molepharmer wrote:Paxson43 wrote:Mark K wrote:It's truly fascinating to me how Bulls fans of all people can be so buoyant about a prospect after he's had an ACL injury, as if we didn't go through the Derrick Rose experience.
Having a science background helps tremendously, if you're genuinely fascinated and not being facetious......
If you have a science background, you might find this interesting. I don't know anything about the journal "Sports Health", but I assume this publication has been reviewed by peers since it's at PubMed and written by an orthopedics group.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3806178/Apparently that 2011 publication has been referenced in a recent, although not as large sample size, 2017 publication.
https://www.ncbi.nlm.nih.gov/pubmed/28449611 TLDR version - Return to performance the first season after ACL is generally slightly less than pre-ACL. But by season 2, there's no significance difference in performance from controls (i.e. those w/o ACL injuries, and adjusted for adding two years in age). note - I probably butchered the conclusions a bit.
Those are the same studies I found as well, when doing a literature search on ACL tears and the subsequent recovery. Obviously the data is pretty limited in sample size when it comes to elite, NBA athletes, but the new research coming out is definitely very encouraging. That first study has most of its results confounded by including players with ACL tears in the 80s and 90s, when sports rehabilitation was just exploding as a medical field. Despite this, they still didn't find any significant drop off in performance in year 2, when compared to the control group. The second study is more recent, and has similar findings.
I've been scrubbed in on two ACL reconstructive surgeries, and the procedure itself is pretty simple in concept - it also hasn't changed all that much over the years. Depending on the doctor, different grafts are used, but the research on which one is better is inconclusive so far. Regardless of this, all the grafts used are all usually stronger than the native ligament, so ligament strength is certainly never the issue. The most complicated aspect, then, ends up being the rehab process. Most elite athletes, especially if below their physical prime years (late 20s), will regain all of the original strength in the knee, and then usually get even stronger. Remember Rose jumping even higher after his ACL injury?
So strength obviously isn't an issue, unless you tear an ACL in your late 20s or early 30s. The biggest obstacle for these younger players then is the proprioception that's lost with an ACL tear. This is where partial tears can be differentiated from whole ACL tears, even though the surgery and rehab process is the same. With partial tears, like LaVine's most likely was, during the surgery the original ACL ligament strands that are undamaged are left in place, and the new graft is added to the bundle. The research on preserving the original undamaged ligaments is pretty new over the past 10 years, but early studies have shown a faster return to sport, and improved recovery times with respects to balance and proprioception. This is all because the remaining ACL fibers still carry some of native receptors, making the recovery process much smoother.
There are no guarantees when it comes to ACL tears, but being a 22 year old and tearing an ACL is infinitely better than being 26+. Guys like Dennis Smith, Kyle Lowry, Baron Davis, Bonzi Wells, and Jamal Crawford, who had ACL tears in college or early in their NBA careers, all returned as better players, and as more athletic players. On the flip side, players like Rondo and Al Jefferson, who suffered the injury later on in their career, returned as shells of their former selves.
And then we have Derrick Rose, the guy who's causing most of us on this board to be extremely pessimistic when it comes to LaVine... That's another topic entirely. Standard ACL re-injury rates are about 3-5%, and Rose's ACL repaired knee actually did hold up pretty well. It was all of his other problems that ruined him. What was the cause of those injuries? Who knows...