I really think this topic should be picked up globally by
someone in medicine, orthopaedics, and sports injuries to deeply investigate
the possibility that this is almost an accident waiting to happen in certain people
with family history.
Some medical researchers have already looked into Genomics
influence. Looking to highlight the invisible deficiency of a Gene affected ACL.
Is there a combination of genetic variants on areas such as
collagen or one profile in particular that could affect structural function of
tendons and ligaments?
Based on a conclusion, could a patient receive prevention protocols
based on genetic sequencing that profiles someone of higher than normal risk?
In Summary the Family History…
My late farther: Snapped both ACL’s one in football
and one working on a roof and slipped. No surgery, he just stopped activity.
Myself: Snapped ACL twice in right leg, second surgery
failed. Then after over a decade of no cruciate had full reconstruction and new
allograph ACL and LCL. 7xOperations on Right (Ligaments and Cartlidge) and 2 on
left (Cartlidge)
My Son: Snapped ACL at 16, rehabbed. Graph failed and snapped and had reconstruction using Allograph at 19. Rehabbed and returned. Age 23, snapped ACL in other knee with multiple ligaments torn, cartilage torn and deep bone bruising.
Living with ACL injuries and failed operations long term.
I’ve certainly seen the change in the management of severe
knee injuries. I did my 1st cruciate at 17 years old and I was
placed in a full plaster cast from hip to ankle and I felt like my world had
been tipped upside down. I always remember as well coming out of that plaster.
Of course my muscle had completely wasted and I went to take a step and had no
control over my leg and fell. Of course this technique would never happen now
and early mobility techniques are used. I had it repaired and was playing non
league football and it went again when I was 21 and this time for me it was
game over. The surgeon at the time attempted reconstruction and I woke to the
news that he was unable to do the repair and that my ligament was unrepairable
and permanently detached. I was devastated. At the time, I was only thinking
about football, what I didn’t realise was how this would affect the next 15 or
so years of my everyday life.
I was always reasonably fit, I loved sport but I couldn’t do
it. The trouble is that you cant see the injury though. So people would say “I
have dodgy knees as well”. But, painful and swelling knees was not the only
problem, I would feel guilty and so would take part in things, I couldn’t resist.
But I felt embarrassed, I could see people would think your just exaggerating.
However, the result was that on a regular basis my knee would dislocate. The
joint coming part in that horrible way we have all seen on TV. I got used to it.
I had a way of putting it back and then the huge pain would settle in around
ten minutes from 10/10 down to 4/10. Then I could limp home and be out of
action for 2 weeks while the swelling went down. This would happen 4-5 times a
year.
At 23 my Dad suddenly passed away. Everyone that has had
trauma in their life will relate to that knowledge that sport can give your
brain a rest from its emotions. 90 minutes of football can take you away to a great
nonreality world where you forget your personal turmoil. So, when I heard there
was a football match, I could play in I decided to play. The inevitable happened
and I dislocated my knee. I spoke to the doctors and he said there was no way I
was going to be able to carry my dads coffin which was only days later. Of
course I wasn’t accepting that and as a result they arranged a fitting for a
very sturdy splint to be fitted to keep me upright and stable. This was hidden
under some oversized trousers and thankfully I gritted my teeth and did it.
Other stand out memories include being carried around on a
night out to wet the babies head following Jacks birth. Actually Jack was only
weeks old when I was in theatre one of the many time, and I remember easily this being the most
scared I was, for obvious reasons. I couldn’t join in things with my kids growing
up. I’d try and play football and end up on the floor. We went to the beach
with our best friends and quickly my knee dislocated and I sat on the floor
watching my best mate picking up the reigns and running around playing football
with my lads.
Trying to do normal work was also impossible if it involved
anything physical. I had grown in the AV industry and had a business installing
and maintaining projectors. This included pubs and you may recall the big three
gun projectors that pubs had with the big three red green blue lenses. I had an
agreement to maintain these and I needed to do one myself. I was stood on the table
unbolting it and just as I was about to take the weight (nearly 100kg) I
twisted my hips to reach, with my feet planted. My knee dislocated and I
collapsed. The projector fell from the ceiling and hit me straight in the chest
and yet again I was back in hospital.
