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Long Recovery In Store For Robert Griffin III After Return From ACL Surgery

By ZAC BOYER

zboyer@freelancestar.com | @ZacBoyer

There will be no greater reminder of the Washington Redskins’ recent failed playoff run than the sight of Robert Griffin III’s wobbly right knee bending awkwardly underneath him.

The rookie quarterback embodied so much potential for the ill-fated franchise, especially as he piled up multiple victories and collected a variety of records throughout the season.

But as he turned to pick up a loose ball late in the Redskins’ eventual loss to Seattle, his knee corkscrewing underneath him into the pockmarked turf at FedEx Field, hope turned to horror.

The 22-year-old was later determined to have damaged two ligaments in his right knee, both of which he has had previous issues with – the lateral collateral ligament, which he had stretched in a game nearly a month before, and the anterior cruciate ligament, which he tore in 2009 when he was a sophomore at Baylor.

James Andrews, a renowned orthopedic surgeon considered amongst the best in his field, performed a roughly four-and-a-half-hour surgery to repair both ligaments early Wednesday morning.

Once considered the end of a player’s career, medical advances have made returning from an ACL injury more likely than ever.

No more than 24 hours after his surgery was complete, Griffin was eager to begin his rehabilitation, focused on the possibility of returning for the start of the 2013 season.

Trying A Tendon Graft

The ACL is one of four ligaments that are responsible for the strength and stability of the knee. Combined with the posterior cruciate ligament, it governs extension and flexion in the knee and prevents it from sliding back and forth.

Those two ligaments are located inside the knee, while the LCL and the medial collateral ligament run along the outside of the knee.

It is not uncommon for anyone who leads a less active lifestyle to tear the ACL and never have it repaired. One can regain the range of motion necessary through physical therapy, though the knee will always be less stable than before the injury.

According to a study by Washington University in St. Louis in 2011, more than 200,000 ACL reconstruction surgeries take place in the United States each year, with anywhere between one percent and eight percent of those replacements failing and requiring a second operation.

Repairing the ligament was typically done one of two ways: either through transplanting a healthy ligament from a cadaver, or by grafting a piece of the hamstring tendon onto the bone as a replacement.

But there are other ways of repairing the knee, and Griffin’s two surgeries were different. In 2009, Mark Adickes, a Houston-based orthopedic surgeon who also coincidentally played football at Baylor and for the Redskins, reportedly repaired Griffin’s ligament by screwing a synthetic band into the knee.

On Wednesday, Andrews opted for a more progressive procedure: taking a piece of the patellar tendon from his healthy left knee and grafting it onto his right.

It was the same procedure as the one performed on Minnesota running back Adrian Peterson, who returned from a torn ACL after eight months and fell nine yards shy of setting the single-season rushing record.

Benjamin Wedro, an emergency physician at a trauma center in La Crosse, Wisc. who has followed Griffin’s case, said the procedure performed by Andrews is complicated, but reliable.

“It’s a technical problem in the operating room because they don’t use the primary tendon grafts that they used to do, but the orthopedic doctors are good and finding ways of rebuilding the knee with different types of tendons and cleaning things up,” Wedro said. “He’s a young, healthy guy, and the knee should heal.”

Complicating Griffin’s situation, Wedro said, is the existence of an LCL injury as well. While recovery from a torn LCL can take up to six months, the rehabilitation required of a reconstructed ACL typically takes longer.

“The question is when is that timeframe going to be?” Wedro said. “That’s individualized for each patient. You’ve got a guy like Adrian Peterson, who no one thought was going to come back in six months but does, or seven months, and then you’ve got people like [Chicago Bulls guard] Derrick Rose who’s still not back and it’s been a year. They’re both rehabbing. They both invested the time in the rehab, and everyone’s a little bit different.”

Clearing A Mental Hurdle

Julian Bumbrey, the quarterback at James Monroe High School, tore the ACL in his left knee in a Sept. 21 game against Eastern View and is three months into his recovery. He’s aiming to play baseball and run track in the spring, but he remains concerned about the strength in the quadriceps muscle of his left leg.

The muscle typically atrophies from the lack of use, and strengthening it enough to participate in athletics is often the focal point of the second half of the recovery period.

“The toughest part is mental,” Bumbrey said. “You have to know that you want to get back and play sports. It doesn’t just come overnight. You have to work every day hard at strengthening your knee.”

Chase Minnifield is seven months removed from his second surgery to repair a torn ACL – both of which were performed by Andrews.

Though he had no additional ligament damage in either case – the first tear happened in 2007, late in his senior year of high school – the Redskins cornerback and former University of Virginia standout said the recovery process can be grueling.

Four other Redskins players tore their ACLs since the start of training camp in late July – nose tackle Chris Neild, running back Tristan Davis, strong safety Brandon Meriweather and rookie safety Jordan Bernstine, who also tore the MCL and PCL in the knee.

Defensive end Jarvis Jenkins tore the ACL in his left knee in a preseason game in Aug. 2011 and didn’t fully round into football form until midway through this past season.

Then there’s Tim Hightower, the Redskins’ primary running back over the first seven games in 2011. He tore the ACL in his left knee in a loss at Carolina that October and tried to return for the start of this past season, but the knee wasn’t fully healed and the team released him.

“I don’t think an injury like this is easy, no matter how much you know or who’s working with you,” Minnfield said. “It comes down to you versus yourself. How much can you take?”

Several NFL players have torn the ACL multiple times. Jonathan Goff, who signed with the Redskins in an attempt to revive his career after missing the better part of the 2011 season with a torn ACL in his right knee, did so for the second time in less than a year when he went down on July 28.

New York Giants receiver Domenik Hixon tore the ACL in his right knee in 2010 and again in 2011, then caught 39 passes for 567 yards and two touchdowns this past season. Thomas Davis, a linebacker, tore the ACL in his right knee three times – in 2009, 2010 and 2011 – but had 70 tackles and an interception and forced two fumbles while starting 12 games for Carolina.

And then there’s Casey Hampton, regarded as the most reliable nose tackle in the NFL, who also tore an ACL three times. Hampton tore the ligament in his left knee while in college in 1997, then tore the one in his right knee in 2004 and again last January in a loss to Denver in the playoffs.

If it wasn’t for his determination to resume his football career, Hampton told reporters in August, he would have foregone the most recent surgery.

A Stealth Rehabilitation

Griffin’s work ethic and desire to be the best quarterback in the NFL has been well-documented, and the veracity with which he will undertake his recovery is certain to be at a high level. The details of how he will do so, however, are guarded.

Requests to speak to Andrews, Griffin or head coach Mike Shanahan about the quarterback’s injury have been repeatedly denied by a team spokesman.

Minnifield, who reached out to Griffin before the surgery but hasn’t spoken to him since, said he spent several weeks rehabilitating the knee near Andrews’ office in Pensacola, Fla., where his surgery took place.

Griffin has, reportedly, planned to do so as well.

“[It was] just to make sure everything was going OK, everything was going right,” Minnifield said. “They have a pretty high-tech facility down there, and you know, it’s just a good environment to be in, I think.”

The quarterback is certain to miss all offseason workouts, from the voluntary portion that begins in mid-April through the minicamps that take place in early June. He’ll also likely miss training camp, which moves to Richmond next August.

Robert Griffin Jr. told reporters during the week that his son would try to match Peterson’s recovery to be ready for the opener the first week of September.

Leading the team out of the tunnel and onto the field at the start of next season, wherever it may be, would certainly something else worth remembering.

Staff sports reporter Taft Coghill Jr. contributed to this report.

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