Inside word on David Rodan’s radical knee surgery

We’ve all heard about the radical knee surgery performed on Port Adelaide midfielder David Rodan’s injured cruciate ligament. But to get a more informed look on the topic, I thought I’d get in touch with Port Adelaide club doctor Mark Fisher.

Fisher was present for Rodan’s Ligament Augmentation and Reconstruction System (LARS) procedure which took place just over five weeks ago.

Incredibly since then, Rodan has returned to the training track with Port Adelaide and is due to get into some light jogging this week as part of the rehabilitation process.

The 26-year-old midfielder has already been able to do some walking, swimming and gentle cycling since the surgery.

Indeed, this new-age treatment may revolutionalise the recovery time for knee reconstruction injuries, but as Fisher acknowledges, its use is still at an infant stage in AFL circles and a conservative approach is currently the go.

Only two other AFL footballers have used the treatment, Sydney’s Nick Malceski and Fremantle’s Luke Webster, with the former returning mid-season after a pre-season injury, while the latter never managed to return to AFL level.

So I began by asking Fisher about the actual procedure.

Fisher started: “It’s just a standard cruciate ligament reconstruction but the only difference is you are using an artificial ligament called the LARS ligament. You’re just using an artificial ligament instead of tendon tissue which is the standard knee reconstruction, which is normally done.”

He added: “With the standard reconstruction, you need that tendon to strengthen over a minimum of six months in order to get it up to strength that it will withstand the rigours of agility work like playing football. And that’s the reason why it takes potentially 12 months to get back to actually playing competitive sport.

“With the synthetic ligament you don’t have to wait that six months, so that’s why you can get them going sooner.”

Indeed, the benefits are obvious, with Rodan able to maintain muscle strength and fitness in the meantime. And Fisher added the club were hoping for a mid-season return for the midfield gun.

“The whole point of this is to try and get him back playing this season, whereas normally with a standard reconstruction there’s certainly a minimum of nine months out which would have put unable to do any core training until at least September so that virtually rights off this whole season,” he said.

Fisher, though, acknowledged they didn’t want to put any undue pressure on Rodan, after learning a few lessons from the Sydney Swans medical team who kindly offered their help to the Power after their experience with Malceski’s surgery in 2008.

“We’d be certainly quite happy to commend Sydney’s help and co-operation as well. They were great,” Fisher stated.

“I spoke to their doctor, Nathan Gibbs, and David Rodan spoke to Nick just before he had his surgery just to see how he experienced it all and they were great.”

He continued: “The main thing we’ve learnt is that he (Malceski) expressed quite significant surprise at how quickly he recovered. They were thinking this is all a bit too good to be true when he managed to get back when he did.

“So we didn’t want to put those sort of expectations on David, so we tended to go conservatively, as we didn’t want to put unrealistic expectations on him. We’ve learnt not to get too carried away too early, even though he is doing well.”

Webster’s example, on the other hand, offers another lesson but Fisher explained: “It does have its failure rate, just like the ordinary cruciate reconstructions, they can bust just like any cruciate can. So they still have their failure rate, just like the standard reconstruction.”

And while the process is still an unfamiliar one, Fisher has confidence in it, although he admits there’s more to learn, especially with regard to the long-term effects of the treatment on the knee, which is the largest joint in the human body and crucial to general movement and life after footy.

“The only concern that we have about the synthetic ligament is that people haven’t really been using them long enough to know how they behave in the long-term.

“So while you don’t know, you tend to err on the side of caution and take your time getting him back up to his agility work again, because we don’t know exactly what the normal expectation is with these, because there aren’t many people at AFL level who’ve actually had this type of surgery before.”

Outside Australia, the procedure has been used and Fisher continued: “Most of the other sports, reading the literature, were soccer players and rugby players and they seemed to have done very well at the 2-3 year stages. Certainly a significant number have managed to return to their elite level of sport without any major complications.

“The traditional concern with the artificial ligament was always the body rejecting it like a foreign material in the knee joint, but this new ligament appears to not be that sort of problem. So that’s the reason why it is starting to be used more often.

“But we certainly aren’t recommending it to be used with everybody. We are only using it in certain circumstances, such as an older sportsman who has got limited time to get back to their elite level. So if it was a young 19-year-old who did his cruciate, we’d still do the traditional one, because he’s got plenty of time to recover from it.”