Saints "Surgery is better for Brees" - Dr. David Chao (@ProFootballDoc) (1 Viewer)

[bobad]

The docs knew it was an UCL tear on the sidelines. The MRI/ultrasound isn’t needed to make that diagnosis. The MRI is done to rule out conditions you don’t know about, such as other ligament tears, fractures, or Stener lesions. Think of it as 6 weeks minimum and anything else other that UCL injury adds addition time. The 6 week timeline likely means Brees has a clean, isolated complete UCL tear.

If the docs could diagnose it on the sideline, it means they could see and/or feel evidence of a pretty bad tear. Surgery should not be delayed.

 

[cajunkid]

All I can say about this is, We are still the Saints football team. They need to step up with Drew out. Honest when Drew went out. They looked like crap. Dropped passes, missed tackles they really looked bad. They need to step the hell up. Brees is not their daddy. Lets Go Saints. Bridgewater and Hill must step up and play to the level of the QB position, I know they can do it. I for one fan will stand behind them all. JMO

 

[Dallas_Saint73]

Does the surgical procedure result in a stronger-than-before ligament vs. a partial healing naturally? I guess I'm asking if they can artificially enhance the durability of the ligament.

I've had two surgeries for torn tendons, UCL complete avulsion (elbow) and partially torn triceps tendon. I was told that with the partial tear (by two different ortohos),it isn't guaranteed to completely heal and that I could run the risk of complete avulsion (completely torn from attachment) if I continued activity that stresses that tendon. I don't really notice a difference post-surgery with either, however there is some scarring that formed in my elbow that compresses my ulnar nerve and sometimes my pinky and ring finger will go numb with certain activity.

It will probably depend on the strain grade. If it is a grade 1 strain, then conservative treatment and PT will probably be prescribed. If a grade 2 or 3, then docs may suggest surgery to avoid a complete tear. This is assuming that there isn't a complete tear.

 

[sammymvpknight]

If the docs could diagnose it on the sideline, it means they could see and/or feel evidence of a pretty bad tear. Surgery should not be delayed.

I wouldn’t worry about it. Brees isn’t going to do anything that would compromise that 6 week return to play. He’ll likely get the opinion today or tomorrow and the timetable won’t change.

A second opinion never hurts. People get second opinions for different reasons. Some do it because they don’t want to believe the first guy. Some want to “just make sure.” Some dont have a good rapport or don’t trust the first guy. The last one is huge. So Brees isn’t necessarily shopping a doc to avoid surgery. I trust that he’ll make the best decision.

 

[sammymvpknight]

Does the surgical procedure result in a stronger-than-before ligament vs. a partial healing naturally? I guess I'm asking if they can artificially enhance the durability of the ligament.

In general, you can’t do better than God. But surgeons are getting pretty close to matching.

 

[Reggie09MVP]

Consider that they actually showed the exam on TV, that is very unlikely. I hope that Drew doesn’t get talked into PRP/stem cells. Surgery is very likely the fastest route to recovery. And honestly, I was excited to hear 6 weeks...that was best case scenario in my mind.

A diagnostic test can easily show a false positive. It a test to elicit pain. He had just hurt his hand. Easy to replicate pain given the acute nature of the injury. For a true diagnosis of ligament damage you need an MRI.

 

[sammymvpknight]

A diagnostic test can easily show a false positive. It a test to elicit pain. He had just hurt his hand. Easy to replicate pain given the acute nature of the injury. For a true diagnosis of ligament damage you need an MRI.

It’s not a test of pain, it’s a test of laxity. You compare one side to the other...if you have significant laxity, which was pretty clearly demonstrated by the video, you have a torn UCL. You don’t need an MRI to diagnose an UCL tear...but it’s done anyway to rule out other pathology and confirm diagnosis. It’s also a helpful test if you are unsure if it’s a partial or complete tear.

Remember that MRI is a recent invention. Physicians had no problem making the diagnosis before MRI.

 

[Reggie09MVP]

It’s not a test of pain, it’s a test of laxity. You compare one side to the other...if you have significant laxity, which was pretty clearly demonstrated by the video, you have a torn UCL. You don’t need an MRI to diagnose an UCL tear...but it’s done anyway to rule out other pathology and confirm diagnosis. It’s also a helpful test if you are unsure if it’s a partial or complete tear.

Remember that MRI is a recent invention. Physicians had no problem making the diagnosis before MRI.

I’ll agree to an extent. But Physicians have difficulty picking up true diagnosis of injuries, do even with MRI. Again certain tests can can get false positives if other ligaments are damaged. If ACL is torn and there is only laxity in a posterior drawer it could be due to an anterior tibial shift etc. These diagnostic tests aren’t 100 reliable. I have not seen the video you have mentioned. Can you direct me to it?

 

[sammymvpknight]

I’ll agree to an extent. But Physicians have difficulty picking up true diagnosis of injuries, do even with MRI. Again certain tests can can get false positives if other ligaments are damaged. If ACL is torn and there is only laxity in a posterior drawer it could be due to an anterior tibial shift etc. These diagnostic tests aren’t 100 reliable. I have not seen the video you have mentioned. Can you direct me to it?

Nothing is 100% but a competent sports med can call an acute UCL injury without an MRI. There’s not much that allows significant valgus stress of the MCP joint that isn’t also badness (avulsions for instance, which are much less common). Of course you get an MRI but the doc knows.



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