MrRaspberryJam 201 Posted March 21 Share Posted March 21 5 hours ago, OTF said: It's a tough one as there is a push for not performing surgery for ACL 'injuries'. Sometimes there are differing opinions on MRIs as to whether there is a full rupture or not, and if not whether it can recover on its own. The ACL is not in an area of the knee that gets good blood flow as it's internal compared to say the MCL which is on the outer of the knee and gets greater flow and is easier to see the condition in scans. From what I've read there were conflicting opinions with his original injury as to whether surgery was required. If it was a full rupture then surgery is definitely required as you need your ACL to play any level of sport let alone professionally. The ACL (in the middle of the knee) and the PCL (at the back) are the cruciate ligaments that form a cross to prevent the knee from being able to twist the wrong way (hence the name cruciate). After choosing the non-surgical option they must have done further MRIs that showed that the ligament was connected and presumably had increased in size/condition. Subsequent to returning he's injured it again, this time regardless of whether it's a complete rupture or not they'll have to go with surgery. Thing is there are many options for the surgery itself, each with pros and cons. Generally the best option for long term outcome is a graft using either hamstring or patella with a very slight reduction in recurrence percentage when using patella. Other options can be to use a donor (cadaver), but there is a higher chance or recurrence, though the benefit is there's no need for rehabilitation of the hamstring/patella. In my case I used my own hamstring, and subsequently suffered multiple hamstring injuries during my recovery from doing relatively mundane tasks. Hamstring seems to be mostly ok now which has helped to get the knee recovery back on track. There's also loads of different conjecture around the best angles for the graft to be attached, it's complicated stuff and having gone through some of it you can understand how his situation has played out like it did. Hindsight is always 20/20 but of course now we know they should have opted for surgery originally. He'd have missed the rest of this season as a minimum but given how he's not been himself simce returning that wouldn't have been such an issue anyway. I’d be surprised if Botman ever walks again. 5 Link to comment Share on other sites More sharing options...
Chaser 1054 Posted March 21 Share Posted March 21 6 hours ago, OTF said: It's a tough one as there is a push for not performing surgery for ACL 'injuries'. Sometimes there are differing opinions on MRIs as to whether there is a full rupture or not, and if not whether it can recover on its own. The ACL is not in an area of the knee that gets good blood flow as it's internal compared to say the MCL which is on the outer of the knee and gets greater flow and is easier to see the condition in scans. From what I've read there were conflicting opinions with his original injury as to whether surgery was required. If it was a full rupture then surgery is definitely required as you need your ACL to play any level of sport let alone professionally. The ACL (in the middle of the knee) and the PCL (at the back) are the cruciate ligaments that form a cross to prevent the knee from being able to twist the wrong way (hence the name cruciate). After choosing the non-surgical option they must have done further MRIs that showed that the ligament was connected and presumably had increased in size/condition. Subsequent to returning he's injured it again, this time regardless of whether it's a complete rupture or not they'll have to go with surgery. Thing is there are many options for the surgery itself, each with pros and cons. Generally the best option for long term outcome is a graft using either hamstring or patella with a very slight reduction in recurrence percentage when using patella. Other options can be to use a donor (cadaver), but there is a higher chance or recurrence, though the benefit is there's no need for rehabilitation of the hamstring/patella. In my case I used my own hamstring, and subsequently suffered multiple hamstring injuries during my recovery from doing relatively mundane tasks. Hamstring seems to be mostly ok now which has helped to get the knee recovery back on track. There's also loads of different conjecture around the best angles for the graft to be attached, it's complicated stuff and having gone through some of it you can understand how his situation has played out like it did. Hindsight is always 20/20 but of course now we know they should have opted for surgery originally. He'd have missed the rest of this season as a minimum but given how he's not been himself simce returning that wouldn't have been such an issue anyway. 4 Link to comment Share on other sites More sharing options...
RobinRobin 9230 Posted March 21 Share Posted March 21 1 hour ago, toonotl said: I'd prefer to get an idiot's opinion on this one. 40 minutes ago, MrRaspberryJam said: I’d be surprised if Botman ever walks again. 4 Link to comment Share on other sites More sharing options...
