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Tiger Woods' ACL Surgery: FAQ

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

When is ACL reconstruction surgery needed? continued...

However, one concern is that when the knee has an abnormal motion to it, if you do engage in cutting-and-pivoting sports, the knee can continue to give way, and this can cause further damage in the knee.

There's a high rotational torque to the knee in the forward leg during a golf swing, and this is Tiger's left knee, which is his forward leg. With an ACL-deficient knee, you do run the risk of developing further tears in the meniscus over time.

Mishra: It's amazing he won the U.S. Open, given the fact he didn't have an ACL reconstruction [earlier]. To be able to compete at that level with that sort of disability is flat-out astounding.

He tore his ACL in 2007. According to what his agent released, he planned on trying to compete as much of the season as possible, especially through Torrey Pines [the U.S. Open]. He might have planned this and said, 'Let's see how far I can go.'

What is the rehabilitation process like?

Mishra: The rehab process is range of motion first, followed by strengthening, and then coordination and endurance. ... What he's facing is six to 12 months of time to get back into superior condition, but what does that mean for Tiger Woods? Hard to tell. I mean, he beat everybody else and he didn't have an ACL.

McCulloch: The patient is usually off crutches within a few weeks. They then need to continue work on regaining their range of motion and their strength in the knee while we wait for the new ligament to heal into place.

What about the stress fractures?

McCulloch: I find that kind of curious. Stress fractures are often microscopic fractures that occur in the bone. They often won't show up on an X-ray, but they show up, because of swelling, on an MRI.

In general, stress fractures tend to heal when you limit the amount of activity on them. So in a runner who develops a stress fracture, if we take them out of, say, marathon training, the stress fracture will often get better on its own. There are some stress fractures where we recommend that you be on crutches for a period of several weeks or months to allow it to continue to heal.

In [Woods'] case, it's not clear to me whether he had true stress fractures or these bone contusions or a stress response that we often see in relation to ACL instability. If we find out later that rather than being on crutches for just a week or two that he's on them for several weeks, that may be an indication that they're hoping to take stress off that injured bone.

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