Repurcussions from Malceski's 2nd LARS surgery

[DaVe86]

Malceski is getting a 2nd LARS reco and will be out half the year.

There is so little medical research on this operation, and the 2 case studies we've had in the AFL have both failed. Rodan and Malceski are each having their 2nd reco on the same knee.

Unless you are 28 and playing for your career, then I don't think it should even be an option.

This is a huge setback for Nathan Brown, but realistically he'll be back to his best next year. Once upon a time a knee reco nearly ended a career...now the surgery is so much better and players hit their full strides again.

Much better to go the tried and true method on the younger players. The LARS surgery should be kept for the desperate footballer who is fighting for his career.


I do wish Malceski a speedy recovery

 

[mdc]

Re: Malceski's knee gone again - proves our call right on Brown

http://en.wikipedia.org/wiki/Hasty_generalization

Not sure what purpose this thread serves other than re-stating common knowledge and using the unfortunate case of Nick Malceski to mount a specious argument.

 

[Happy Mastenator]

Re: Malceski's knee gone again - proves our call right on Brown

It's sad to see Nick go down again, but plenty of players have had mulitple full recon's on the same knee.

here's hoping Brown comes back and doesn't have any problems. Hate to see a player from any team missing for any extended period of time.

 

[DaVe86]

Re: Malceski's knee gone again - proves our call right on Brown

It's sad to see Nick go down again, but plenty of players have had mulitple full recon's on the same knee.

here's hoping Brown comes back and doesn't have any problems. Hate to see a player from any team missing for any extended period of time.

True. ALl I'm saying is that there is little research on the LARS method. All we have to work with is the 2 case studies in the AFL. Both have failed in terms of long-term stability.

My point is that LARS surgery should not be an option for young players.


As you say, wishing a speedy recovery to Brown...and hoping this round of LARS surgery work for Malceski and Rodan.

 

[Syphoncom]

Re: Malceski's knee gone again - proves our call right on Brown

He could be a mediocre player in 2-4 years too I guess. Very viable thread, nothing wrong with it.

But an alternative argument would be we should've opted to have him back during the time where our window is definitely at the "most open" heh. We'll never be expected to win more I wouldn't believe and should be favourite for most games unless something goes wrong.

We'll see at the end of the season whether it was the right decision or not

 

[Scodog10]

Re: Malceski's knee gone again - proves our call right on Brown

All we have to work with is the 2 case studies in the AFL. Both have failed in terms of long-term stability.

2 cases is hardly decisive proof one way or the other on LARS, especially considering there are another 3-4 players that have opted for that surgery (X. Clarke, Ebert, Fisher and Heath). I'm very glad Brown chose the traditional method, but i also support Malceski and Rodan for following the LARS path because they've both had traditional knee surgery before and they may feel its best for them rather than the painstaking recovery of traditional surgery!

The thread title is strange as well, how does Nick Malceski doing his knee prove we made the right call?? I'd say the only way that's proved is if Brown goes on to play another 10 season's without problems and even that's inconclusive proof.

 

[DaVe86]

Re: Malceski's knee gone again - proves our call right on Brown

I've tried to change the thread title but can't. I agree it looks bad.

In Rodan's case, I agree it was the right decision. He was really on his last legs as a player. If he didn't take his chance with Port, then his career was over after he was already dumped by Richmond after a knee reco.

However, Malceski was still young and I wouldn't have taken the punt on an unproven method.

Same goes with Heath. It's a different case with guys like X.Clarke and Ebert who are on their last legs. Clarke has tried everything so has nothing to lose. Ebert is having one last crack at it and looks sharp enough at the moment.

We'll wait and see on the other case studies. For now we only have the 2 to go by, and both have failed pretty quickly after the surgery.

Until there is more research into the procedure, I'm pretty comfortable for Collingwood to take the cautious approach...especially with guys who had 10 years left to play for us.

 

[Scodog10]

Re: Malceski's knee gone again - proves our call right on Brown

Btw I agree with what your saying I don't think that LARS surgery is good for the game especially with the advancement of traditional methods, mainly because its possible the material they use isn't suitable to the rigours of AFL!

 

[Optimax]

Re: Malceski's knee gone again - proves our call right on Brown

Isn't LARS surgery the most common form of knee reco surgery in European football leagues?

I'm happy Nate chose the conventional method but LARS has enough history behind it to be an option, especially given the amount of players that need a second reco even after the conventional method

 

[DaVe86]

Re: Malceski's knee gone again - proves our call right on Brown

Isn't LARS surgery the most common form of knee reco surgery in European football leagues?

I'm happy Nate chose the conventional method but LARS has enough history behind it to be an option, especially given the amount of players that need a second reco even after the conventional method

My concern...particularly with Rodan, is that the synthetic ligamet they used on his knee began freying. Hopefully it was just a defect and this isn't commonplace.

