by: Dr. Eriko Kristoff Dela Cruz, M.D.
Days before the UAAP season starts, several outlets have reported that incoming sophomore Ateneo Blue Eagle Lebron Nieto has suffered a partial ACL tear and will be out for UAAP season 87. For a lot of people, the letters A, C, and L are enough to send them into a panic. Understandably so, since the knees are very crucial to the game of basketball and countless athletes have had their basketball careers derailed following injuries to their knees. However, in this day and age, with the advances in medicine and rehabilitation techniques, an injury of this magnitude is no longer the career death sentence it used to be.
Understanding the knee
The knee is made up of the femur (thigh bone), the tibia (leg bone) capped off by the patella. Aside from these bones, there are other structures that are in there. The medial and lateral menisci prevent the bones from touching, distribute the weight load, and function as a shock absorber, and lubricant among other things. Connecting the two bones together are four ligaments: the Anterior and Posterior cruciate ligaments, and the Lateral and Medial Collateral ligaments.

The blood supply of the knees come from the branches of the femoral and popliteal arteries Aside from connecting the two bones of the knee together, the ligaments function as a stabilizer, preventing excess movement of the bones. The anterior cruciate ligament, as the name suggests, prevents the tibia from moving forward too far.
What may cause a tear to the ACL?
Sudden directional changes, rotation of the knee joint (such as pivoting), as well as sheer forces (such as the knee getting hit on the side) may cause the ligaments on the knee to tear.
Sudden directional changes? Pivoting? Sheer Forces? All of those are present in the game of basketball. This is what makes news of ACL injuries common among basketball players.
How it’s diagnosed
Physical examination and imaging studies (MRI) diagnose an ACL tear. Once diagnosed, an orthopedic surgeon decides whether the injury requires operation, or if medical management would suffice.
Treatments
As of writing, there have been no reports whether the youngest of the Nieto siblings will go under the knife.
Medicine has evolved in the past decades, where surgical ACL repairs are now minimally invasive. Arthroscopy is generally less painful compared to open repairs, and scars are minimal and take a shorter time to heal. It also has a shorter recovery time compared to Open surgeries.
Nonsurgical methods are also available, such as using a brace on the affected knee in order to stabilize and immobilize the knee. The common denominator between surgical and nonsurgical management is the need for physical therapy and rehabilitation. It is important to note that a lot of patience and understanding are required during the road to recovery.
Modern medicine has developed to a point where a lot of diseases are no longer death sentences and a lot of injuries are no longer career death sentences, knee ligament injuries being among those. It is not only the manner of surgery that has changed, but also the process of rehabilitation. With better understanding about how, when and where ligaments occur, medical professionals from doctors, surgeons, physical therapists, trainers and all those involved in keeping athletes in top shape, are better able to treat, repair and most importantly prevent these kinds of injuries or re-injuries. This is why more players have been able to come back to the game they love, stronger than they were prior to the injury.
Not playing for a season can be excruciating for an athlete, but is needed in order to still have a future ahead of his young career. We wish Lebron all the best in his road to recovery.


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