Isaac Menning, now a rising senior at Palatine High School, has undergone two surgeries less than one year apart to repair a torn anterior cruciate ligament (ACL) in the same knee. For an athlete, one torn ACL can cause him or her to lose a season, but two can be devastating.
When Isaac, a lacrosse player, tore his ACL for the first time, he was out of town in a tournament. “I was pushed from behind, my foot planted, and suddenly it felt like my knee blew up,” he reflects. “I couldn’t put any weight on it, and it hurt so badly,” he says.
At a local emergency department, he was given a knee immobilizer and told to return home to consult with an orthopedic surgeon. There, he was diagnosed with a torn ACL, medial collateral ligament (MCL), and meniscus; what some refer to as a knee ‘blow out.’ Surgery quickly followed and then nine months of continuous rehab. During this time, he also struggled with painful tendonitis in the knee and a weak right leg. Eventually, his physician cleared him to return to lacrosse.
Just three games into his sophomore lacrosse season, Isaac felt his knee give out and knew that he had injured it again. “This time it didn’t hurt as bad, but I was so sad because I had worked so hard to get back on the field,” he explains. Imaging confirmed that he had ruptured the same ACL again.
Seeking the best treatment
This time, Isaac and his parents, Lyndsey and Curt, knew they had to seek the best possible care available. Lyndsey, a physical therapist, searched the internet to learn more about ACL revision surgery and state-of-the-art procedures to provide her son with the best outcome. She became curious about an ACL repair technique called iliotibial band (ITB) tenodesis which seemed to provide more stability in younger, active patients.
She learned that ITB tenodesis is a surgical procedure that is sometimes used in conjunction with ACL reconstruction. This technique augments the ACL reconstruction and involves taking a strip of the ITB and passing it beneath the lateral collateral ligament (LCL). It is then secured on the lateral femur on the outer side of the knee. This treatment option can increase knee stability and create a more stable ACL for active patients.
Lyndsey was pleased to see that Dr. Brian Cole at Midwest Orthopaedics at Rush commonly performs ITB tenodesis in conjunction with ACL reconstruction. She also liked Dr. Cole’s care for professional athletes and his vast experience. They booked an appointment right away.
“We had a long video conference with Dr. Cole from our home,” Lyndsey explains. “We loved how he explained this procedure, how he does it, and that he understood we wanted to give Isaac the best chance to return to sports.”
According to Dr. Cole, “The “ITB tenodesis procedure has an abundance of evidence supporting that in some instances, it can prevent ACL re-injury and because of our research dedicated toward maximizing outcomes following ligament reconstruction in general, we more commonly utilize this as an adjunct to provide additional knee stability.”
Dr. Cole successfully performed Isaac’s ACL revision surgery including ITB tenodesis at the Gold Coast Surgicenter in Chicago and Isaac went home the same day. Soon after, he was cleared to begin physical therapy.
“Since I had just completed a lot of therapy after the first surgery, I knew I wanted a fresh start and change of scenery for my next rehab,” Isaac explains. “And I wanted to make sure I was really confident about my therapist.” He discovered Zach Ullman at Team Rehab in Palatine, and they clicked right away. “I really liked how Zac wanted to focus on form first and then strengthening. I also liked how he explained the development of good habits and how I could get the strength back in my leg that was always weak after the first surgery.”
Zach and Isaac worked together for 13 months after which Dr. Cole noted his dedication to rehab and excellent progress. Dr. Cole also recommended Isaac undergo a program at the MOR Sports Performance Lab to maximize his chances for a successful return to sport. Isaac collaborated with a specialized trainer there for ten sessions.
Back on the field
Earlier this year, at the start of his junior year season, Isaac was cleared to play. “I was cleared on my birthday, and it was the best gift I’ve ever received,” he says. “Zach encouraged me to ease into the season, which I did, starting with footwork, passing, and eventually full contact.” Isaac became a varsity starter and gained more confidence, speed, and agility with each game. He has experienced no pain and says his leg strength is back.
“I know that I want to continue to play lacrosse either at the club or competitive level in college,” he says. “I’m very grateful for the care I received this time around.”