Golf Doctor
(orthopaedics)
Golf Days Aren't Over, Even With a
Torn Ligament
Michael Leighton, M.D.
Dear Golf Doctor:
Dear Golf Doctor: While golfing in Australia last month, my ball
got stuck in a tree. While trying to retrieve it, a koala scared the
wits out of me. I fell, twisted my knee, had big-time swelling and
couldn't put weight down on my foot. My doc says I've got a torn ACL
and medial meniscus and that it needs to be fixed. Does it? I'm 38, a
12 handicap and play only golf. If I get it repaired, how long before
I'm back on the links?
&endash;Rich Berke, WPB
Dear Rich:
Thanks for the e-mail, Rich. You have an interesting problem. Not
the part about losing a ball up a tree - anyone can do that; but an
ACL-deficient knee with a torn meniscus in an active but not
overly-athletic 38 year old. The anterior cruciate ligament (ACL)
gets significant airtime on football and basketball games. It is one
of the two major ligaments inside the knee that helps stabilize the
knee for cutting maneuvers. Running straight ahead, swimming, golf
and bicycling, among others, are really unaffected by the loss of the
ACL.
In your case, you need to have your knee arthroscoped to remove
the torn medial meniscus (cartilage). Recovery from this procedure
will be short; certainly, you should be back on the course by 3 or 4
weeks.
The occasional individual will have difficulty and instability
even with activities of daily living. This is the person who should
consider a ligament reconstruction (not repair). If an anterior
cruciate ligament reconstruction is considered for instability that
doesn't respond to strengthening or a brace, time off the course will
be much longer. Reconstruction is a big deal, and many issues need to
be addressed: choice of a graft (cadaver graft, a portion of your own
patella tendon, or hamstring tendons), outpatient or inpatient
surgery (I do 95% of ACL reconstruction as an in-and-out procedure),
use of a brace after surgery and for how long, arthroscopic or open
technique (don't let anyone open your knee in 1997 unless there's a
really good reason), weightbearing and rapidity of rehabilitation.
These questions need to be discussed with your surgeon. Remember,
Fred Barnett gets paid big $$$ to play for the Dolphins, so his rehab
after surgery is his job - as many hours a day as his trainer sees
fit. You can't get as good as he can as fast as he can. Your job and
lifestyle need to be able to accommodate ACL reconstructive surgery.
Losing the ACL is like losing your 3-iron - you know it's missing but
you can certainly get by. And you're the only one who really knows if
you need that 3-iron!
Michael Leighton, M.D. is an avid golfer who specializes in
orthopaedic surgery and sports medicine. He can be reached at
Atlantis Orthopaedics, 561-967-4400 or by e-mail at
KNEESURG@aol.com
