January 30, 2025 • 8 mins
Dr. Adam Metzler from OrthoCincy joined us to talk about Bengals tight end Erick All and his continued ACL issues, the complications of having a surgery designed to fix problems from a previous injury, and what's next.
Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
Learn more about OrthoCincy by going here.
Listen to the show live weekday afternoons 3:00 - 6:00 on ESPN1530.
Listen Live: ESPN1530.com/listen
Get more: https://linktr.ee/MoEgger
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
All right, we do this on Wednesdays. It's typically in
the four o'clock hour where we talk with one of
the experts from Ortho Since the orthopedics and sports medicine
Orthos since he has specialists, locations and services all over
the tri State, including walkin orthopedic urgent care at five
locations with extended evening and weekend hours in Edgewood and Anderson.
(00:21):
Learn more at orthosinc dot com. That's orthos ci Ncy
dot com. Doctor Adam Metzler from Orthosincia is with us
because we've got to talk about Eric all Unfortunately, this
kid has dealt with knee issues going back to his
college years and suffered the injury the ACL tear in
his right knee in that game against the Raiders in
(00:43):
early November, had surgery on it. We found out yesterday
that he's going to miss all of twenty twenty five
because he's dealing with complications from the previous knee surgery
that he had after he dealt with the injury to
his knee that he suffered in college. So let's start
with this. Is it common for something like this for
(01:05):
the effects of a previous ACL injury to affect the
surgery to repair the ACL a second time.
Speaker 2 (01:11):
Yeah, I think it's really it's a culmination of the
of the original injury. The reality is is that what
people don't realize is about seventy five percent of the
time when you have an ACL injury, you also have
a cartilage injury, either to the smooth cartilage of the
joint or a meniscus tear. It's about seventy five percent
of the time that happens. So when that happens, then
(01:32):
we need to try to address those on the original surgery,
try to repair meniscus or try to get the cartilage
to grow and repair that as well. And so as
ideal as we like to have things as sometimes things
don't always heal, and it's not to the issue of
the surgeon per se, just more of sometimes things just
don't heal even when you repair them. And so you know,
(01:54):
when you have a previous injury, a previous surgery specifically
to the ACL, and you have meniscus tears or cartilage injury,
the second surgery and can be more challenging from the
fact that you've a had previous surgeries, a previous surgery performed,
and other things involved such as cardiog mniscus tears. So
that is why your evaluation of the physical exam and
(02:14):
your MRI is so important when you're prepping for revision
or redo surgeries, and they can lead to excuse me,
more complicated or complex secondary surgeries.
Speaker 1 (02:25):
So this might be a stupid question, but could the
second surgery maybe undo the effects of the surgery that
he just had?
Speaker 2 (02:35):
Yeah, I really wouldn't look at it that way. I'm
really unfortunately without more information exactly the insight of what
it is. If he had a cardiloge injury, for example,
it may take longer for the cartilage to grow. It's
oftentimes the second injury can have an impact a new
injury too, so he may have had additional injury to
something new and something that was already repaired in the past,
(02:56):
even if it was done perfectly. You can have a
perfect meniscus repair and have full feeling of that and
then recare what was repaired before, even in a perfect surgery.
And I tell my patients, and I've done fourteen hundred
ACL surgeries in my career here at Orposienci. Look, I
mean I've done I do one hundred and fifty five
acls a year and a perfect You tour what you're
born with, You tour your ACL, you toured your meniscus,
(03:18):
and I can do a perfect job on your ac
on your meniscus, and you can retear what we do.
And so I think when you say things that way
to patients, I think they really start understanding a little
bit more that you he tore what he was born with.
You can retaar what a surgeon does, and we try
to do everything we can in our ability to make
that as perfect as possible. So, and I don't really
like saying undoing something that was done from before, but
(03:38):
I say, look, we've got a problem. We got to
try to solve it together as a team.
Speaker 1 (03:42):
So it's a lot of surgeries and a short amount
of time for a young guy. Are there concerns about
there just being an accumulation of procedures like this.
