Cushing's Surgery Went Well

[CloakNNNdagger]

Brian Cushing’s ACL surgery goes ‘very well’

[Thorn]

Good news. Hopefully he will be back for our 2nd Super Bowl.

[speedfreek]

Awesome, guy is a player!

TJ

[417Texan]

I hope he is well. Guy has a strong work ethic and he will be back in force. His news of him being out took a lot of Texans during the loss at Green Bay.

[dc_txtech]

Thanks doc. Could you explain what "went well" might mean? What complications might arise or why one successful surgery might be better than another successful surgery.

[silvrhand]

well maybe at least when we resign him we'll get a "reduced" signing cost, and can wrap him up for a few more years. Don't like that he seems to already be having knee issues so early in his career.

[MEGA SWATT]

Good news.

[painekiller]

never mind

[Brisco_County]

Originally Posted by silvrhand

well maybe at least when we resign him we'll get a "reduced" signing cost, and can wrap him up for a few more years. Don't like that he seems to already be having knee issues so early in his career.

I thought about this too, and decided that it won't make any difference. His value will be determined by the market, and he'd be a premier free agent. His body didn't fail-- the cause was external. And any team in the league would benefit from the addition of Cushing.

Congrats to Brian on a successful surgery. Silver lining: He may get to spend a little more time with his new baby.

[CloakNNNdagger]

Originally Posted by dc_txtech

Thanks doc. Could you explain what "went well" might mean? What complications might arise or why one successful surgery might be better than another successful surgery.

Cushing’s surgery having gone “very well” is standard for we didn’t come up against problems during the surgery that we didn’t expect or were able to handle them if encountered. It does not speak for prognosis per se.

A 2006 American Journal of Sports Medicine study looked specifically at ACL injuries in NFL players (running backs and wide receivers) found those who suffer one of these injuries will likely never be the same player again. Essentially, total yards and touchdowns were markedly diminished (~30%) when they returned after surgery.

The lead author concluded that these players were only playing at approximately 2/3rds of the level they were playing at before the injury. This study was the first time anyone used player performance and their statistics to look at the outcomes of a surgical procedure.

Probably the most concerning stat was that 21% (1/5) of these injured players never played another NFL game. The predominant thinking when 31 head NFL team physicians were interviewed, was that 90 to 100 percent of players, presuming not borderline talent, return to the NFL. Of those who did return, it took 9 to 12 months to get back on the field.

The chief author of this study stated that it gave all of his co-authors pause. He said that even in the best case scenarios these were players who were going to work in the extreme doing rehab 8 hours a day to get back to playing and even then a fifth of them weren’t getting back to playing. Interestingly, those who sustained ACL injuries are more likely to be high-performance players, essentially those players who perform frequent accelerations, decelerations, twisting, cutting maneuvers, that puts them at the highest risk. They were also more likely to be injured because they compete in more plays per game, carry the ball longer on each play, and attract more defensive attention.

The biggest problem with an ACL injury is that once it's torn there is no way that it's going to heal or be repaired, except with surgery. But those elite players ended up less great after that surgery. It's believed players don't get back to where they were because of one or more factors, including knee pain, stiffness, loss of strength, deconditioning and reduced proprioception, which is the sense of knowing where your leg is. A summary message was left that ACL reconstruction does not perfectly recreate the complex anatomy and composition of a player's ACL before injury.

Now, some could say that this is an older study and that both surgical and rehab techniques have improved since then. So then we are handed additional information from a newer study published in July 2010 in the same Journal that concluded that 63% of NFL athletes returned to NFL game play at an average of 10.8 months after surgery. Age at time of surgery, position, and the type and number of procedures were not significantly different between those who did and did not return to play. They found that the return to play rates after ACL reconstruction in NFL football players are lower than previously perceived. More experienced and established athletes (4 years or more) are 5 times more likely to return to competition at the same level after this procedure than those with less professional experience. Being selected in the first 4 rounds of the NFL draft was highly predictive of return to play.

Keep in mind that not all ACL injuries reflect the same level of trauma. Approximately only 1/3rd are solitary injuries, where as 2/3rd are accompanied by a combination of tears to the medial or lateral collateral ligaments, and/or medial or lateral menisci. If you ever talk to a professional football player who has undergone the reconstruction.....even the elite who return to commendable performance....if they are totally honest with you, they will tell you that their knee still doesn’t feel entirely “right.”

I’ve posted the above more for those interested in reviewing some of the “available” information on the subject in NFL players. It does not include the recent attempted use of combined platelet or stem cell therapy, which at this time are still in infancy and not of proven value. As for Cushing, the “gym rat” in him gives him the best shot for returning “in tact” to kick butt.

[LondonTex]

Originally Posted by CloakNNNdagger

As for Cushing, the “gym rat” in him gives him the best shot for returning “in tact” to kick butt.

Good to hear ... rep given for that informative post btw

[ObsiWan]

Originally Posted by CloakNNNdagger

Brian Cushing’s ACL surgery goes ‘very well’

I guess that's good news. We'll see how the rehab process goes.

