Amanda Wilde (Host): This is Woodlawn Health Doc Talk. I'm Amanda Wilde with Dr. Jeffery Sheedy, an orthopedic surgeon from Woodlawn Health. Today, we'll be diving into the essentials of ACL reconstruction surgery from injury to recovery. Welcome, Dr. Sheedy. It's so good to have you back again.

Jeffery Sheedy, DO: Thanks for having me.

Host: Can you start things off by explaining exactly what is the function of the ACL in the knee?

Jeffery Sheedy, DO: Yeah. The ACL or anterior cruciate ligament is a stabilizer of the knee. There's four basic ligaments in the knee, each providing stability in a different plane. The ACL prevents the tibia from being unstable on the femur. So, it's a primary stabilizer of the knee.

Host: And what typically causes an ACL tear?

Jeffery Sheedy, DO: Well, it's interesting because, in most people's minds, they would probably think it would be a more of a collision or contact injury. And typically, it's not. The majority of ACL injuries are non-contact injuries, meaning you didn't collide with another individual. There's either a strong planting of the foot on the ground, and then that's kind of the more sports-oriented. But they can happen also in the normal day-to-day livings of regular folks. And, you know, misstepping or coming down hard on your leg, but the majority are not "trauma" or contact-related.

Host: How will you know if you tore your ACL?

Jeffery Sheedy, DO: Many people or most people hear a pop or feel a pop. You get immediate swelling in pain and limited range of motion and not really wanting to put your weight on it. Most people who tear their ACL know something major happened in their knee immediately.

Host: Got it. So, is it crucial to see an orthopedic provider within 24 hours of an ACL injury, or can it wait?

Jeffery Sheedy, DO: Typically, we like to get them in the same day, next day, within a couple of days, and fully examine and make the diagnosis for them to get them better quicker. And there's good evidence to support early interventions, as far as reconstruction or if you're going to rehab and try and treat it conservatively, also to begin that rehab early.

Host: So, as soon as possible. And let's talk about ACL repair, which is what we often commonly call it, versus reconstruction, which is actually what you do, what is the difference between repair versus reconstruction?

Jeffery Sheedy, DO: There have been many attempts and there's very limited indications for repairing. Repairing means you would sew it back to use the native ACL, what was there to begin with and try and sew it back into the bone, which is only recommended in very limited instances.

Then, normally, we have to put a graft or another part of your own body, be it your own hamstrings, tendons, or part of your tendons of your body in place of it so that we have the stability to rehab your knee and begin walking, moving and doing things right away.

Host: And what does that recovery look like post-surgery?

Jeffery Sheedy, DO: Typically, I know we've been talking about joint replacement is much quicker than that. And the normal patient is typically young and healthy, and of course they tend to heal faster in general. But typically, within six weeks of ACL reconstruction, people are off crutches, back to kind of a normal lifestyle. They're doing the rehab. And then, there's no real set time to return to if someone was in sports. Time's has not been shown to be as big a factor as getting your strength, range of motion and ability to pass a hop test per se, you know, basically getting your normal function back. Some will do it faster than others. So, there's not a set time that's agreed upon.

Host: Speaking of athletes, are female athletes more prone to ACL tears than male athletes? I ask because I believe they get more of those surgeries.

Jeffery Sheedy, DO: Yes. I believe in the last studies I saw, it's like eight to one. The reasons are not quite clear. We're not sure if just basic anatomy plays a role in that. Female body and male body are a little structured different in terms of angles of their femur and they don't know if estrogen can play a little role in that. So, I think the reasons aren't completely clear, but it clearly is a greater incidence in the female population, especially in athletics.

Host: Are there ways to prevent ACL tears?

Jeffery Sheedy, DO: Yeah. The studies are pretty clear on that there are preventative exercise routines that include strengthening plyometrics and different techniques to prevent ACL tears, and they have been shown to be effective.

Host: And what would you say are the differences between going to Woodlawn Health or a larger orthopedic practice? And how does treatment at Rochester Orthopedics part of Woodlawn Health compare with larger orthopedic practices?

Jeffery Sheedy, DO: I did have the opportunity to do a sports medicine fellowship out in Lake Tahoe, California, Nevada border, of course. So, I did have the opportunity to get the special training. And initially, before becoming a more general orthopedic surgeon in a rural setting, I thought, for sure, I wanted to solely do sports medicine.

So, I think I provide the skillset necessary and we get a fair number of ACL reconstructions here. So, I think we're well-versed in it. So, it really is patient choice if they want to get it close to home. I think we are doing all the advanced techniques in ACL reconstruction as well. So, I think we provide a good service.

Host: What are the advantages you see, especially for high school athletes of staying close to home for their ACL reconstruction?

Jeffery Sheedy, DO: Again, I think it's easy for the families to not have to, you know, travel to Indianapolis or Chicago to get it done when we can provide the same service. It's just that the convenience is the number one thing. And then, our therapists are well-versed in the rehab, because we do quite a few for the surrounding area.

Host: Dr. Sheedy, thank you so much for providing these valuable insights into ACL reconstruction surgery.

Jeffery Sheedy, DO: Thank you for having me.

Host: That was orthopedic surgeon Dr. Jeffery Sheedy. For more information on Dr. Sheedy and his team, please visit woodlawnhospital.org/orthopedics. If you enjoyed this podcast, please share it on your social channels and explore our entire podcast library for topics that interest you. And thanks for listening to Woodlawn Health Doc Talk.