atrophy happened due to knee immobilization post surgery to protect the graft. Early repair of the ACL may slow down this process and speed up recovery time by decreasing total atrophy of the quadriceps. We do not know the extent of Atkins’ injury due to confidentiality but we have some things to consider for healing and recovery. Some things to consider with recovery times include type of surgery performed (auto vs allograft), how soon the surgery was performed, condition of athlete before surgery, rehab intensity or efficacy, and extent of injury that needed to be repaired.
We saw that Adrian Peterson was ready for training camp and that RGIII arguably was not ready. An example of different surgical procedures can be given with these two athletes. With an autograft, tissue is taken from the athlete’s body to replace the torn ACL which is initially 65-75% stronger than a normal intact ACL but with time it weakens. The above picture represents the autograft. With an allograft a foreign tissue is used to replace or repair the torn ACL which is also 65-75% stronger than a normal intact ACL. This tissue can be synthetic or organic. Recent progress has been made in synthetic allografts (i.e. LARS ligament advanced reinforcement system) which can decrease recovery times up to 4-6 months when compared to autografts because they do not weaken. The LARS does have drawbacks for knee health in the future (arthritis). You can speculate that Adrian Peterson used an allograft or LARS in order to get back to the field faster. A lot of elite athletes choose this because of the short amount of time they have in sport and the need to recover quickly. We also can speculate that RG III used the autograft technique which can take longer to recover.
We do not know which procedure Geno Atkins had but we can speculate. If he returns with the same mobility or even close to AP’s then he may have chosen a more risky but effective path for the present. As we say in the Physiotherapy world. It all depends!