Holden McGroin 4855 Posted March 21 Share Posted March 21 6 hours ago, OTF said: It's a tough one as there is a push for not performing surgery for ACL 'injuries'. Sometimes there are differing opinions on MRIs as to whether there is a full rupture or not, and if not whether it can recover on its own. The ACL is not in an area of the knee that gets good blood flow as it's internal compared to say the MCL which is on the outer of the knee and gets greater flow and is easier to see the condition in scans. From what I've read there were conflicting opinions with his original injury as to whether surgery was required. If it was a full rupture then surgery is definitely required as you need your ACL to play any level of sport let alone professionally. The ACL (in the middle of the knee) and the PCL (at the back) are the cruciate ligaments that form a cross to prevent the knee from being able to twist the wrong way (hence the name cruciate). After choosing the non-surgical option they must have done further MRIs that showed that the ligament was connected and presumably had increased in size/condition. Subsequent to returning he's injured it again, this time regardless of whether it's a complete rupture or not they'll have to go with surgery. Thing is there are many options for the surgery itself, each with pros and cons. Generally the best option for long term outcome is a graft using either hamstring or patella with a very slight reduction in recurrence percentage when using patella. Other options can be to use a donor (cadaver), but there is a higher chance or recurrence, though the benefit is there's no need for rehabilitation of the hamstring/patella. In my case I used my own hamstring, and subsequently suffered multiple hamstring injuries during my recovery from doing relatively mundane tasks. Hamstring seems to be mostly ok now which has helped to get the knee recovery back on track. There's also loads of different conjecture around the best angles for the graft to be attached, it's complicated stuff and having gone through some of it you can understand how his situation has played out like it did. Hindsight is always 20/20 but of course now we know they should have opted for surgery originally. He'd have missed the rest of this season as a minimum but given how he's not been himself simce returning that wouldn't have been such an issue anyway. thanks for the insight OTF. It makes much more sense why players never come back the same after injuries like this. 2 Link to comment Share on other sites More sharing options...
Holden McGroin 4855 Posted March 21 Share Posted March 21 Nufc.com mentioning Lloyd Kelly again. Link to comment Share on other sites More sharing options...
RobinRobin 9230 Posted March 21 Share Posted March 21 28 minutes ago, Holden McGroin said: Nufc.com mentioning Lloyd Kelly again. Out of contract which will make him more attractive (although I recognise signing on fees and higher wages have an FFP impact). 1 Link to comment Share on other sites More sharing options...
Kid Dynamite 5910 Posted March 21 Share Posted March 21 42 minutes ago, Holden McGroin said: Nufc.com mentioning Lloyd Kelly again. Sounds like he's pulling a Ryan Fraser Link to comment Share on other sites More sharing options...
MrRaspberryJam 201 Posted March 21 Share Posted March 21 1 hour ago, RobinRobin said: I’ve got feelings you know 2 Link to comment Share on other sites More sharing options...
RobinRobin 9230 Posted March 21 Share Posted March 21 28 minutes ago, MrRaspberryJam said: I’ve got feelings you know In that case 🙂 2 Link to comment Share on other sites More sharing options...
Dr Gloom 19825 Posted March 21 Share Posted March 21 9 hours ago, OTF said: It's a tough one as there is a push for not performing surgery for ACL 'injuries'. Sometimes there are differing opinions on MRIs as to whether there is a full rupture or not, and if not whether it can recover on its own. The ACL is not in an area of the knee that gets good blood flow as it's internal compared to say the MCL which is on the outer of the knee and gets greater flow and is easier to see the condition in scans. From what I've read there were conflicting opinions with his original injury as to whether surgery was required. If it was a full rupture then surgery is definitely required as you need your ACL to play any level of sport let alone professionally. The ACL (in the middle of the knee) and the PCL (at the back) are the cruciate ligaments that form a cross to prevent the knee from being able to twist the wrong way (hence the name cruciate). After choosing the non-surgical option they must have done further MRIs that showed that the ligament was connected and presumably had increased in size/condition. Subsequent to returning he's injured it again, this time regardless of whether it's a complete rupture or not they'll have to go with surgery. Thing is there are many options for the surgery itself, each with pros and cons. Generally the best option for long term outcome is a graft using either hamstring or patella with a very slight reduction in recurrence percentage when using patella. Other options can be to use a donor (cadaver), but there is a higher chance or recurrence, though the benefit is there's no need for rehabilitation of the hamstring/patella. In my case I used my own hamstring, and subsequently suffered multiple hamstring injuries during my recovery from doing relatively mundane tasks. Hamstring seems to be mostly ok now which has helped to get the knee recovery back on track. There's also loads of different conjecture around the best angles for the graft to be attached, it's complicated stuff and having gone through some of it you can understand how his situation has played out like it did. Hindsight is always 20/20 but of course now we know they should have opted for surgery originally. He'd have missed the rest of this season as a minimum but given how he's not been himself simce returning that wouldn't have been such an issue anyway. we're now looking at being without our best defender for the best part of two seasons instead of just one. tough call to make, of course, but an ACL rupture isn't the career-ending injury it once was. surgery is quite advanced and often players come back looking like they've never been away after 9-12 months. Link to comment Share on other sites More sharing options...
Monkeys Fist 38767 Posted March 21 Share Posted March 21 9 hours ago, OTF said: Other options can be to use a donor (cadaver) Zombie Defender. 2 Link to comment Share on other sites More sharing options...