Speaker 2 (03:52):
Yeah. Anytime you're doing a multitude of surgeries on an athlete,
much less a professional high level athlete, you know it's
a big TOLLI told mentally, I think we lose focus
of these young kids. These are young kids, and you
know they're trying to make in the NFL. It's it's
tough mentally to recover from a primary ACL much less
of revision. You know, return to play rates aren't as
high with revision ACL surgeres as they are primary. But yeah,
(04:15):
there's a cumult of effect on multiple surgeries and the
abilities for these athletes to get back to their previous
level of function. And I think, you know, the goal
is to be positively, your athletes do a great job
surgically and many, many of our athletes are able to
get back to their previous level function with significant rehab
and recovery. And it sounds like in this situation, you know,
as injury happened in November, they're going to take that
(04:37):
full year of recovery to optimize his recovery, cartilage procedure,
and growth and get that ACL to be as strong
as it possibly can without pushing the envelope too fast.
And I think sometimes we try to push that envelope
a little too quick and push bilogy a little too fast,
and that's where we can sometimes run into trouble. When
you're dealing with NFL athletes. Every game that's a paycheck game.
(04:58):
So we have to be OSHA's biology while also understanding
the debility for athletes to make money while they're still
young and healthy.
Speaker 1 (05:05):
Doctor Adam Metzler from Orthosinsia is with us talking about
eric Al. So let's say that the best possible outcome
is what we get and he's able to play for
the Bengals in twenty twenty six, which admittedly feels like
forever away. But let's assume that the procedures go well,
the rehab and recovery go well, and he's back on
the field. Given the fact that he has dealt with
(05:25):
multiple ACL injuries and surgeries, are there extra precautions that
can be taken to prevent him from having to go
under the knife again.
Speaker 2 (05:35):
I think the number one thing is giving his body
time to recover. From a strength standpoint, you've got to
get him as strong as possible to support that kneejoint.
The stronger the kneejoint is, the less likely there is
for reinjury. Bracing is very debatable with return of play
for ACL injuries or for many of our patients. We
use bracing for just a short period of time to
get them more mentally ready to play. At the NFL,
(05:56):
wearing a brace for a high level athletes other than
maybe alignment is hard. It's hard. It does slow you
down a notch, and at that level, every bit count,
So you know, he might see him wear a specialized
brace to help protect him to answer that question, but
at that point you'd be looking at gosh, you know,
eighteen months plus from the secondary surgery. To hope is
(06:17):
that there's enough stability of the knee and strength around
the knee that he doesn't have to do that. But
we might see them employee that for a little bit,
as we saw Joe Burrow did with his first season
back as well. If we all remember that.
Speaker 1 (06:29):
I feel like ACL surgeries have become so commonplace that
we have almost obscured how complex and how difficult to
recover from they can be.
Speaker 2 (06:40):
Absolutely. I think there's so much media around ACL surgery
it's rather fascinating. And someone quoted the other day there's
as much ACL research as there is heart research, which
is rather interesting to think about. And you know that's
in some ways a little concerning, but anyway, side note, Yes,
(07:01):
it is extremely common. It's extremely difficult to recover from
an ACL surgery. And I'll just use the basic references.
If you break your collar bone and I fix your collarbone,
if everything goes well, you're back returning to contact sports
and ten to twelve weeks maybe earlier. And that's because
bones heal really fast, and that's awesome, and if we
do a great job surgically, that bone's going to heal fast.
(07:21):
But ACL surgery you take a piece of tissue, your
pitel attendant or your coats, and then you make them
an ACL well that has to integrate inside of a
knee and takes nine months plus to become biologically stable.
And there's a lot of quaterceps and hamstring strength, muscle
recovery that has to accommodate that as well, versus when
you break the bone. My three months, most of our
kids are returning back to sports. And I think that's
(07:43):
the challenge when you have complex ligament injuries like ACL injuries,
and it's it's a hard pill for patients and families
to swallow. Whether it's a Division I athlete, a professional athlete,
or a local high school athlete. That's the time frame
it takes. And these are all scientifically proven timeframe international recommendations,
and so that I think is the hardest thing to
(08:03):
swallow for our patients is that's the time frame it
takes and it's mentally and physically a huge challenge and
hurdle for the patients to overcome.
Speaker 1 (08:12):
Yeah, that definitely makes sense. Doctor Adam Metsler from Orthos
since terrific insight. I do appreciate it, man, Thank you.
Speaker 2 (08:20):
You guys have a great day. Always appreciate it.
Speaker 1 (08:22):
Awesome stuff, great insight. Doctor Adam Metzler from Orthos Sincy.
I say this every single week because it's true. The
great thing about Ortho Sincy is they have specialists and
locations all over the Tri State, including walk in orthopedic
urgent care weekdays nine a to nine p and Saturday's
nine a to one p at both Edgewood and Anderson.
