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Ouch Part II, HarkinBanks Jr. is down!

post #1 of 14
Thread Starter 
HB Jr., a captain on his 8th grade football team, took a hit at practice on Wednesday (09/24/08) on the outside of his knee. He had pain and swelling, to the point where he could not walk without a limp, so we went over to Jackson to see Dr. "X", a US Ski Team doctor.

Diagnosis: HB Jr. has a small tear on his Meniscus, a deep tear of his MCL, and a bruised Lateral Fermoral Condyle. No surgery and everything should heal on its own.

Prognosis: HB Jr. is in a DonJoy brace, a compression stocking, and crutches. He has to wear the brace and stocking 24/7. He has to stay on crutches until 10/23. He can put 50% weight on his leg right now and can graduate to one crutch on 10/6. He is done with football for the season.

He will be able to ski this season, but will wear a sport brace for the entire season. He will be able to get on snow 12/15.

He is in very little pain and is fine with all that has gone. He is just a little dissapointed that he won't be able to elk hunt very much. He's more dissapointed that he can't play football. He's relieved he can ski - especially since he is getting new equipment this year.

Way too young (his 14th birthday was yesterday) to have issues like this.

He is looking forward to seeing and skiing with everyone at the 2009 Gathering.

HB
post #2 of 14
That's a shame; hope no permanent damage.
post #3 of 14
HB Jr.....a speedy recovery and let the girls coo over your injuries at school. Come back next year with a vengeance.
post #4 of 14
To say I'm not an MD is an understatement, but my understanding of a ligament is that it doesn't have a blood supply to it. Therefore how does it heal? Can someone please set me straight. Thank You To HarkinBanks I'm sorry for your sons' accident and hope all heals well.
post #5 of 14
Quote:
Originally Posted by RayCantu View Post
To say I'm not an MD is an understatement, but my understanding of a ligament is that it doesn't have a blood supply to it. Therefore how does it heal? Can someone please set me straight. Thank You To HarkinBanks I'm sorry for your sons' accident and hope all heals well.
That's cartilage you're thinking of, probably.

I don't think MCL tears usually require surgery, but sometimes LCL tears do, and of course usually ACLs do. Someone else will have to tell you why MCLs heal better than other knee ligaments.
post #6 of 14
vibes+++ tell him to heal up quick! I believe he's been assigned guide duty for the gathering
post #7 of 14
Segbrown
One main difference between ligaments and tendons is that tendons have a blood supply and ligaments don't, as I understand it. Ligaments go from bone to bone, tendons go from muscle to bone. Wether MCL or LCL they both go from bone to bone. The cartilage is based on bone also (no blood supply)There has to be an MD out here to help us.
post #8 of 14
Thread Starter 
I'm not a doctor, but I do have some medical training.

My understanding is that while we are young (up to say late teens or early 20's) menesci, ligaments, and tendons do have and get blood supply and heal much quicker than us old guys. Thus the reason for no surgery.

It's very unlikely that a Dr. will operate on an MCL - even in older patients the MCL tends to heal itself over time. HB Jr's MCL tear was "deep", but only around a 15% or so tear, so not worth going after. The menescus tear was "slight", so again not worth going after. I was with the Dr. looking at the computer screen when the MRI was first being pulled up.

I have a significant amount of faith in this Dr., so I'm willing to trust his judgement.

In addition HB Jr.'s rest and brace, I also have him on glucosomine and chondriotin (sp?).

He will be in a brace this coming ski season, but he will be skiing.

Again, he's looking forward to helping guide at the gathering, but looks like no jump or airs for awhile (like me).

We also hope that this will not become a chronic issue.

Yes, the girls are carrying his books, lunch tray, etc.

He still is going to football practices and games, cheering his teammates on. Again, at 5'8", 155 lbs., he was one of the team captians and one of the tougher kids on on the 8th grade team.

Thanks to all and good karma back to everyone.

HB
post #9 of 14
Quote:
Originally Posted by RayCantu View Post
Segbrown
One main difference between ligaments and tendons is that tendons have a blood supply and ligaments don't, as I understand it. Ligaments go from bone to bone, tendons go from muscle to bone. Wether MCL or LCL they both go from bone to bone. The cartilage is based on bone also (no blood supply)There has to be an MD out here to help us.
Well, that's true ... the way you put it sounded like the way most usually describe cartilage, so that's what I thought. I just know that the MCL is the "best" ligament to tear; I guess they get more blood than the others.
post #10 of 14
My understanding is that there is some blood supply to ligaments, and tendons, no matter how old the person is. They are both live tissue and without blood supply they would otherwise be dead tissue.