[SAMURAITEXAN]

Glad surgery went well. We need you back next year Cush!!!

He is a true leader for our D!!!

Go Cush!!!

Go Texans!!!

[IDEXAN]

Keep in mind that not all ACL injuries reflect the same level of trauma. Approximately only 1/3rd are solitary injuries, where as 2/3rd are accompanied by a combination of tears to the medial or lateral collateral ligaments, and/or medial or lateral menisci.
****************************************
And I've not read or heard any reports that Cushing had any damage/injury to the medial or lateral collateral ligaments ? So if this is the case and Cushing is in the "1/3rd solitary injury" category this would seem to improve his chances for a successful and full recovery ?

[dc_txtech]

Thanks doc!

[CloakNNNdagger]

Originally Posted by IDEXAN

Keep in mind that not all ACL injuries reflect the same level of trauma. Approximately only 1/3rd are solitary injuries, where as 2/3rd are accompanied by a combination of tears to the medial or lateral collateral ligaments, and/or medial or lateral menisci.
****************************************
And I've not read or heard any reports that Cushing had any damage/injury to the medial or lateral collateral ligaments ? So if this is the case and Cushing is in the "1/3rd solitary injury" category this would seem to improve his chances for a successful and full recovery ?

Experience has shown that teams usually freely report the major damage to the ACL but seldom include the full extent of "collateral damage." There is one aspect of Cushing's situation that would have me concerned over the "typical" ACL injury..........and that is the mechanism involved leading to the injury.

The "typical" mechanism involves NON-CONTACT. In fact 80% of all ACL tears fall under this category. Cushing's involved CONTACT. In other words, the violent active unnatural external forces he experienced compliments of Matt Slauson very likely would have applied significant additional stresses to his knee joint, thus encouraging more distraction and displacement of the femur and tibia which make up the knee joint than would have occurred with the more limiting passive forces seen in a non-contact injury...........thus more damage to other supportive ligaments (MCL, LCL, PCL) and cartilaginous structures (medial meniscus, lateral meniscus).

[IDEXAN]

Originally Posted by CloakNNNdagger

Experience has shown that teams usually freely report the major damage to the ACL but seldom include the full extent of "collateral damage." There is one aspect of Cushing's situation that would have me concerned over the "typical" ACL injury..........and that is the mechanism involved leading to the injury.

The "typical" mechanism involves NON-CONTACT. In fact 80% of all ACL tears fall under this category. Cushing's involved CONTACT. In other words, the violent active unnatural external forces he experienced compliments of Matt Slauson very likely would have applied significant additional stresses to his knee joint, thus encouraging more distraction and displacement of the femur and tibia which make up the knee joint than would have occurred with the more limiting passive forces seen in a non-contact injury...........thus more damage to other supportive ligaments (MCL, LCL, PCL) and cartilaginous structures (medial meniscus, lateral meniscus).

But I seem to recall instances of player injury in the past where the reports would state that 2 or maybe even all 3 ligaments were torn/damaged and would require surgical repair, as contrasted to Cushings situation where there was explicit mention of just the ACL ?

[CloakNNNdagger]

Originally Posted by IDEXAN

But I seem to recall instances of player injury in the past where the reports would state that 2 or maybe even all 3 ligaments were torn/damaged and would require surgical repair, as contrasted to Cushings situation where there was explicit mention of just the ACL ?

Your recollection is correct. But again, you can seldom depend that a report on an ACL tear is all-inclusive. HIPAA privacy regulations do not require "patient players" or without permission allow teams to volunteer details of the surgical findings or surgical procedures.

Exemplified by the following:

Coming off of back-to-back seasons in which he compiled over 1700 yards and tallied 17 or more touchdowns, Larry Johnson had high hopes for the 2007-2008 National Football League ("NFL") season. 1 After spending the Kansas City Chiefs' ("Chiefs") entire training camp negotiating a new contract, however, Johnson began the season with a slight hamstring injury and never seemed to get going. 2 In a November 4, 2008 game against the Green Bay Packers, Johnson limped off the field, putting no weight on his right leg. 3 From the moment Johnson left the field, announcers and fans began to speculate. The subsequent actions taken by Johnson and the Chiefs organization led to the creation of a mystery injury.

After Johnson limped off the field on November 4th, the Chiefs' organization failed initially to issue a formal statement disclosing any specifics about the injury. 4 Additionally, Johnson neglected to issue a statement as to the exact nature of his condition, noting only the severity of the initial swelling and the fact that the condition improved to where he could walk without a protective boot. 5 It is important to note that NFL organizations typically release information relating to on-field injuries. 6 When the Chiefs' president, Carl Peterson, finally issued a formal statement, the information he provided remained ambiguous. Peterson stated, "[i]f a patient doesn't want medical information out there, then (the doctor) is obligated, as we are, under the rules of HIPAA [Health Insurance Portability and ...

...........just like Cushing protected details of his supposed hormonal brain "tumor" information.