by James Bicos, M.D., Orthopedic Surgeon & Sports Medicine Specialist; voted Top 10 Sports Medicine Surgeons by Sports Illustrated for cartilage issues
In the sports world, we had heartbreaking news today. Lindsey Vonn will not be able to compete in the 2014 Winter Olympics. Vonn, age 29, is one of the most successful skiers in U.S. Olympic history and a winner of four overall World Cup championships. She sustained a partial tear to her already reconstructed ACL in November 2013 and although physicians said that she may be able to heal the injury and compete in the Olympics in Sochi this year, she did not feel that her knee was stable enough to compete.
Lindsey is very familiar with knee injuries. In 2007, she suffered a partial tear to her ACL of the same knee she injured now. At that time, it was treated without surgery and she went on to compete at the Vancouver Olympics in 2010. Unfortunately, in February of this year, she suffered a horrific accident at the World Championships in Austria. That is where she completely tore her ACL, her MCL and she had a tibial fracture. She underwent immediate surgery and rehabbed to the point of trying to make a run for the 2014 Olympic Games. Then the unimaginable happened, she tore her ACL again, just 9 months after the surgery that was supposed to fix her enough to get a gold at the Olympics.
Three thoughts come to mind: Bad Luck, Olympic Pride, and She Will Be Back!
Over 100,000 ACL reconstructions are done each year. And as with any surgery, there are a certain number that just don’t heal, are not strong enough to get back to sport, or because of other factors we don’t understand, certain people are just prone to retearing the ligament.
In the case of Lindsey Vonn, her surgeon is one of the best around, so how could this happen? There is a known retear rate of ACL reconstructions. No matter how good you are, a few will tear again. Studies have shown that rate is anywhere from 3 – 6 percent. In addition, there was a tight timeline. The level of sport that Lindsey needed to get back to pushes the limits of healing and ACL reconstruction repair techniques. I believe that if Lindsey had more time to recover from the first injury that she would not be in this position. The same thoughts also go for her need for the knee to hold up to going 80 MPH down a mountain.
As the team orthopedic physician for the USA Gymnastics Team, I know the pressure that is put on both the athlete, coaches, trainers and physicians when the Olympics are just around the corner. Basically, it calls for creative thinking, using your medical skills to their fullest and most importantly listening to the athlete. Our Olympic athletes are the pride of our nation. They win our gold medals. They are the face of the USA. After the second injury this past November, I would have been surprised if Lindsey didn’t try to come back from it. There was no other choice for Lindsey but to take what the diagnosis was, rehab as best as she could, and give it her best to try to make the team. That is what Olympic pride is all about. Unfortunately, the mechanical issues in her knee could not stand up to the forces skiing places on the body.
She Will Be Back
In order to become the most decorated skier in US history, you must overcome adversity. Lindsey has done this in the past and I believe she will do it again. This time, she will have more time to recover before putting her knee and body to the ultimate test of downhill skiing. I wish Lindsey all the best! She will be back. Go USA!