So the big news today is that Tom Brady is having further procedures done on his injured left knee to relieve an infection that has set in. It’s also not much of a surprise that word is starting to filter out that the Patriots are not happy Brady spurned team doctors (led by Dr. Thomas Gill) to have the procedure done on the West Coast. They’d rather have him here where they can keep an eye on his recovery.
Knowing Brady didn’t choose some fly-by-night operation (he went with the well-known Kerlan-Jobe Clinic in LA) got us thinking about how this can happen and what do you do when it happens.
For those answers, I talked to the Celtics team physician, Dr. Brian McKeon, at his office at HealthPoint in Waltham. He had some very interesting things to say… here’s the transcript.
On the risks of ACL surgery, which has become more common amongst athletes:
Any surgery has a risk. Any time you’re implanting tissue that is not live or a foreign body into a joint or another part of your body there is always a risk of infection. It’s the number one concern for surgeons.
On the odds of this happening to Tom Brady or anyone:
The literature varies, the rates vary… but an easy guess would be 0.8 to 1% of the time you can experience an infection with ACL surgery. Oh yeah, this is 1 in 100, clearly.
On how severe these infections can get:
It’s difficult to assess because when you hear infection, when you’re a surgeon and someone tells you you have an infection, typically you think the most common, which is the superficial skin infection or a little suture abscess which you can just clear up in the office with a little oral antibiotics. But from what I understand Tom’s now had two subsequent surgeries and likely to have more, so that means only one thing – he’s had deep sepsis – that the joint itself is infected and the infection went deep all the way down to where the ACL reconstruction took place.
On how he would treat such a problem:
They jumped on this very early, and they’ve done an excellent job thus far from what I’ve read and if you jump on it early and do sequential washouts as we call it, or clean out the knee, irrigate it out literally with high powered fluid with antibiotics every other day or so for three or four consecutive surgeries often you can save the graft – you have a very high chance of graft survival.
On how Brady’s rehab would be affected if the surgery had to be redone:
Redo the surgery again? It’s a tremendous setback. You start from ground zero and not only that, it’s now a compromised joint that’s had surgery, there’s more scar tissue so it’s almost like doing a revision, doing a re-do surgery, which is much more complex, less success rates than if it was a primary injury.
If you do enough surgeries, enough ACL reconstruction surgeries, you take care of high level athletes you do a high quantity number of surgeries eventually it’s going to happen. You take all the necessary precautions, the New England Baptist Hospital in particular – leaders in the field, we think, in infection prevention – but no matter where you have the surgery done: Los Angeles, Boston, or anywhere, there’s still a significant chance of complications and infections just happen to be one.