It's easy because you don't need an appointment, and it's
(08:43):
definitely cheaper than going to an er when you have
an urgent orthopedic injury. Good to Orthosincy dot com. That's
Orthos c I n c Y dot com.
All right, we do this on Wednesdays. It's typically in
the four o'clock hour where we talk with one of
the experts from Ortho Since the orthopedics and sports medicine
Orthos since he has specialists, locations and services all over
the tri State, including walkin orthopedic urgent care at five
locations with extended evening and weekend hours in Edgewood and Anderson.
(00:21):
Learn more at orthosinc dot com. That's orthos ci Ncy
dot com. Doctor Adam Metzler from Orthosincia is with us
because we've got to talk about Eric all Unfortunately, this
kid has dealt with knee issues going back to his
college years and suffered the injury the ACL tear in
his right knee in that game against the Raiders in
(00:43):
early November, had surgery on it. We found out yesterday
that he's going to miss all of twenty twenty five
because he's dealing with complications from the previous knee surgery
that he had after he dealt with the injury to
his knee that he suffered in college. So let's start
with this. Is it common for something like this for
(01:05):
the effects of a previous ACL injury to affect the
surgery to repair the ACL a second time.
Speaker 2 (01:11):
Yeah, I think it's really it's a culmination of the
of the original injury. The reality is is that what
people don't realize is about seventy five percent of the
time when you have an ACL injury, you also have
a cartilage injury, either to the smooth cartilage of the
joint or a meniscus tear. It's about seventy five percent
of the time that happens. So when that happens, then
(01:32):
we need to try to address those on the original surgery,
try to repair meniscus or try to get the cartilage
to grow and repair that as well. And so as
ideal as we like to have things as sometimes things
don't always heal, and it's not to the issue of
the surgeon per se, just more of sometimes things just
don't heal even when you repair them. And so you know,
(01:54):
when you have a previous injury, a previous surgery specifically
to the ACL, and you have meniscus tears or cartilage injury,
the second surgery and can be more challenging from the
fact that you've a had previous surgeries, a previous surgery performed,
and other things involved such as cardiog mniscus tears. So
that is why your evaluation of the physical exam and
(02:14):
your MRI is so important when you're prepping for revision
or redo surgeries, and they can lead to excuse me,
more complicated or complex secondary surgeries.
Speaker 1 (02:25):
So this might be a stupid question, but could the
second surgery maybe undo the effects of the surgery that
he just had?
Speaker 2 (02:35):
Yeah, I really wouldn't look at it that way. I'm
really unfortunately without more information exactly the insight of what
it is. If he had a cardiloge injury, for example,
it may take longer for the cartilage to grow. It's
oftentimes the second injury can have an impact a new
injury too, so he may have had additional injury to
something new and something that was already repaired in the past,
(02:56):
even if it was done perfectly. You can have a
perfect meniscus repair and have full feeling of that and
then recare what was repaired before, even in a perfect surgery.
And I tell my patients, and I've done fourteen hundred
ACL surgeries in my career here at Orposienci. Look, I
mean I've done I do one hundred and fifty five
acls a year and a perfect You tour what you're
born with, You tour your ACL, you toured your meniscus,
(03:18):
and I can do a perfect job on your ac
on your meniscus, and you can retear what we do.
And so I think when you say things that way
to patients, I think they really start understanding a little
bit more that you he tore what he was born with.
You can retaar what a surgeon does, and we try
to do everything we can in our ability to make
that as perfect as possible. So, and I don't really
like saying undoing something that was done from before, but
(03:38):
I say, look, we've got a problem. We got to
try to solve it together as a team.
Speaker 1 (03:42):
So it's a lot of surgeries and a short amount
of time for a young guy. Are there concerns about
there just being an accumulation of procedures like this.
Speaker 2 (03:52):
Yeah. Anytime you're doing a multitude of surgeries on an athlete,
much less a professional high level athlete, you know it's
a big TOLLI told mentally, I think we lose focus
of these young kids. These are young kids, and you
know they're trying to make in the NFL. It's it's
tough mentally to recover from a primary ACL much less
of revision. You know, return to play rates aren't as
high with revision ACL surgeres as they are primary. But yeah,
(04:15):
there's a cumult of effect on multiple surgeries and the
abilities for these athletes to get back to their previous
level of function. And I think, you know, the goal
is to be positively, your athletes do a great job
surgically and many, many of our athletes are able to
get back to their previous level function with significant rehab
and recovery. And it sounds like in this situation, you know,
as injury happened in November, they're going to take that
(04:37):
full year of recovery to optimize his recovery, cartilage procedure,
and growth and get that ACL to be as strong
as it possibly can without pushing the envelope too fast.