OTF 6148 Posted March 21 Share Posted March 21 44 minutes ago, Dr Gloom said: we're now looking at being without our best defender for the best part of two seasons instead of just one. tough call to make, of course, but an ACL rupture isn't the career-ending injury it once was. surgery is quite advanced and often players come back looking like they've never been away after 9-12 months. It's far from career ending but generally wipes out a season. It's if there is a recurrence (2-3% overall but probably higher in professional sportspeople) then it can become a career ender. There's a much higher incidence of ACL injuries in women's football due to the angle of their knee based on their wider hips (according to my physio). The surgery is very advanced and is very common, as I mentioned earlier there are loads of papers regarding the placement of the graft and research into the benefits of each graft type, but considering most ACL injuries don't involve contact they don't really know why they really occur initially which makes it difficult to attempt to prevent recurrence anyway. There's loads of collateral damage that can also occur when the ACL ruptures as the knee can move into an unnatural position putting stress onto the other ligaments and the meniscus (the shock absorbers of the knee). One of the worst is the unhappy triad where you tear the ACL, the MCL and also damage the medial meniscus (the one on the inside). Sometimes the meniscus damage is picked up on an MRI but othertimes if it's a bucket handle tear it can't be confirmed until surgery. I had a partial MCL tear as well as the full rupture of the ACL bit thankfully no meniscus damage. I did however have a lot of bone bruising seeing as the unnatural twisting motion was stopped by bone hitting bone rather due to the ACL not doing its job. Took ages for me to be able to bend that knee any significant amount. I had to work on this before surgery. So sometimes it's best not to operate straight away after an injury occurs also, if they do and the rest of the knee is not in a good state it won't ever recover fully. With Botman there wouldn't have been any other damage when the initial injury occurred so operating right away (with hindsight) would have been the best option. It seems strange when they get the decision wrong at that level, but it makes sense when you consider all factors at play. Now I hope that noone who is medically trained reads any of what I have posted as they're likely to tell me it's a complete load of shit. Link to comment Share on other sites More sharing options...
Dr Gloom 19825 Posted March 21 Share Posted March 21 16 minutes ago, OTF said: It's far from career ending but generally wipes out a season. It's if there is a recurrence (2-3% overall but probably higher in professional sportspeople) then it can become a career ender. There's a much higher incidence of ACL injuries in women's football due to the angle of their knee based on their wider hips (according to my physio). The surgery is very advanced and is very common, as I mentioned earlier there are loads of papers regarding the placement of the graft and research into the benefits of each graft type, but considering most ACL injuries don't involve contact they don't really know why they really occur initially which makes it difficult to attempt to prevent recurrence anyway. There's loads of collateral damage that can also occur when the ACL ruptures as the knee can move into an unnatural position putting stress onto the other ligaments and the meniscus (the shock absorbers of the knee). One of the worst is the unhappy triad where you tear the ACL, the MCL and also damage the medial meniscus (the one on the inside). Sometimes the meniscus damage is picked up on an MRI but othertimes if it's a bucket handle tear it can't be confirmed until surgery. I had a partial MCL tear as well as the full rupture of the ACL bit thankfully no meniscus damage. I did however have a lot of bone bruising seeing as the unnatural twisting motion was stopped by bone hitting bone rather due to the ACL not doing its job. Took ages for me to be able to bend that knee any significant amount. I had to work on this before surgery. So sometimes it's best not to operate straight away after an injury occurs also, if they do and the rest of the knee is not in a good state it won't ever recover fully. With Botman there wouldn't have been any other damage when the initial injury occurred so operating right away (with hindsight) would have been the best option. It seems strange when they get the decision wrong at that level, but it makes sense when you consider all factors at play. Now I hope that noone who is medically trained reads any of what I have posted as they're likely to tell me it's a complete load of shit. i'm no expert either. just a supporter who is annoyed that we're losing him for the best part of two seasons, when it could have been just one if they had operated straight away, and looking for someone to blame Link to comment Share on other sites More sharing options...
Dazzler 5508 Posted March 21 Share Posted March 21 So are we now thinking maybe the physio that got the bullet, got shot unfairly? Because it kind of seems he was right all along. Link to comment Share on other sites More sharing options...
Dr Gloom 19825 Posted March 21 Share Posted March 21 2 minutes ago, Dazzler said: So are we now thinking maybe the physio that got the bullet, got shot unfairly? Because it kind of seems he was right all along. 5 Link to comment Share on other sites More sharing options...
Rayvin 4964 Posted March 21 Share Posted March 21 Fuck this season. 1 Link to comment Share on other sites More sharing options...
OTF 6148 Posted March 22 Share Posted March 22 22 hours ago, Rayvin said: Fuck this season. Basically. In the long term we'll be better for it. Last season was so bloody good. Wheels fell off this season when we capitulated against Liverpool. 1 Link to comment Share on other sites More sharing options...
Alex 30414 Posted March 22 Share Posted March 22 23 hours ago, Dr Gloom said: Any excuse: 9 Link to comment Share on other sites More sharing options...
NJS 3978 Posted March 29 Share Posted March 29 I know consent in medicine is all good and proper but I still feel something isn't right when a footballer opts not to have surgery that's been advised. I'm not sure what level of persuasion is fair but I'd like to think they should have pushed some way at least. It all seems a bit iffy to me. 1 Link to comment Share on other sites More sharing options...
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