something different(last man standing)

[annew]

So, sneaking up the inside rail.....It's Dempster! .... Looks like he has at least another 2 years in him.

Original post said playing for the swans so it looks like Goodes is the winner.

[ugg]

and now that the winner has called time on his career, perhaps it's time to start the 2012 GF edition.

We've already lost Shaw, Mattner, O'Keefe, Goodes, Roberts-Thomson, Bolton and Morton. Mumford, Malceski and most likely Jetta will be at other teams.

Leaving Richards, Johnson, Grundy, Smith, Jack, Hannebery, Bird, Reid, McVeigh, Kennedy, Pyke and Parker

Parker is the youngest of the lot so the smart money will on him.

[bloodspirit]

and now that the winner has called time on his career, perhaps it's time to start the 2012 GF edition.

We've already lost Shaw, Mattner, O'Keefe, Goodes, Roberts-Thomson, Bolton and Morton. Mumford, Malceski and most likely Jetta will be at other teams.

Leaving Richards, Johnson, Grundy, Smith, Jack, Hannebery, Bird, Reid, McVeigh, Kennedy, Pyke and Parker

Parker is the youngest of the lot so the smart money will on him.

I agree the smart money will be on Parker - but what about AJ!? Definitely worth a flutter. If he makes it back he'll be 80 odd games fresher!

[paper_rival]

I agree the smart money will be on Parker - but what about AJ!? Definitely worth a flutter. If he makes it back he'll be 80 odd games fresher!

With a very dodgy knee!

[YvonneH]

Esky had 2 or 3 knee reconstructions and had a very good career so why not AJ?

[goswannies]

Esky had 2 or 3 knee reconstructions and had a very good career so why not AJ?

With little consideration:
- AJ had chronic indeterminate infections (may not resolve, may re-flare up if the cause is not determined)
- muscular atrophy (muscles will have wasted as his rehab has been considerably delayed at times)
- compromised proprioception (this is a natural consequence of an ACL recon but in Eski could commence proprioceptive re-training rapidly with the LARS & he missed at most 12 months between recon & resumption - way less with the LARS; AJ is missing a lot of time to redevelop his proprioception & this will increase the risk of re-injury)
- potential predisposition to ACL rupture (some people have either more lax ligaments or potentially innately weaker ligaments; some are just unlucky; Eski is probably the latter, the force that ruptured his ACL & subsequent graft would damage any ACL; AJ's were either more innocuous or it simply failed)
- Eski's more rapid rehab & return means much less match-deconditioning

Doesn't mean AJ won't get back, just giving some reasons as to "why not AJ?"

[YvonneH]

Well that is depressing goswannies. Sometimes ignorance is bliss.

[bloodspirit]

Well that is depressing goswannies. Sometimes ignorance is bliss.

My reaction too!

[goswannies]

Well that is depressing goswannies. Sometimes ignorance is bliss.

YvonneH & bloodspirit, the initial question could be re-phrased as ""why AJ?" instead of "why not AJ?" ... ie "why AJ will come back as well as Eski?" ... well, there are plenty of reasons!

- if the recurrent infection is indeed the cause of the graft failures, then once the infection is controlled, away we go. Fortunately we have access to a number of world class infectious disease specialists in this country and specific anti-biotics for combatting these bugs. There have been far worse cases that have been effectively managed

- the time out of the game could actually be of benefit. An autologous ACL graft takes time to heal. We often say that 9-12 months is recommended. But at 12 months the graft is only about 70-80% healed. Remodelling of the healing tissue continues for at least another 12 months. Extra time could allow further strengthening of the graft. This is a good thing

- at least a couple of AJs graft failures were attributable to uncontrolled infection, if I recall correctly. If graft failure is due to trauma, there is a chance that other tissue damage has occurred (eg to chondral cartilage, meniscii, collateral ligaments etc). Hopefully the reduced trauma will have saved AJ of this to a degree, resulting in a less degenerative knee (eg like Goodsey & Pike) than if all of AJs recons were as a consequence of trauma (like Eski)

- presumably AJ has been behaving like a professional athlete since his first ACL recon & been devoting much of his time to rehab. This should greatly negate atrophy & proprioceptive loss. Matt Cameron would be right on to this, as well as his cardiovascular fitness.