And I think sometimes we try to push that envelope
a little too quick and push bilogy a little too fast,
and that's where we can sometimes run into trouble. When
you're dealing with NFL athletes. Every game that's a paycheck game.
(04:58):
So we have to be OSHA's biology while also understanding
the debility for athletes to make money while they're still
young and healthy.
Speaker 1 (05:05):
Doctor Adam Metzler from Orthosinsia is with us talking about
eric Al. So let's say that the best possible outcome
is what we get and he's able to play for
the Bengals in twenty twenty six, which admittedly feels like
forever away. But let's assume that the procedures go well,
the rehab and recovery go well, and he's back on
the field. Given the fact that he has dealt with
(05:25):
multiple ACL injuries and surgeries, are there extra precautions that
can be taken to prevent him from having to go
under the knife again.
Speaker 2 (05:35):
I think the number one thing is giving his body
time to recover. From a strength standpoint, you've got to
get him as strong as possible to support that kneejoint.
The stronger the kneejoint is, the less likely there is
for reinjury. Bracing is very debatable with return of play
for ACL injuries or for many of our patients. We
use bracing for just a short period of time to
get them more mentally ready to play. At the NFL,
(05:56):
wearing a brace for a high level athletes other than
maybe alignment is hard. It's hard. It does slow you
down a notch, and at that level, every bit count,
So you know, he might see him wear a specialized
brace to help protect him to answer that question, but
at that point you'd be looking at gosh, you know,
eighteen months plus from the secondary surgery. To hope is
(06:17):
that there's enough stability of the knee and strength around
the knee that he doesn't have to do that. But
we might see them employee that for a little bit,
as we saw Joe Burrow did with his first season
back as well. If we all remember that.
Speaker 1 (06:29):
I feel like ACL surgeries have become so commonplace that
we have almost obscured how complex and how difficult to
recover from they can be.
Speaker 2 (06:40):
Absolutely. I think there's so much media around ACL surgery
it's rather fascinating. And someone quoted the other day there's
as much ACL research as there is heart research, which
is rather interesting to think about. And you know that's
in some ways a little concerning, but anyway, side note, Yes,
(07:01):
it is extremely common. It's extremely difficult to recover from
an ACL surgery. And I'll just use the basic references.
If you break your collar bone and I fix your collarbone,
if everything goes well, you're back returning to contact sports
and ten to twelve weeks maybe earlier. And that's because
bones heal really fast, and that's awesome, and if we
do a great job surgically, that bone's going to heal fast.
(07:21):
But ACL surgery you take a piece of tissue, your
pitel attendant or your coats, and then you make them
an ACL well that has to integrate inside of a
knee and takes nine months plus to become biologically stable.
And there's a lot of quaterceps and hamstring strength, muscle
recovery that has to accommodate that as well, versus when
you break the bone. My three months, most of our
kids are returning back to sports. And I think that's
(07:43):
the challenge when you have complex ligament injuries like ACL injuries,
and it's it's a hard pill for patients and families
to swallow. Whether it's a Division I athlete, a professional athlete,
or a local high school athlete. That's the time frame
it takes. And these are all scientifically proven timeframe international recommendations,
and so that I think is the hardest thing to
(08:03):
swallow for our patients is that's the time frame it
takes and it's mentally and physically a huge challenge and
hurdle for the patients to overcome.
Speaker 1 (08:12):
Yeah, that definitely makes sense. Doctor Adam Metsler from Orthos
since terrific insight. I do appreciate it, man, Thank you.
Speaker 2 (08:20):
You guys have a great day. Always appreciate it.
Speaker 1 (08:22):
Awesome stuff, great insight. Doctor Adam Metzler from Orthos Sincy.
I say this every single week because it's true. The
great thing about Ortho Sincy is they have specialists and
locations all over the Tri State, including walk in orthopedic
urgent care weekdays nine a to nine p and Saturday's
nine a to one p at both Edgewood and Anderson.
It's easy because you don't need an appointment, and it's
(08:43):
definitely cheaper than going to an er when you have
an urgent orthopedic injury. Good to Orthosincy dot com. That's
Orthos c I n c Y dot com.
Mo Egger News
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