I questioned this fact about him yesterday and two posters told me that two ACLs(one in each knee) most likely with modern medicine means there is very, very little chance it happens again.
I was being half serious.
Zaniolo seems a prick to me, but if we are going to sign a strong italian I don't see any other alternative to Berardi than him. I would welcome Berardi. He would certainly strengthen us while we continue to grow and next year we can just sign a stronger RW again and have Berardi as an alternative.
I need to correct myself. I'm not a physio or a doctor in any shape or form, I'm just a guy after ACL reconstruction. The comment I made about ACL was based on the conventional / anecdotal knowledge I picked up from other athletes and physios during my recovery.
Turns out the data paints a somewhat different picture (which kinda surprised me). The reinjury of reconstructed ACL is not taht uncommon. It turns out that ipsilateral (same leg) reinjury is almost as probable as contralateral (opposite leg) injury.
"Overall, the total second ACL reinjury rate was 15%, with an ipsilateral reinjury rate of 7% and contralateral injury rate of 8%. The secondary ACL injury rate (ipsilateral + contralateral) for patients younger than 25 years was 21%. The secondary ACL injury rate for athletes who return to a sport was also 20%. Combining these risk factors, athletes younger than 25 years who return to sport have a secondary ACL injury rate of 23%."
This systematic review and meta-analysis demonstrates that younger age and a return to high level of activity are salient factors associated with secondary ACL injury. These combined data indicate that nearly 1 in 4 young athletic patients who sustain an ACL injury and return to high-risk sport...
pubmed.ncbi.nlm.nih.gov
Buuut ipsilateral reinjury is most common within 12 months after the surgery. Proper recovery process is vital. It is already 1 year after Zaniolo is back on the pitch, and 20 months after his second injury, so he's risk is much lower now.
"The most common cause of graft failure was during sporting activity 12 months or less from initial surgery (77%)."
So after that period the risk would be somewhere about 2-3% and that's an average, with better surgeon, the chance is even smaller (in another paper I read that a big risk factor in ACL graft rapture is "nonideal tunel position")
Anyway my main point in my previous post was that the ACL rapture is not a recurring thing like muscle problems.
But even if we disregard the risk of ACL reinjury, I would still be really really concerned with signing someone after 2 ACL reconstructions.
When i had my ACL reconstructed and I learned what the surgery looks like, I thought they were telling me about some procedure straight from the middle ages. Basically they take tissue from other part of your body - like from a hamstring tendon, and fashion a new ligament graft from that tissue. Then they drill two holes in your knee - one in the femur and one in the tibia. Next they thread the new ligament through those holes and secure it on both ends with placks or something. After few month the holes in your bones fill up fixing the ligament graft in place. Of course now it is all done with arthroscopy, so it is much less impactful than it used to be, but still it is a pretty fuckin invasive procedure.
One thing to worry about with a prospect like Zaniolo is the repercussions of the injury - the knee joint is very complex and fragile, and such invasive procedure will most likely have long term negative effects. It's hard to predict anything, as every case will be different. In my case it's been a nightmare, but I'm not a pro athlete with access to top doctors and physio staff 24/7, so yeah... your mileage may vary. Many player come out of it with their performence restricted. Knee swelling and stiffness, cartilage defficiency, pain, etc. But some come back to near full fitness. In case of Zaniolo time will tell.
But the other concerning thing is that there are preexisting risk factors that led to those ACL injuries in the first place. And in case of Zaniolo it wasn't an unfortunate foul that caused the injuries, but rather it was his own movement. There can be problems in the ankle-knee-hip axis stability, improper movement mechanics, lack of proper deceleration training. The latter is common in young athletic players. If you focus your training only on explosive acceleration, and neglect to train your body for deceleration, then bad things can happen. Deceleration movements are often less predictable during game scenario, hence also more violent. You are driving a Ferrari with faulty breaks basically. It would have to be identified and retrained, but that takes time and patience, and pro athletes are often rushed, as was the case with Zaniolo after his first ACL injury apparently. I think he returned to play after 5 months, which is waaay too fast after ACL reconstruction.
"Young Athletes Who Return to Sport Before 9 Months After Anterior Cruciate Ligament Reconstruction Have a Rate of New Injury 7 Times That of Those Who Delay Return"
Returning to knee-strenuous sport before 9 months after ACL reconstruction was associated with an approximately 7-fold increased rate of sustaining a second ACL injury. Achieving symmetrical muscle function or quadriceps strength was not associated with new ACL injury in young athletes. <i>J...
pubmed.ncbi.nlm.nih.gov