(Poll) Modified brostrom surgery: orthopedic surgeon or ankle specialist?

Today, I’m posing a question to readers:

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Here’s some background:

Last November, in a championship rec basketball game, I landed on my opponent’s foot and felt a pop.

“Nothing unusual,” I thought, since I had sprained this particular ankle about twelve times in my basketball career. So I laced my sneakers a bit tighter and continued to play – and win

Turns out, however, that this was not such a simple injury. It was the turning point – at least as far as the stability of the lateral ligaments in my right ankle is concerned.

The next week, I could barely walk.

A few more weeks past, and still – considerable pain.  Two different orthopedic surgeon visits and two four-month sessions with physical therapy  later, I still feel considerable intermittent pain, particularly after exercise and with long periods of standing or walking.

Finally, I made an appointment to go see Dr. Paul Cooper at Georgetown Foot and Ankle Clinic. He immediately recommended a procedure called “modified brostrom.”

Apparently, when you sprain your ankle enough times, the ligaments loosen and it creates instability, which results in pain. If you look at the pictures in this post (yes, they’re my actual x-rays) you’ll notice that there is some considerable space between my ankle bones. (that’s not supposed to happen)

Modified brostrom surgery essentially tightens everything up and “makes you feel like you have a new ankle,” or so Dr. Cooper says.

He told me it would require a month in a cast and at least another month of physical therapy. But this would be a simple procedure that he could do in about half an hour.

The next day, Dr. Cooper’s surgeon scheduler called. She proceeded to tell me that Dr. Cooper is booked for surgeries until March of 2009.

“Uhh… that’s a little ridiculous,” I replied.

She told me the operating room is jam packed and Dr. Cooper is booked solid. This really sucks for someone who loves to play rec sports in the spring.

So I made an appointment with another well-respected sports medicine orthopedic surgeon, Dr. Weimi Douoguih at Washington Hospital Center. Impressed by Dr. Wouoguih’s contribution to Insider Medicine and his e-mail address present on his business card, I was hopeful that he would be right for me.

I was immediately impressed by his personality and ability to talk to me.

Dr. Douoguih said he thinks I do, in fact, need the surgery. He mentioned that he doesn’t do a lot of this type of surgery, but he’s trained in it and feels comfortable performing it. And – even better – he can work around my schedule.

So here’s what I need help with – do I wait until March for the specialist (Dr. Cooper)? Or, do I get it done sooner with Dr. Douguih? Does anyone have any experience with this?

Appreciate your opinions.

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Female athletes and ACL injuries: preventable?

If you are a female and you played sports through puberty and beyond, changes are pretty good that you either suffered an ACL injury or some of your teammates did.

A recent NCAA report says that females are two and a half to four times more likely to tear their ACLs then men. And new research says it’s preventable.

Luckily, I never suffered one of these awful injuries. But many of my old teammates did – all the way through both high school and college. Many of them found themselves sitting on the sidelines watching for at least six months, along with weeks of excruciating therapy and a huge knee brace slapped on their legs.

But how (exactly) is it fair that the ACL injury (for the most part) seems to target women? Turns out, when women hit puberty, we have a different way of landing on our knees than our male counterparts. (Has to do with hormones and the way our bodies change).

But here’s the exciting part: Researchers recently have figured out a training regimen to prevent this from happening. That’s right – prevention, and it all comes down to neuromuscular training that our bodies need to learn at an early age.

From NCAA,

“Boys are running around and athletic and are being trained from a neuromuscular perspective early on and women are later to get into that, and they never develop the same neuromuscular training as boys do even if they’re incredible athletes,” says Dr. Craig Levitz, chairman of the Department of Orthopedics, Orthopedic Surgery and director of sports medicine at South Nassau Communities Hospital in Oceanside, New York.

While Levitz says neuromuscular training programs that teach the muscles how to protect the knee are critical for girls, they don’t seem to be necessary for boys.

“For some reason, that’s something that seems ingrained in the male genetics and has to be learned in the female genetics,” Levitz says.

Apparently, implementing programs that target young female athletes is key.

The NCAA Web site, the ACL Feature – where I got all of this information – is an incredible step in the right direciton. They’re utilizing social media to tell us exactly how the injury happens and how we can prevent it. It utilizes flash media, audio and video – I highly encourage you to check it out and pass it along.

It’s very promising to see the NCAA not only taking an interest in female sports injuries, but also utilizing new social media platforms (and even message boards!) to encourage discussion and the expansion of knowledge about injury prevention.

Great job NCAA!