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Tiger Woods' ACL Surgery: FAQ

Woods to Get ACL Reconstruction and Expects to Miss the Rest of the PGA Season

Is this an injury that an elite athlete could come all the way back from?

McCulloch: Yes. This is a very common injury in general and in professional sports. There are over 100,000 ACL reconstructions performed per year. The general success rates of patients rating their knee as good to excellent are in the 90th percentile. There are several instances of other professional athletes who have returned to the highest level of competition after this, and given Tiger's demonstrated resolve and focus, I have no doubt that he will return fully.

Mishra: I think, as a fan, that he can come back and that he didn't do anything permanent to make him less stable to have a long career. That will only be known by Tiger and his doctor.

People can come back from an ACL reconstruction and have done that in many, many other sports at elite levels. So I have no doubt that he'll be back at the same level -- which is to win the U.S. Open -- or better.

What does the ACL do?

McCulloch: The ACL is the anterior cruciate ligament. It's a ligament that goes between the thigh bone and leg bone in the knee. The role of the ACL is to help to control abnormal motion at the knee. When the ACL is torn, the leg has a tendency to slip forward and to rotate in an abnormal fashion, which can give people a sense of instability, as if their knee will buckle on them.

At the time of an ACL injury, the leg slips forward and because of that, you can sustain a tear of the meniscus, which is a protective cartilage that sits between bones. Approximately 40% to 50% of patients will sustain a meniscus tear at the time of the ACL injury.

What does ACL reconstruction surgery involve?

McCulloch: The surgery itself is done on an outpatient basis. We can't repair that ACL so we just make a new one. ... We'll take a tendon -- either from somewhere else on the patient's knee or from a donor ... it's fixed to the femur and fixed to the tibia.

Mishra: It typically is a much bigger deal than just a knee arthroscopy [the type of surgery Woods had in April]. You've got to reconstruct the ligament, which is a bigger challenge than doing just a meniscus surgery. It takes an hour and a half or two hours of time, depending on how they do it.

When is ACL reconstruction surgery needed?

McCulloch: The decision whether or not to reconstruct the ACL ligament is based on several factors, the most important of which is the patient's desired activity level and type of activities they engage in.

If someone has a low demand on their knee and they tend to participate in linear sports such as jogging or running or swimming, they may do fine without having the ACL reconstructed. And in fact, Tiger went on to win five of his next six or seven tournaments after he had rehabilitated from the torn ACL itself.

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