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Dr. Budoff’s Injury Update: Stevan Ridley and Carson Palmer

Carson Palmer

Dr. Jeffrey E. Budoff is a board-certified orthopedic surgeon who wades through misleading coach-speak and vague team injury information to offer advice for your fantasy team.

Stevan Ridley

Stevan Ridley, New England’s 25 year old running back, tore his anterior cruciate ligament (ACL) as well as the medial collateral ligament (MCL) on 10/12/14 while playing against Buffalo. He underwent ACL reconstruction in mid-November. Primary (first time) ACL reconstruction is a fairly predictable surgery, with generally good outcomes. Baring any mishaps, the professional athlete can usually to return to sports in under 9 months.

A recent study of 21 professional soccer players who underwent ACL reconstruction noted that, by 12 months (the admittedly arbitrary data point they used), 95 percent (20/21) had returned to their pre-injury athletic level. One patient (5 percent) failed, and had to undergo revision ACL reconstruction. There seemed to be some attrition over time, as four years following ACL reconstruction only 15 patients (71 percent) were still playing professionally. It’s unclear if that attrition was related to the ACL reconstruction, or the normal, limited life span of a professional athlete.1

As Ridley is young, and this is his first ACL reconstruction (at least, the first of which I’m aware), he should be ready for training camp in July. Conversely, if he’s not ready by nine months following surgery, that’s a bad sign; something did not go well. So, if you’re potentially interested in drafting him, following him in training camp should give you a pretty good idea of how he should do in 2015 from a post-surgical standpoint.

Carson Palmer

Carson Palmer, Arizona’s 35 year old quarterback, had a previous ACL reconstruction performed with cadaveric tissue (Achilles tendon allograft) in 2006. That’s somewhat unusual in highly active patients, such as professional athletes, as allograft (cadaveric) tissue often doesn’t hold up as well as autograft (ie. your own) tissue. Unfortunately, this was the case for Palmer, as his reconstructed ACL tore on 11/9/14. Palmer underwent revision ACL reconstruction using his own bone-patellar tendon-bone composite as the graft.  The Cardinals think he’ll be ready for training camp in July.

Compared to primary ACL reconstruction, players typically don’t do as well following revision (second time) ACL reconstruction. The recovery following revision reconstruction is less predictable with regard to discomfort, strength, and motion. Players therefore often don’t perform as well following revision ACL reconstruction, especially during their first season back. If Palmer played running back, a position that requires quick cuts, jumps and changes of directions, I’d be fairly skeptical of his 2015 season production. However, the demands on a quarterback’s knees are somewhat less. Palmer could do well, as long as he doesn’t need to scramble too much, or take too many hits on his reconstructed knee. Therefore, his ability to play throughout the year could be dependent on getting good protection in the pocket. Hopefully, Arizona’s offensive line will be able to provide that for him. However, if he’s asked to hold the ball for a long time (in Bruce Arians’ ‘long-ball’ offense) without good protection, his knee could be exposed to more hits and forced scrambles (ie. quick changes in direction) than it can comfortably handle in its first year back.  If so, it’s very possible that this could negatively impact Palmer’s 2015 performance.

Reference

  1. Zaffagnini S, Grassi A, Marcheggiani Muccioli GM, Tsapralis K, Ricci M, Bragonzoni L, Della Villa S, Marcacci M. Return to sport after anterior cruciate ligament reconstruction in professional soccer players. Knee. 2014 Jun;21(3):731-5.

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