On the fateful day of November 10, 2018 at the Araneta Coliseum, UST Growling Tigers super rookie CJ Cansino was driving to the hole for a fastbreak layup. It must be a move he has done in practice so many times, a move that was his bread and butter during his days in the juniors division. As he started his gather to the rim, his knee buckled under his weight. CJ tweaked his ankle some games back. Not once, but thrice. Another injury would be a blow not just to him, but the entire program. The whole coliseum was stunned in silence, as CJ was crumpled on the floor, grimacing in pain. A Magnetic Resonance Imaging (MRI) study revealed that the King Tiger in waiting tore his Anterior Cruciate Ligament, and will not be able to play their last game against the Ateneo Blue Eagles. There are surely a lot of questions in the minds of the UST and basketball fans, and as a medical student, I will do my best to answer it.

What is an Anterior Cruciate Ligament, and how do you tear it?

The knee joint is composed of the femur (thigh bone), tibia (shin bone), and the patella (kneecap). These bones are connected by four ligaments. The Anterior Cruciate Ligament (ACL) is one of the ligaments holding the joint together and controls the back and forth movement of the knee (along with the Posterior Cruciate Ligament or the PCL). CJ tore his ACL as the sudden change in speed was too much to bear on this knee. His patella was pushed forward, causing great stress on his ACL.

How do you repair a torn ACL?

The problem with a torn ACL is that unlike certain body parts, it does not have the capacity to heal on its own. This is why surgery is done to repair and replace the torn ligament.

The traditional way of repairing a torn ACL is through arthrotomy, or opening the knee area and replacing the ligament with a new one either from another a tendon (connects muscle to bone) graft, or a ligament from a donor. While this can ensure full mobility and range of movement in the long run, it can also add to recovery time as the procedure requires to dislocate the kneecap in order to access the ACL. In addition to that, the tendon graft must also heal properly.

With the advancement of modern medicine, arthroscopy is now the new standard procedure. It is minimally invasive, as it only requires to cut small incisions for the entry point of the camera and the probes to be used. Unlike arthrotomies, it provides a better vantage point as the surgeon can maneuver and look at the afflicted area without having to dislocate the kneecap.

A third option is being developed and is currently under study. Bridge-Enhanced ACL Repair (BEAR) surgery is a method that uses a special sponge made of proteins that act as a bridge between the torn pieces. The need for a replacement ligament or a tendon graft is therefore eliminated. Blood is drawn and injected to the sponge, and the torn ligaments are pulled to the bridge with sutures. Within six to eight weeks, the ligament will heal on its own.

What is the prognosis on CJ Cansino’s injury?

ACL injuries are no longer a death sentence to an athlete’s career. It has been reported that Cansino is set to be back on the court in six to eight months if he recovers and rehabilitates properly.

This is the challenge in rehabilitation. It must be adequate, as too little or too aggressive rehabbing can be detrimental to the athlete. CJ must wear a leg brace and not put weight on the injured leg as the ligament heals. The next thing on the list is to restore the movement and range of motion of the knee. This is excruciating physically and psychologically as it is a challenge for a patient to do the tasks required. Patience is the key factor in the process, as he must not rush his own body to recover. Once he has his movement and range back, it’s time to work on rebalancing the usage of both legs. Since he has not moved nor put weight on his left leg for a long time, his leg muscles will atrophy and weaken. He has to regain strength and muscle size. Only then can CJ think of getting his explosiveness back.

Six to eight months can feel like a lifetime. CJ Cansino needs all the support he can get from friends, family, and fans. We all wish for his speedy recovery. It does not have to be speedy, we just want to see CJ play the sport he loves again.