No such luck today.
The MRIs confirmed a full and complete tear of Kacie's left ACL. It also showed relatively minor damage to the MCL, damage that will not require surgical repair. Lastly, it did show meniscus damage, the extent of which likely won't be known until Dr. Rosneck gets in there and fixes what's messed up.
In short, it could have been worse, not that any of it is ideal.
What the pictures also showed was a lot of bruising to the bones that collided when the ACL tore. Without the ACL in place to prevent it, the femur slams down on the tibia as if you just quickly pulled the middle book out of a stack of three books. That bruising, and the related inflammation to soft tissues around the injury, will require a couple weeks of waiting before the surgery itself can be performed. Those bones collide with enough force that there is actually a small indentation in the femoral bone. Picture the end of a typical dog bone with a tiny melon-ball sized scoop removed
The surgery will consist of Dr. Rosneck removing the middle third of Kacie's patella tendon (from the same damaged knee) and using that to replace the blown up ACL. It's a "biomedical rope", as Dr. Rosneck explained.
That "rope" will be anchored to the femur and the tibia through "canals" put into each of those bones. The patella tendon will be placed into the canals and then secured with some sort of hardware (screws, if I understood correctly). Any meniscus issues will be cleaned up or repaired at that time as well.
Dr. Rosneck's preference to wait a couple weeks while the bruising heals also gives Kacie time to work on some exercises that will benefit her immensely after the surgery.
Kacie had a ton of questions that she had written down and Dr. Rosneck dutifully and patiently answered them all. The surgery takes anywhere from 45-90 minutes depending on what else they need to do in addition to the ACL repair, and rehab begins only a few days later.
The doctor explained the nature of rehab and how it's almost always a "one step forward, half step back" proposition. It will be too slow for her at times and it will be painful at times. But his obligation is to the graft site and he'll seek to protect it and have it heal without her damaging it in its infancy. The graft doesn't actually fully heal for 2-3 years from the time of the surgery. There's just not a great deal of blood flow to promote healing, but the rehab, functional strengthening, and dedication to both allows for athletes to return to the field well before that.
He, and others, have cautioned us to not put a specific time frame on that return. Beating the number by a month is far less meaningful it if means a greater likelihood that the graft fails or that she reinjures herself.
He did not say, and we forgot to ask, whether a brace would be required. It may be required during the rehab, as a friend pointed out, to lock and prohibit the leg from full extension and to limit the exertion she can put on the knee. Sadly, as another friend noted, there are doctors who caution against the brace once one returns to play for an all together pathetic reason: the brace makes the wearer a target for kids who will go after that knee.
But all of that is down the road. Along with the uncertainty of how the knee will respond to inadvertent contact or the cuts required in a game situation. But we'll cross that bridge when we get to it, and there's a long stretch of road before that's a big worry.
Right now it's knee bends and flexion exercises, along with letting the bruising heal. All of that waiting is the hardest part of this right now. Time keeps ticking and the knee is still in a state of derangement. I wasn't blessed with a great deal of patience, so I want one hurdle cleared as quickly as as possible and the next one in our sights. I simply prefer action over planning ;-) From a more practical standpoint, three weeks from now Kacie is back in school. Missing classes at Gilmour is not an ideal approach toward academic advancement and excellence at Gilmour.
Which brings us to the next issue: we have nearly no control over any of this. We're good with the doctor and his plan, but Kacie isn't his only patient and her body isn't ready for surgery yet. There are also grafts that fail and a myriad of other complications that drive me crazy, but I'm not in position to fix them. Nor can I hold her hand and drag her to rehab. I don't think I'll have to, given her determination to let this recovery and return define her, as opposed to letting this injury define her.
But tomorrow is another day closer to clearing this immediate hurdle. This injury devastates thousands of kids in Kacie's age range every year. But that also means it's common and that Dr. Rosneck does close to a hundred of these surgeries annually. I'd almost venture to call it routine if it wasn't my daughter whose knee was in disrepair.
Tomorrow is also the second day of two a days at Gilmour. Kacie is hoping to watch some freshman vomit during a run and maybe go see the trainer for some exercises and ice. She had her concussion testing yesterday like every other junior, and she'll be at the team picnic Saturday after a week of attending practice.
I asked her today if she'd exchange a healthy knee for the National Cup title they won last weekend and the state championship they won last November. She looked at me like I had three heads and said, emphatically, "Not a chance".
Me neither. Not today. But I reserve the right to ask that question of myself again, as often as I want to, over the next six months.
