It was the last day of play in 16-year-old Brooklynn Zanski’s Junior Varsity softball season. During the first game of a double header, she was pinch running for the pitcher. Brooklynn saw an opening and made a run to steal second base. And that’s when everything went wrong…
"I was just about to slide but at the last second I decided not to. So, I came back up and I heard a pop in my knee and I just fell to the ground."
Brooklynn’s mother, Shannon, called her pediatrician the next morning. The pediatrician knew there was a significant injury, and got Brooklynn into DMC Children’s Hospital of Michigan that day.
After an MRI, Brooklynn saw Dr. Kunal Kalra – a pediatric orthopaedic surgeon at Children’s – who specializes in sports medicine. And the results weren’t good. "When I saw Brooklyn’s MRI results, I saw that she had a complete ACL rupture as well as a tear of both menisci on the inside and outside of her knee," said Dr. Kalra.
ACL is also known as anterior cruciate ligament. It’s a very important knee ligament for any kind of pivoting movement of the knee and to prevent any translation of the knee. The meniscus is a piece of tissue in the knee which acts as a shock absorber and evenly spreads the forces in the knee.
Dr. Kalra told Brooklynn that she would need surgery to repair her ACL and meniscus. Tough news for a high school junior who had found out just two days before the injury that she had made the varsity cheerleading team. Brooklynn was crushed.
Surgery of this nature, when performed on children, requires the expertise of a pediatric orthopaedic surgeon so that damage isn’t done to the growth plates on a child’s bones. These plates allow children to grow as they get older.
Dr. Kalra describes the surgery this way: "ACL is a ligament in the knee which unfortunately does not heal by itself so we had to replace the ACL with a tissue. In younger athletes I prefer to use an autograph, which is using tissue from your own body. What we do is we recreate the ACL in its native position by drilling tunnels into the bones around the knee joint – that’s the femur and the tibia. We insert the ligament in – into those tunnels and fix it with either a screw or a suspensory ligament. Ultimately, her ACL will incorporate into her bone and she’ll have a new ACL which will function almost as well as her original ACL ligament, if not better.
This type of injury commonly occurs when an athlete jumps, lands, twists or pivots the knee in the wrong way. Dr. Kalra says ACL injuries are on the rise, especially among girls. It could be due to the increase in the investigations in terms of MRI and new imaging modalities, but it seems it’s not only due to that, it’s more common because kids these days are playing on a more competitive level and they are bigger and faster than the kids 20 years ago.
Following surgery to repair the ACL, intense physical therapy is needed to strengthen the knee. Patients receive therapy for six to nine months depending on the speed of their recovery.
For Brooklynn, she was determined to push herself to be back in action for the beginning of competitive cheer season in December. A lofty goal considering that was just five months after her surgery…
"At the clinic I go to physical therapy about two times a week. And then the rest of the week I go to the clinic for physical therapy two times a week and I do three days of working out with the school trainer."
Three months after her surgery, Brooklynn was back in Dr. Kalra’s office for a follow-up appointment.
"Brooklyn is doing very well. I would say that she’s among the top 10 percentile of the patients in terms of rehab and recovery of her muscle strength. Typically, at three months you do not expect fully recovery of the muscle strength; you see that around five to six months after surgery."
With that great news from Dr. Kalra, Brooklynn is headed towards full participation in her cheer season this December, as well as varsity softball in March. Quite a triumph after such a setback. When she looks back on her experience, she wants people to know that sometimes, injuries like these can be prevented.
"Every athlete should properly warm up because it could affect how they perform during their game or competition or meet or whatever they do. And that it's an important thing that everyone should do, because I don't want to end up with another torn ACL. And I want to make sure I get everything done correctly so I can be the best athlete I can."
Her mother agrees – "She sees that once she puts her mind to something, the sky is the limit. As a parent who could be happier? Who could ask for more?"