 

[FIGJAM]

Re: Malceski's knee gone again - proves our call right on Brown

Agree with mdc that a two event scatter diagram looks pretty lonely, but it's not exactly a good sign either.

We've had no recurrence of knee injuries via the natural route with Tarx, Dicky and Dawes (touch wood on the last two), so I'm perfectly happy to do it this way for a young player.

 

[vjknight]

Re: Malceski's knee gone again - proves our call right on Brown

theres plenty of examples, recent & past, where the traditional method fails as well.

it may come down to luck, or the players physiology.

 

[Ed D]

Re: Malceski's knee gone again - proves our call right on Brown

Just shows the risks of it, that's all. Still to early to say but I think Brown can comfortably say he didn't make a poor decision when choosing to go the full knee reco.

Did Licuria have a double knee reco? Wasn't with us at the time though. Tom Davidson did, he was a promising player.

 

[Vinnie Vegas]

Re: Malceski's knee gone again - proves our call right on Brown

Just shows the risks of it, that's all. Still to early to say but I think Brown can comfortably say he didn't make a poor decision when choosing to go the full knee reco.

Did Licuria have a double knee reco? Wasn't with us at the time though. Tom Davidson did, he was a promising player.

I don't think either of those guys had two recos on the same knee - I think they had one on each.

I don't think we've had a Collingwood player need a second reco on the same knee since Lee Walker - Given that, steady as she goes, boys.

 

[Ed D]

Re: Malceski's knee gone again - proves our call right on Brown

Ahh yep, got you. Yeah Davidson was one on each knee, that guy had no luck, it was a real pity when he got delisted. Seems like the main guys who need double knee recos are usually the bigger bodied players. Fingers crossed.

 

[Jedi01]

Re: Malceski's knee gone again - proves our call right on Brown

In Rodan's case, I agree it was the right decision. He was really on his last legs as a player. If he didn't take his chance with Port, then his career was over after he was already dumped by Richmond after a knee reco.

However, Malceski was still young and I wouldn't have taken the punt on an unproven method.

Same goes with Heath. It's a different case with guys like X.Clarke and Ebert who are on their last legs. Clarke has tried everything so has nothing to lose. Ebert is having one last crack at it and looks sharp enough at the moment.

These are all good points and the limited research you can find on the internet tends to agree with you for long term prospects;

"In summary, this evidence suggests at 4 year follow up the LARS show improved outcomes of:

• Donor Site Morbidity
• RTP Timeframes
• Knee Stability

I could not in good conscience recommend the LARS ligament to athletes. If you are pushing for one more season, one more Olympic Games or one more contract signing in the short term then the LARS may be the appropriate decision. However, there is no long-term data to display what the longer term outcome is going to be."

http://www.thesportsphysiotherapist.com/acl-reconstruction-with-the-lars-ligament/

 

[The Royal Sampler]

Re: Malceski's knee gone again - proves our call right on Brown

These are all good points and the limited research you can find on the internet tends to agree with you for long term prospects;

"In summary, this evidence suggests at 4 year follow up the LARS show improved outcomes of:

• Donor Site Morbidity

Hahahaha, what a finding! Given there is no donor site for LARS, you'd expect that morbidity re: the donor site for LARS as opposed to autograft to be significantly improved!

The thing that orthopaedic surgeons are almost unanimous on is that if you have to revise a failed LARS implant as they've done with Malceski and Rodan, that it's a particularly difficult surgery and the prognosis post elite sport is not at all good (ie. they're going to end up with osteoarthritis of the knee, bookmark it!).

 

[Vinnie Vegas]

Re: Malceski's knee gone again - proves our call right on Brown

[/LIST]
Hahahaha, what a finding! Given there is no donor site for LARS, you'd expect that morbidity re: the donor site for LARS as opposed to autograft to be significantly improved!

The thing that orthopaedic surgeons are almost unanimous on is that if you have to revise a failed LARS implant as they've done with Malceski and Rodan, that it's a particularly difficult surgery and the prognosis post elite sport is not at all good (ie. they're going to end up with osteoarthritis of the knee, bookmark it!).

Am I right in saying that the view is that with all of the drilling that they have to do to implant the ligament, that there's not sufficient cartilage regrowth in the area by the 8-10 week turnaround that athletes who've had LARS would be running in, which would lead to osteoarthritis?

For proper cartilage regrowth, they suggest that one would need to wait about 16 weeks, at which point you're basically talking about the same turnaround as a conventional knee reco, right?

 

[The Royal Sampler]

Re: Malceski's knee gone again - proves our call right on Brown

The size of the drill holes is certainly one problem, the other is that loose Dacron fibres from a frayed LARS implant make for a serious irritant to the cartilage and synovium. I've spoken with surgeons who've had to revise LARS surgeries and they've said it's just a mess... and essentially impossible to clean up through an arthroscopic incision.

 

[Football God]

If he hurts himself again, something could permantly go bad for him.