- I always say that professional athletes are best placed for rehab outcomes. The rest of us have distractions from the optimal rehab conditions to fully recovere. We work and this take 8 or so hours out of our day that could be devoted to improving surgical outcome. The cost; physio can add up so often you'd see your physio every 1-2 weeks (or less). Facilities; we rarely have access to all the devices we need, so we either make do (or join a gym ... refer back to cost).
The professional athlete (ie AJ) his job is now rehab. His 8 hours at work is to get his knee right! His physio is covered by the club ... none of this every two weeks business, I'd be surprised if he didn't engage Matt Cameron every day or two (he'd almost certainly have access to him & the club doctors (who specialise in sports medicine) any time they're needed. Facilities? State. Of. The. Art!

Not knowing AJ, the impression I get from when I've seen him interviewed is that he's a very determined and motivated young man. This psychological aspect cannot be underestimated and plays an important role is recovery.

Glass half full

[Untamed Snark]

Thanks Goswannies.

Your insight to the medical issues is always fascinating

[bloodspirit]

Yeah, thanks goswannies. Here's hoping that's the way it pans out for good ole AJ. Can't wait for him to make a successful return. You're still in our thoughts mate!

[Ludwig]

- the time out of the game could actually be of benefit. An autologous ACL graft takes time to heal. We often say that 9-12 months is recommended. But at 12 months the graft is only about 70-80% healed. Remodelling of the healing tissue continues for at least another 12 months. Extra time could allow further strengthening of the graft. This is a good thing

Not having heard anything about the status of AJ's knee for a while, is it possible to make any prognosis at all? I know his surgery was scheduled for August, but hasn't been reported, to my knowledge. Did he actually have the surgery? What type of reco is he having (or had)?

What would be the case for someone like AJ who has had the entire removal of the ACL and the knee cleaned up from prior surgery?

Perhaps there's been another delay in his surgery for some nefarious reason.

And thanks again for your insights into medical matters.

[goswannies]

Not having heard anything about the status of AJ's knee for a while, is it possible to make any prognosis at all?

Almost impossible. My initial response was answering a 'why not' question. My subsequent post was 'this is why', because 'why not' seemed pessimistic. There are a multitude of other factors too. All hypotheticals, I'm afraid, unless we have intimate knowledge of his situation (which the club should not give, because of patient confidentially) but probably more accurate that the New Idea poorly substantiated, conjecture riddled, "reporting" of the Buddy situation. It was more to give insight as to what could influence outcome.

I know his surgery was scheduled for August, but hasn't been reported, to my knowledge. Did he actually have the surgery? What type of reco is he having (or had)?

Not sure that it's been reported (I haven't heard)

What would be the case for someone like AJ who has had the entire removal of the ACL and the knee cleaned up from prior surgery??

Pretty much the same as for most people.

There are many ways to perform an ACL reconstruction but many of them removing the torn ACL anyway (otherwise it would impinge with the new graft in a confined space within the knee ie the intercondylar notch of the femur).

It's also not uncommon for a surgeon with a first time ACL rupture to perform an initial "exploratory/examination" arthroscopy to assess the knee & clean up meniscal & chondral cartilage (& to establish that the ACL is ruptured & actually requires reconstruction) and then, once the inflammation has settled, subsequently perform the reconstruction.

Without typing a massive response, that is a simple answer to your postulation. Bear in mind, however, ACL recons are often done with out an initial arthroscopy, & some reconstructive procedures can preserve part (or all) of the ACL.

Perhaps there's been another delay in his surgery for some nefarious reason.

Quite possibly. We can postulate all we want but without facts to base it on, it's simply hypothetical.

And thanks again for your insights into medical matters.

All to be taken with a disclaimer of it being general information only. I have no insider knowledge of AJs specific circumstances, nor should RWO readers use it as medical advice for their own circumstances. Having said that, you're most welcome