This went on for many years through my working life in Sports
and Business. For those that know me will know that I covered this with comedy.
Laughing and laughing at my own downfalls and bad luck. Its my coping mechanism.
I was well into my thirties and had done many roles at Luton Town and had found
myself doing a role for the first team which I loved. I would try to obtain as
much information and tactical evidence for the manager and this would help him
form his plans for the second half. This also meant I needed a good vantage
point so I would often find the highest point in the stand. However, there is
then a dash to the dressing room to get this info to the manager and adjust
content on the screen to help the half time plan. This day was cold, I could
feel my knee hurting. Just before the end of the half, I made the dash, I knew
the route at Kenilworth Roads little passageways well of course, but as I came
down the stairs and went to change direction, down I went. I fell. But I was embarrassed
and knew the team needed my input. I limped to the dressing room and got done
what I needed. but the physio, great guy Harry spotted I wasn’t right and
during the managers team talk he waved me into the medical room. He started
work to help me and this was a life changing moment, little did he know. He
quizzed me about the history. He grabbed the doctor to help me with pain and then
after the game he insisted I go back to my doctors and helped me draught a
letter. He knew there had been developments in surgery and was adamant that I
should not have to live like this. Within weeks I met the absolutely unbelievable
guy Mr Sanjiv Manjure and he said he wanted to operate on me with a unique rare
fix, But he wanted a go. Of course I jumped at it and I became a case study for
the hospital as he was proud of the outcome. Finally, he gave me a secure knee
I could walk on and even do some sports. Would you believe, he is now my sons surgeon. Now I have incredible pain in damp and cold conditions due
to the arthritis and that has extended to my opposite hip which is due to years
of limping. Eventually I will have my knee replaced but finally I was able to
do things, play sports and I even played in some charity football matches. He
even managed to extend my coaching career as a result. But by sharing more
detail about my adult life with this I hope that you see why I’m now so
concerned about my son and actually, for my future grandchildren.
Football is a cruel world. Its currently one that certainly shows
a lot of sympathy for players that have set backs and we are very open to mental
health. Well it shows this online and on social media and actually, sometimes
you wonder what goes on in reality. Jack had great options and was looking at a
really promising career in football. But he’s not famous yet. So, he and like
many get cast aside in this game and I don’t think the support networks are
there. Thankfully, we had good friends that had experienced similar set backs.
Former Luton Town player Tom Craddock was one example of a tremendous human
that went out of his way to try and help him on his lonely journey. Players
like Jack had no opportunity to earn a few million pound before the setback so
suddenly you look back at your education and acumen for the working world. I
believe he and players like him should have access to a recovery fund to cover
the full education costs. The club took them out of school. The club would have
happily accepted sell on fees. You should not be able to simply cast these
players adrift when it goes wrong. https://footballpathway.blogspot.com/2021/03/the-youth-academy-system-part-2-will.html
In summary
I think this family history and genetics subject needs
investigating. Its too late for me and we will wait and see for Jack but he’s certainly
been severely hampered. But what about others? Including my own future family?
The benefits in this genetic identification could be…
1)
Prevention for others. If someone is identified
as having higher risk, could they have more bespoke biomechanical development
plans? Is there other intervention and medicines that could be developed to
help? Are there any dietary benefits or supplements to support or counter any
genetic defect?
2)
Is there any evidence, that if this is genetic make
up that this includes the hamstring graft. My hamstring graft failed. My sons
Hamstring graft failed. Is this more than coincidental? Should allograft be
considered for this group of people? Mine is stable, Jacks is stable.
I would love to see a medical professional or university
pick up a study of this and perhaps prevent and predict this with people that
could help them reduce impact and suffering.
Tony McCool
@antmccool7