I’m not a doctor, and I didn’t stay at a Holiday Inn Express last night. But I do know the smartest guy who writes on the medical side of sports. He’s Will Carroll. His Substack newsletter is titled, “Under The Knife.”
We spoke Tuesday. Cutting, pun intended, to the chase, Carroll believes Ronald Acuña Jr. will be fine, even after tearing the ACL in his left knee not three years after tearing the one in his right.
Carroll’s database runs deeper than my Google search. He referenced the NFL defensive lineman I’d mentioned Monday – Casey Hampton – and dropped a rather large baseball name.
“Manny Machado had (surgery on) both knees, but it wasn’t the ACL. It was a different ligament. He’s certainly had a good career. The example I’ve been using is Frank Gore. He tore both when he was at Miami (meaning the U). He went on to have a 16-year NFL career where he was the last battering ram running back.”
Then: “There’s just not that many ACLs (torn by baseball players). In football, it’s very common – two and even three (tears) on the same knee, both sides. (The process) is no different. It’s a little harder with the same knee because they tend to take the patellar tendon as the graft. If you’ve done it once, now you’ve got to get it from the other side, or you’ve got to go to the hamstring tendon or the quad tendon. It’s not as big a deal these days because not everybody is using patellar tendons.”
After double ACL surgery, Gore rushed for 1,000-plus yards in nine NFL seasons. The first was when he was 23; the ninth was when he was 33. So yeah, he did OK.
Back to Acuña. Carroll believes his return from the first ACL surgery – he was the National League’s unanimous MVP in his second season back – could/should ease a second comeback.
Said Carroll: “He’s had the bad – bad, relative – 2022, and everything I’ve read from people who’ve talked to him, it’s always been (Acuña saying), ‘I didn’t have confidence in it. It took a long time to get it back. I didn’t want to run, I didn’t want to jump, I didn’t want to put the full force into my swing.’
“Is that going to come back? Because he knows now what he’s into. He’s done this before. Does he get his confidence back, or is that still going to stick in the back of his mind? Everybody’s treating ‘25 as if it’s baked in that he’s going to have a down year, and I’m just not sure of that.”
I asked Carroll if it was better, big-picture-wise, to have torn the other ACL than the first one again. “You’d rather not tear them anytime,” he said, “but I don’t think it matters. We’ve gotten so good at repairing these things. A revision? No big deal. Honestly, most of the Tommy John revisions we’re seeing now are holding up because of better technology – the internal brace.”
So: good news for Spencer Strider, too.
My first response to Acuña’s second torn ACL was probably like yours: He might never be the same. And I, probably like you, recalled cautionary tales.
Gale Sayers was the NFL’s best back before tearing an ACL in 1968. He returned from surgery – as chronicled in the made-for-TV movie “Brian’s Song,” starring Billy Dee Williams as Sayers and James Caan as teammate Brian Piccolo, who would die from cancer – to lead the league in rushing. After an injury (though not an ACL tear) to the other knee, Sayers played his last game at 28.
Mickey Mantle caught a spike on a Yankee Stadium drain cover in the 1951 World Series. (Joe DiMaggio called him off a fly ball.) Two years passed before Mantle had surgery. In her 2010 book, “The Last Boy,” Jane Leavy suggests he played the rest of his career – he retired in 1968 – on an never-repaired ACL. How much greater might the Hall of Famer have been?
Then I returned to reality: This is 2024, not 1968 or 1951. The science is better. The surgeons are better.
If Will Carroll believes we’ve not yet seen the last of peak Acuña, that’s enough for me.
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