lindsey-vonn-2Winter Olympics has officially begun. It will be without Ski champion Lindsey Vonn. She underwent a successful knee surgery, following an injury that forced her to pull out of the Olympics just weeks before the US team was set to leave for Sochi.

Vonn had ACL reconstruction in January 2014 by the world-renowned sports medicine Dr. James Andrews.  Our very own Dr. Brown had the pleasure of working with him during her training. Vonn hopes to be back competing in February of 2015, and Dr. Andrews is confident that she will.

It all began with an injury she sustained a year ago. Vonn, who has 59 World Cup race victories to her credit and who is the reigning Olympic downhill champion, badly injured her knee while competing in a super-G at the World Championships in February 2013. She tore her anterior cruciate ligament (ACL), medial collateral ligament (MCL) and fractured her lateral tibial plateau.  Dr. William Sterett of Vail-Summit Orthopaedics performed ACL reconstructive knee surgery in Vail, Colo. After an ACL reconstruction, female athletes are particularly vulnerable to a second ACL injury, a recent study showed.

After reconstructive surgery, and a lengthy layoff, Vonn returned to World Cup competition at Lake Louise, Canada in early December 2013. She unfortunately injured the same knee while training in Copper Mountain, Colorado in November 2013. She suffered a partial tear of the anterior cruciate ligament of right knee following the crash.

She continued to compete. At Lake Louise, Vonn was 40th in the first downhill, 11th in a second downhill and fifth in a super-G. She then competed in a downhill at Val d’Isere in the French Alps just before Christmas 2013, where she skied off course during world cup downhill run in Val d’Isere clutching her knee. She was diagnosed with a medial collateral ligament sprain.

In early January 2014 Vonn announced she would not compete in the Sochi Winter Games. In a statement, she said: “I did everything I possibly could to somehow get strong enough to overcome having no ACL but the reality has sunk in that my knee is just too unstable to compete at this level.

LCL Pic

The anterior cruciate ligament (ACL) is one of the main stabilizing ligaments in the knee, and it is the most commonly torn ligament in the knee.  It prevents the thighbone (femur) from moving forward on the shinbone (tibia).  It may be torn by pivoting and twisting the knee, or by hyperextension.  Landing awkwardly from a jump may also result in a torn ACL.  Symptoms include hearing or feeling a pop in the knee, swelling in the knee, pain, and a feeling of instability, especially with side to side movement.  The knee may “give way” or “buckle” with weight-bearing.  An athlete in a sport which requires pivoting, cutting, or jumping requires surgical reconstruction to prevent recurrent episodes of instability and further knee damage such as meniscus tears and cartilage damage.  The surgery involves reconstructing a new ACL from either the athlete’s own tissue or donor tissue from a cadaver.  The rehabilitation process after surgery takes several months, and return to play depends on the type of surgery and the sport, however on average the recovery time is 7 to 10 months.

Women are more likely to tear their ACL than men for a number of reasons.  One is the anatomical difference in the knee-joint, the space where the ACL sits is narrower in women, and so the ligament has less room when the knee is hyperextended or twisted and therefore more prone to injury.  Another reason is the alignment of the female knee as compared to the male knee.  Women in general have wider hips and therefore place increased stress on the ACL when the knee is twisted.

Additionally there are hormonal differences in women, which may make the ligaments looser and more prone to tearing.  Lastly, an important factor in ACL injury is conditioning and muscle strength of the muscles surrounding the knee.  There are a number of conditioning programs specifically designed to reduce a female athlete’s risk of ACL tear.

 

Provided by Primus Sports Medicine Staff