AJ's knee

[Ludwig]

Surely everyone was on the alert for a possible infection and every precaution must have been taken, so it's hard to imagine how something like this could happen. There seems to be a problem with AJ responding normally to antibiotics. It doesn't seem to work for him. I wonder if there's anything that can be done from here. I'd send him off to the best infection specialist in world, wherever that may be.

[dimelb]

Intense disappointment and sadness, and regret at what could have been. I hope they can find out why this keeps returning.

[stevoswan]

Been otherwise distracted and just read this. I feel sick for the poor bastard. It's such a downer for him, the club and all the fans. Just as we, and he, were dreaming of a magical return to the game, it could be over. Feel for him....

[goswannies]

The tough thing is that retiring still doesn't solve the problem. He faces the prospect of now having the recent graft removed and quite probably having to live the rest of his life without and ACL. That is quite doable but will leave him unable to do many things that a young sporty gut would otherwise want to do.

Living without an ACL is very doable. I couldn't be bothered having my left one done after 2 ACL recons on my right knee.
In some instances scar tissue can provide some stability to the torn ACL remnants. Probably not in AJs case though as he's had so much done in there. & it's a crappy "solution", as scar tissue is weaker/less flexible than tendonous/ligamentous tissue & would be prone to rupture with enough force.
Even an ACL deficient knee can be OK with rehab (to strengthen the muscles around the knee & re-train proprioceptors) and activity modification (avoiding jumping, twisting, pivoting) so footy at any level is out (well it should be, but I've seen some try & do it - but not at the elite level). But sport can still be played in some way if that's what the individual wants.
It comes down to quality of life and is a very individual/personal choice. Many people who love their sport would be shattered to think that (particularly after participating at such an elite level) that this has just been cruely taken away from them. Others might think that they have achieved the ultimate (being an AFL footballer and a premiership player) and are satisfied and proud and can be content knowing that no one can taken that away from them. They might think that there are other things can achieve in life, other challenges that can test them & bring the best out of them in a non-sporting arena. Others, still, stoically soldier on & say they will keep trying until every avenue is exhausted or until the decision is taken out of their hands.

Surely everyone was on the alert for a possible infection and every precaution must have been taken, so it's hard to imagine how something like this could happen. There seems to be a problem with AJ responding normally to antibiotics. It doesn't seem to work for him. I wonder if there's anything that can be done from here. I'd send him off to the best infection specialist in world, wherever that may be.

One problem we, as interested onlookers, have is that no specific detail has been given to the public as to the exact nature of the "infection(s)" - and quite rightly so, as it's medical confidentially. Moreover, realistically it's probably unknown - or he'd hopefully be better by now.
But it could be a general infection (like the pesky multi/Methicillin resistant bugs); or a reaction to synthetic material (eg the LARS graft itself, suture material, metal fixation - screws/buttons); excessive (albeit necessary) previous antibiotic use can reduce its subsequent effectiveness; an infection in another area can manifest at the surgical site systemically; the list can go on.
Regardless, the is still hope (though it's dimming) ... it comes down to how long the Club and Alex can persist.
Pragmatically, if the club is willing to persist, and Alex has the intestinal, physical & mental fortitude, he is on a good wage to continue to try and get his body right & resume his career.
Good luck AJ - my thoughts & prayers are with you tonight.

[Ludwig]

One problem we, as interested onlookers, have is that no specific detail has been given to the public as to the exact nature of the "infection(s)" - and quite rightly so, as it's medical confidentially. Moreover, realistically it's probably unknown - or he'd hopefully be better by now.
But it could be a general infection (like the pesky multi/Methicillin resistant bugs); or a reaction to synthetic material (eg the LARS graft itself, suture material, metal fixation - screws/buttons); excessive (albeit necessary) previous antibiotic use can reduce its subsequent effectiveness; an infection in another area can manifest at the surgical site systemically; the list can go on.
Regardless, the is still hope (though it's dimming) ... it comes down to how long the Club and Alex can persist.
Pragmatically, if the club is willing to persist, and Alex has the intestinal, physical & mental fortitude, he is on a good wage to continue to try and get his body right & resume his career.
Good luck AJ - my thoughts & prayers are with you tonight.

Thanks Goswannies for your wonderful insights into matters medical.

What I find so perplexing is that there must have been the highest priority placed on preventing just such a recurrence of what has happened by his medical team. As you said, we are just concerned outsiders, but it would seem to me that there must be something immanent to AJ's physiology that is at the root of these infections. What are your thoughts?