I also understand that if a ligament is completely torn, it will not reattach and heal itself, so the only solution is reconstructive surgery, no matter what the patient's age. However, a minor tear can heal itself, but this happens more slowly than with other tissue like muscles, because the blood supply is less.

I have known many guys who spend their entire lives suffering from old football injuries to their knees. Its gotta be one of the worst sports for bad injuries. I would suggest to HB Jr. that tennis is a much better lifetime sport that fits well with skiing. I even played a lot of indoor tennis last winter while I was skiing. And its a great social game for families and to meet girls as well.
post #11 of 14
I hope all heals well and glad he can still ski! I know what it is like to be down at that age. I had a full femur break at 15 and spent 6 weeks in traction and 8 weeks on crutches (That was long time ago!) Not a fun way to spend your time when you have pent up energy!
post #12 of 14
Quote:
Originally Posted by RayCantu View Post
To say I'm not an MD is an understatement, but my understanding of a ligament is that it doesn't have a blood supply to it. Therefore how does it heal? Can someone please set me straight. Thank You To HarkinBanks I'm sorry for your sons' accident and hope all heals well.
My understanding is LCL and MCL heal, ACL and PCL do not heal.
and I'm not medical either, but I've had enough knee injuries to be informed though.
post #13 of 14
Quote:
Originally Posted by HarkinBanks View Post
HB Jr., a captain on his 8th grade football team, took a hit at practice on Wednesday (09/24/08) on the outside of his knee. He had pain and swelling, to the point where he could not walk without a limp, so we went over to Jackson to see Dr. "X", a US Ski Team doctor.

Diagnosis: HB Jr. has a small tear on his Meniscus, a deep tear of his MCL, and a bruised Lateral Fermoral Condyle. No surgery and everything should heal on its own.

Prognosis: HB Jr. is in a DonJoy brace, a compression stocking, and crutches. He has to wear the brace and stocking 24/7. He has to stay on crutches until 10/23. He can put 50% weight on his leg right now and can graduate to one crutch on 10/6. He is done with football for the season.

He will be able to ski this season, but will wear a sport brace for the entire season. He will be able to get on snow 12/15.

B
The meniscus have blood supply to the outer third of the edge. They are capable of healing, particularly in a young person.

an exert from here follows:
http://www.emedicine.com/sports/TOPIC160.HTM

Studies have shown that 10-30% of the periphery of the medial meniscus and 10-25% of the lateral meniscus receives a vascular supply; the remainder receives its nutrition from the synovial fluid from passive diffusion and mechanical pumping. A few terminal branches of these vessels, along with the middle geniculate artery through the synovial covering of the anterior and posterior horn attachments, supply increased vascularity to the meniscal horns. The potential for vascular ingrowth is essential for successful meniscal healing and surgical repair. Various zones of the meniscus are described based on the blood supply; the red zone is the well-vascularized periphery, the red-white zone is the middle portion with vascularity peripherally but not centrally, and the white zone is the central avascular portion.

Ligaments have blood supply also...
I couldn't quickly find an article on the MCL. Here is an example for the ACL.

http://www.emedicine.com/radio/TOPIC853.HTM

The primary blood supply to the ACL derives from arteries to the surrounding synovial membrane. These in turn derive from branches of the middle geniculate artery piercing the posterior capsule (Resnick, 1995). The central core of the ACL is relatively avascular. This may partly account for the generally ineffective healing of ACL tears. Tibial nerve terminal branches innervate the ACL (Resnick, 1995).

I hope this helps!

I would love to join you all in Targhee/JH...

The judge is fickle and still in deliberation...
post #14 of 14
and if you would allow me a little shameless self promotion...

I was reading ESPN magazine...There are quotes from James Andrews, Orthopedic Surgeon. He has operated on famous athletes and stars.

#7. WE'LL TAKE ANY HELP WE GET. "All we can do is roll up our sleeves and try and fix the players. And rehab is more important than surgery, so we have to wait to see how things turn out too. Luckliy, elite athletes can do things the rest of us can't, including recovering. They make a doctor look good."

I repeat "rehab is more important than surgery."

Find a good PT!
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