Injuries Rumors

The grade twos are where you kind of get into the gray zones. There are some patients where the instability that the patients feel, depend on how ACL dependent they are. There are people who have ACL tears and don’t feel any instability. There are people who have ACL tears, and they feel very unstable. So from a clinical perspective, you have to analyze how unstable their knee is objectively and subjectively. So if a patient says that their knee is unstable, even with a partial ACL tear, then typically they need surgery to stabilize that and reconstruct the ACL. But if they’re not clinically unstable, meaning that the knee feels stable, and they don’t have any symptoms from it, there are times where people can be treated non operatively, and rehab and play sports without any issues. So it really depends on the patient.

In such cases as Kawhi Leonard, he probably felt some instability, and they probably had some objective findings of instability, even with a partial ACL tear. Which is why they decided to do surgery. The question next, if you decide to do surgery, is what kind of surgery are you going to do?

Partial ACL tears can be categorized as tears in the anteromedial bundle, or tears in the posterolateral bundle. Those are the two main bundles that occur, that the ACL fiber has. And typically, the anteromedial bundle tears, but they can both tear. If the remaining fibers are competent, meaning that they’re stable and are strong enough to function like a normal ACL, then you could do a partial or single-bundle ACL reconstruction, where you just reconstruct or repair the bundle that’s torn. And those are different techniques that are involved in that. More often, however, the remaining bundle fibers are not competent and not functioning. So even with a partial ACL tear, the remaining fibers don’t work. And so you end up doing a full reconstruction like normal.

Now, when you say recover quicker: In a case like Kawhi, because his injury happened on June 14 and surgery on July 13, where would you realistically put a timetable on his return to play? It depends on the type of surgery that he had. If it was a full ACL reconstruction, you’re looking at the regular time period for recovery, which is typically 6-9 months. Sometimes up to a year. If it was a low-grade partial ACL tear, and they did an ACL repair or an ACL augmentation with an orthobiologic supplementation, then possibly the recovery could be quicker. Maybe even 3-6 months, as opposed to the nine months to a year timeline. But again, it depends on the type of procedure that was done, and what the original injury and severity of the original ACL tear was.