And surely they will hit him up with every conceivable antibiotic treatment available to rid him of this infection. One way or another he needs to be cured of it. Could it involve removing everything from his knee once again?

[paper_rival]

Living without an ACL is very doable. I couldn't be bothered having my left one done after 2 ACL recons on my right knee.
In some instances scar tissue can provide some stability to the torn ACL remnants. Probably not in AJs case though as he's had so much done in there. & it's a crappy "solution", as scar tissue is weaker/less flexible than tendonous/ligamentous tissue & would be prone to rupture with enough force.
Even an ACL deficient knee can be OK with rehab (to strengthen the muscles around the knee & re-train proprioceptors) and activity modification (avoiding jumping, twisting, pivoting) so footy at any level is out (well it should be, but I've seen some try & do it - but not at the elite level). But sport can still be played in some way if that's what the individual wants.
It comes down to quality of life and is a very individual/personal choice. Many people who love their sport would be shattered to think that (particularly after participating at such an elite level) that this has just been cruely taken away from them. Others might think that they have achieved the ultimate (being an AFL footballer and a premiership player) and are satisfied and proud and can be content knowing that no one can taken that away from them. They might think that there are other things can achieve in life, other challenges that can test them & bring the best out of them in a non-sporting arena. Others, still, stoically soldier on & say they will keep trying until every avenue is exhausted or until the decision is taken out of their hands.

I've just freshly torn my 2nd acl and feel a lot like this.
Poor AJ. I feel for him so much, I can't imagine it. His resolve is nothing short of inspiring though, and if anyone can do it, he can (Gary Rohan style).

[goswannies]

What I find so perplexing is that there must have been the highest priority placed on preventing just such a recurrence of what has happened by his medical team. it would seem to me that there must be something immanent to AJ's physiology that is at the root of these infections. What are your thoughts?

And surely they will hit him up with every conceivable antibiotic treatment available to rid him of this infection. One way or another he needs to be cured of it. Could it involve removing everything from his knee once again?

The "shotgun" approach isn't usually practiced with antibiotics. Bugs typically are hit with very specific antibiotics to be most effective. Broad spectrum antibiotics are OK against less resilient bugs but the nasty bugs (which I can only assume AJ has) laugh in the face of broad spectrum antibiotics. The indescriminant prescription of antibiotics has contributed to the rise of MRSA and its kin.

And yes, AJ would have been given the highest priority to avoid what has sadly happened again. Some people are just more prone. That's why some doctors specialise in infectious diseases. Complications like AJ's are not infrequently seen in joint replacement patients postoperatively (not common, mind you, but not super rare either).

[Gronk]

This is a very sad occurrence for a man who has devoted himself to coming back over the last three years.

To my understanding the Swans waited many months to do this operation so that there was confidence that all infections were out of his system.

Alex will be disappointed, but he really needs to move on quickly and start planning his life after football. He has guaranteed money and free medical and physiotherapy care until October 2016.

He needs to get that knee ready enough for life after football using the medical facilities while they are free and available.

I hope he had been careful with his finances over the last couple of years and has some buffer money as he transitions to a new career.

The Swans have amazing contacts in the business world and Alex needs to leverage these contacts to get the great introductions. He wound be able to get far stronger introductions than 90% of university grads and these introductions need to be used to his advantage.

[stellation]

Just horrible, horrible news.

[Primmy]

That is just so sad, depressing and bewildering for the poor man. Thinking of Heath James and his 11 hammies here. He can't still hang in there surely?

[707]

Absolutely devastated for AJ, cannot imagine how he's feeling, been so brave over the last three years.

Salute to the club for standing by AJ and even "upgrading" his Guernsey number for 2016. Still numb at the news :-(

[Doctor]

Like everyone else here, I was so sad to read the news yesterday. I have been optimistic about AJ's recovery all the way through, and figured that once they got the infection sorted that he'd be fine. Now, sadly, it looks like the infection may be the thing that claims his career, rather than the injury itself. The only solace he has, and it's a great one, is that he got to play AFL and that he is a Premiership player. No matte what, noone can ever take that away from him.

[YvonneH]

He has guaranteed money and free medical and physiotherapy care until October 2016.

Did the club only extend his contract for 1 year? I thought it was for 2.

[goswannies]

He has guaranteed money and free medical and physiotherapy care until October 2016.

Did the club only extend his contract for 1 year? I thought it was for 2.

One season

AJ signs on for another season - sydneyswans.com.au

[i'm-uninformed2]

In case this is it - and desperately hope it's not - thought it worth posting this from the 2012 GF. In one small play the pace, composure, smarts and gusto that made him terrific

reid goal - YouTube