Torn ACL treatment: It’s different for girls

By Emily Critchfield and MaryAnn Fletcher
Updated June 27, 2016

Female athletes suffer ACL tears—a common knee injury—more often than their male counterparts. That’s why a Duke orthopaedic surgeon tailors women’s ACL treatment to improve their recovery and reduce their risk of repeat injury. Watch the video to see two young soccer players’ stories.

“I jumped up and landed on my leg and heard a pop,” said high school soccer player Gaby von Arx, 17, of Wilson, NC. “It didn’t swell, it didn’t hurt, but something told me, ‘You just tore your ACL.’”  The ACL is the anterior cruciate ligament, a tough piece of tissue that connects your thigh bone to your shin bone.

Gaby knew instantly she’d suffered an ACL tear because of the telltale popping sound—and because her twin sister and teammate, Jesse, had sustained the same injury a few months earlier. They’d also seen it affect others on their soccer team: “Within one year, four girls tore their ACLs,” Gaby said.

Both sisters had surgery to repair their torn ACLs, followed by intensive physical therapy, before returning to the field. Then Jesse had another ACL tear. That’s not uncommon. “There is a high rate of re-injury in both men and women after they’ve had ACL tears,” said Duke orthopaedic surgeon Dr. William E. Garrett Jr., MD, PhD.

Motion study reveals risks for women athletes

Dr. Garrett, who performed Jesse’s second surgery and treated both girls during their rehabilitation, has studied the differences between ACL tears in female and male athletes. “We’ve looked at motion patterns, how people moved, men versus women,” he said. Among the findings: “The women landed with straighter knees, stiffer knees—consistently.”

For the twins, Dr. Garrett recommended post-surgery physical therapy that included training to reduce their risk of re-injury. “We try to focus on identifying movement patterns that we feel are safer, and that’s landing soft, landing with knees bending—don’t try to stick the landing straight. Have symmetry, have good balance on both legs.”

Their ability to adopt those safer movements also helped determine when they could get back in the game. “In the past, deciding when we sent athletes back to play was time-based: ‘In six months you can go back, or nine months,’” Dr. Garrett said. “But, really, what we’re trying to focus on now is movement-based.”

Rehab returns players to the field

Both girls have completed their rehabilitation and are back in action. They appreciate the way Dr. Garrett coordinated with their physical therapist, sports medicine specialist Patrick Chasse, DPT, to help them learn to protect their knees. “My surgeon would say one thing, and then he would go tell Patrick, my physical therapist, and they would coordinate and change my physical therapy,” Gaby said. “I definitely think it made the recovery process so much more efficient and better. They were both on the same page all the time.”

Another outcome of the intensive training is that both girls now plan to pursue careers in physical therapy, athletic training or surgery. “I didn’t know what I wanted to do before any of this,” Jesse said. “It’s kind of led me to physical therapy and surgery. I had no idea.”

They’re both also grateful to be able to continue to play the game they love—and plan to do so indefinitely. “I think for as long as I live I’m always going to coach soccer or juggle the ball every once and awhile.” Gaby said.

Congratulations and Farewell to Peggy Alford

On June 24, 2016, faculty and staff came together at Page Road to say farewell to Peggy Alford, who is retiring from the Department of Orthopaedics. Peggy Alford worked as Dr. Samuel Stanley’s staff assistant and will be dearly missed. Please enjoy photos taken from her celebration below.

Photo credit: Andrew Smithwick

Dr. Amendola chosen as Washington University’s 2016 J. Albert Key Distinguished Lecturer

Screen Shot 2016-06-23 at 8.28.13 AMWe are excited to announce that on Friday, June 17, 2016, Ned Amendola, MD, spoke at Washington University in St. Louis to the orthopaedic surgery department as the 2016 J. Albert Key Distinguished Lecturer. His talk, entitled, “Academic Success: It’s All About Teamwork!!” was presented during Residents’ Day.

Dr. John M. Harrelson Inducted as Emeritus Faculty

We are pleased to announce that former Duke faculty member and trainee, Dr. John M. Harrelson (T’60, MD’65, HS’69-’73), a professor of orthopedic surgery and associate professor of pathology, was inducted into Emeritus status at Duke University Medical Center. Please enjoy the video above and photos of Emeritus faculty below.

