ACL and MCL Tears: Na Vorro Bowman

Author: Howard J. Luks, MD- Posted in: ACL, Knee, Orthopedic Social Media, Sports Medicine 2 Comments

Anyone who witnessed Na Vorro Bowman’s ACL and MCL injury live on TV was quivering for a while.  Many adults remember where we were when Joe Theisman too his hit and broke his tibia.  This injury looked brutal.  My immediate diagnosis was that Bowman had torn his ACL and his MCL.  Most Orthopedists would have agreed. 

Knee Injury _ Ligament Tear - Howard Luks - Westchester County NYInjuries that involve more than one ligament are far more complex than injuries that involve only the anterior cruciate ligament or the medical collateral ligament in isolation.  The treatment of these multi-ligament injuries is complex and has evolved over time.  

The 49ers feared that linebacker NaVorro Bowman injured both his ACL and MCL against the Seahawks on Sunday and those fears have been realized.

via Torn ACL and MCL for NaVorro Bowman | ProFootballTalk.

Most people understand that an isolated ACL injury is followed by a course of therapy to resolve your stiffness and prepare your knee for a potential surgical repair.  

For patients with an isolated MCL or medial collateral ligament tear, the treatment will vary depending on the “grade” of the tear.  MCL tears are graded as complete or partial.  Partial tears will almost always heal with time, bracing and physical therapy.  Complete tears of the MCL generally require an open repair of the MCL followed by a period of bracing and then physical therapy.  

ACL MCL Tears

Kudos to the Medical Media Group

ACL and MCL Combined Injuries

When both the ACL and the MCL are torn, the timing of treatment is critical.  If the MCL is a complete tear the MCL needs to be repaired soon after the injury. Otherwise the ligament will scar and shorten — making a repair difficult — and threatening the overall result.  Once the MCL is repaired, and the athlete has recovered, they are then looking at an  additional surgery to reconstruct the ACL.  While this is a long recovery process many people do very well if the injuries are managed in a timely manner.  IF the MCL is a partial injury and will not require surgery then an ACL reconstruction can proceed once your range of motion and flexibility has been restored.  Going in to ACL surgery with a stiff, painful knee is probably not the best idea.  It will definitely impede your ability to properly rehabilitate your ACL if you’re hindered by the pain from your MCL injury.  

Whether or not Bowman can return to professional sports is an open ended question.  Not all professionals can  return after an isolated ACL tear.  It is possible, but time will tell.  

 

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Addendum: 2/5/2014

Bowman Undergoes ACL Surgery

It appears that Bowman’s MCL injury was partial.  He underwent an ACL reconstruction yesterday.  By all accounts, he’s doing well.   Now comes the hard part.  Rehabilitation and recovery.  Let’s hope the timing of the surgery, and his MCL does not impede his ACL rehabilitation.  

 

 

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2 Responses to “ACL and MCL Tears: Na Vorro Bowman”

  1. Reply Eddie says:

    Bowman had surgery today. The timing of this surgery tells me that the surgeons felt the mcl could not heal on it’s own and that intervention during the timeframe that a repair could be done medially was chosen. I realize this is speculation but I can’t think of another reason why they would wait 2 1/2 weeks after injury to intervene. If they felt the mcl would heal on it’s own I would suspect they would wait 6 weeks. Thoughts?

    • Reply Howard J. Luks, MD says:

      It does seem that they felt the MCL was healing well enough that it did not require a repair. Operating at 2 1/2 weeks after an MCL sprain can bring up the issue of stiffness since the MCL injury itself can hurt (significantly) for weeks to months. The MCL pain might hold back the ACL rehab ??? We’ll see.
      Thanks for stopping by…
      Howard Luks

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