Constable: Schwarber's knee will fare better than Gale Sayers' did
On Nov. 10, 1968, graceful Chicago Bears running back Gale Sayers was knifing through the San Francisco 49ers defense when cornerback Kermit Alexander dove into the legendary star's legs to make the tackle. The ball bounced away and Sayers grabbed his right knee in pain. The impact tore Sayers' anterior cruciate ligament, his medial collateral ligament and his meniscus cartilage. Teammates carried him to a stretcher and Sayers' season was over.
On April 7 of this year, slugging Chicago Cubs left fielder Kyle Schwarber was lumbering toward a fly ball when center fielder Dexter Fowler dove into Schwarber's legs as they both tried to make the catch. The ball bounced away and Schwarber pounded the turf in pain as his left leg remained motionless. The impact tore Schwarber's anterior cruciate ligament and his lateral collateral ligament and sprained his ankle. Trainers lifted him onto a cart, and Schwarber's season was over.
"This surgery now is night and day compared to then," says Birmingham, 39, who has performed hundreds of knee surgeries, including those where he rebuilds the anterior cruciate ligament and repairs a second ligament.
"A two-ligament injury is much less common, but you still see it," Birmingham says. As happened in Schwarber's case, those injuries usually are the result of a significant blow to the leg while the foot is anchored to the ground.
"It's usually the result of a high-level contact sport or a motor-vehicle accident," says the doctor, who practices at NorthShore Orthopaedic Institute offices in Chicago, Vernon Hills, Gurnee, Glenview and Skokie.
The anterior cruciate ligament, or ACL, links the lower leg to the upper leg and stabilizes the knee. A posterior cruciate ligament adds support. The medial and lateral collateral ligaments help keep the knee from sliding side to side. The meniscus is made of C-shaped pieces of cartilage that act as shock absorbers between the femur bone of the upper leg and the tibia bone of the lower leg.
Schwarber's surgery was performed Tuesday in Dallas by Dr. Daniel Cooper, the team physician for the Dallas Cowboys. Cooper reconstructed the ballplayer's anterior cruciate ligament and repaired his lateral collateral ligament.
When Sayers had his knee surgery in 1968, there was no reconstruction effort. In a 2010 Sports Illustrated article about Sayers, the surgeon who performed his 2009 knee replacement said Sayers' anterior cruciate ligament was gone. His posterior cruciate ligament was stretched and frayed. His medial collateral ligament had been sewn or stapled as part of an ineffective repair attempt. A half-inch chunk of his tibia had been sawed off in an attempt to ease arthritic pain. And his cartilage had been worn away and replaced by dust and fragments from the bones rubbing together for decades.
When he reconstructs the ACLs of professional athletes today, Birmingham says he usually uses the patellar tendon, which has been shown to have a better connection to the bone and a quicker rehab. A hamstring tendon also can be used. Both offer vast improvements over any options of a generation ago.
"There are good studies out there on professional athletes," Birmingham says. The playing career of an athlete with a rebuilt ACL "is not shortened in any significant way," Birmingham says.
While Sayers rehabbed well enough to lead the league in rushing the season after his surgery, he was slower. He suffered an injury to his left knee in 1970, never returned to his old form, and retired before the start of the 1972 season.
That shouldn't be the case with Schwarber or even the teenage soccer-playing girls for whom Birmingham has reconstructed ACLs.
"They should get back to the same level as before," the doctor says. He expects Schwarber to play next season.
Birmingham, who avoided knee injuries while playing football for Holy Cross University in Worcester, Massachusetts, was a physician for the New York Giants in the NFL before moving to Chicago and taking the position with the Bears.
"I'm a casual baseball fan," says Birmingham, who was born into an East Coast family with a mom who rooted for the New York Yankees and a dad who was a die-hard fan of the Boston Red Sox. "But I'm absolutely rooting for the Cubs."