 

Thirteen-Year-Old Cancer Patient Strikes Back With Bake Sale

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Margaret Stoffregen presents a check to her oncologist Brian Brigman, MD, PhD, who is flanked by Margaret’s mother, Molly, and father, Eric. With the help of some of her friends, Margaret hosted a bake sale that raised more than $2,000 to support cancer research and supportive care. Photo credit.

By Karen E. Butler

Read the full story here.

Margaret Stoffregen was just 12 years old when she was diagnosed with osteosarcoma, a rare bone cancer occurring most often in children and young adults between the ages of 10 and 30. Initially stunned by the news, Stoffregen set her sights on remaining positive and upbeat.

“When I heard the news, thoughts raced through my mind,” said Stoffregen, 13, whose cancer is now in remission. “Like most people, my first question was, ‘Will I live?’ Now that cancer is behind me, I feel like I’ve accomplished something that not many other kids have or would want to accomplish.” Continue reading

This Saturday: Watch Piedmont Members Keith and Mike Berend “Race Across America” for Operation Walk!

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This Saturday, two of our loyal Piedmont Members, Keith and Mike Berend, will be participating in a fundraiser for Operation Walk. We encourage you to follow them in their Race Across America at: http://www.raceacrossamerica.org/phone/live-tracking.html

They were also featured on Fox News for their efforts: Click here to view the story.

Let’s all watch them make it to the finish line!

Jody Feld, PT, DPT, MPT, NCS, C/NDT, selected to receive a 2016 Promotion of Doctoral Studies (PODS) I Scholarship

We would like to congratulate Jody Feld, PT, DPT, MPT, NCS, C/NDT, who has been selected by the Foundation for Physical Therapy Board of Trustees to receive a 2016 Promotion of Doctoral Studies (PODS) I Scholarship in the amount of $7,500 for her work entitled “Recovery of Community Mobility After Stroke.”

Will Eward, MD, DVM, and C30 Receive Pilot Funding

We are excited to announce that Will Eward, MD, DVM, and the Consortium for Canine Comparative Oncology have received $156,000 in Pilot Funding to support their research. The Consortium for Canine Comparative Oncology (C3O) is a collaboration between the Duke Cancer Institute and North Carolina State University College of Veterinary Medicine. Duke and NC State have joined forces to further explore new cancer therapies offering better efficacy and less toxicity for both humans and canines. Researchers at both institutions are studying naturally occurring cancers in humans and canines and this collaboration will allow investigators to leverage research and resources to benefit both species, ensuring better treatments and outcomes.

Dedication and Grand Opening of the James R. Urbaniak, MD, Sports Sciences Institute

On Friday, June 10, 2016, members of the Duke University community gathered for a dedication and Grand Opening ceremony for the James R. Urbaniak, MD, Sports Sciences Institute. Keynote speakers included Executive Director of the Institute, Dr. Claude T. Moorman, III; Duke University President, Richard Brodhead; Duke Men’s Basketball and Olympic Coach, Mike Krzyzewski; Chancellor for Health Affairs, Duke University, President and CEO, DUHS, Dr. A. Eugene Washington; Dr. James R. Urbaniak; and the generous donors who made the institute possible, Dr. & Mrs. Steven and Rebecca Scott.

The Institute is the first of its kind, bringing together research (Michael W. Krzyzewski Human Performance Laboratory (K-Lab)), Primary Care and Orthopaedic Sports Medicine, Sports Cardiology, Sports Medicine Rehabilitation, Sports Neurology and Concussion, Sports Performance, and Sports Eye Care and Injury Prevention and Vision Improvement.

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Courtney Karner, PhD, selected to receive an ASBMR Harold M. Frost Young Investigator Award

5b4e8e_32a0dcffcabf43239803d9372ebbad77We would like to congratulate Courtney Karner, PhD, who was selected to receive an ASBMR Harold M. Frost Young Investigator Award to attend the 46th ORS International Sun Valley Workshop on Musculoskeletal Biology in Sun Valley, Idaho, USA, August 7-10, 2016.

The American Society for Bone and Mineral Research and the Sun Valley Meeting organizers honor Harold Frost each year by offering these young investigator awards in his name.  As a mentor to countless clinicians and basic scientists, Harold Frost influenced many young scientists and had a profound impact on the direction of skeletal biology and metabolic bone disease research.

Congratulations again to Dr. Karner!