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On the Road with Ernie

On the Road with Ernie

News from Ernie and Knee Surgeon

News from me…and my knee surgeon, 1 August 2005

Just in case you hadn't read my brief website report that I posted on Friday, and you're checking in this Monday expecting to see the usual tournament news and reviews, here's a quick recap of what's happened. Basically, I injured my knee while I was on a sailing holiday with the family in the Mediterranean last week and, having undergone surgery on Thursday, I'm going to have to take a break from golf on the recommendation of my medical advisers. As I was saying last week, it's the only sensible course of action, so that I can be sure of a prompt and full recovery. Obviously the timing is unfortunate. Although let's face it, there's no such thing as a good time to get injured. But what can you do? I'm not dwelling on my bad luck. All I have to do now is focus on getting better, so I'm out of action for not a day longer than I have to be.

The surgeon who did such a good job on my knee is Andrew Unwin at the Princess Margaret Hospital in Windsor. I asked him to put down on paper a few words about the nature of the injury, the type of operation I've had, and the sort of recovery and rehabilitation period that I can anticipate in the months ahead. He's the expert (I'm just the patient!) and I think it's fair to say he can explain these things a lot better than I can. Here's what he had to say ...


"Ernie has sustained a rupture of the anterior cruciate ligament (ACL). This is an important ligament within the knee which, in brief, provides rotational stability for the knee. When someone does not have an ACL and he/she attempts to twist or pivot on the knee, the knee can give way, causing pain and also harming the other structures within the knee such as the menisci ("cartilages") and the articular surface of the bones within the knee. If the knee repeatedly gives way, these structures become damaged more frequently, leading to premature osteoarthritis of the joint.

"The way in which Ernie ruptured his ACL is quite unusual. Most injuries are caused on the sporting field in soccer, rugby, netball, hockey and other similar sports in which there is a rotational force on the weight-bearing knee. In Ernie's case he got his foot caught and his body twisted on the knee, causing a rotational force to the joint and rupturing the ACL.

"Interestingly enough ACL ruptures in themselves do not cause pain, except in the first few weeks after the injury. The main problem without an ACL is that the knee is unstable on pivoting. Activities such as running and cycling are usually possible without too much trouble (although not always). However, activities that require agility and twisting motions on the knee are often not possible in the absence of a competent ACL.

"The ACL unfortunately does not repair itself well (although there are some recent advances in ways of trying to get the ACL to repair itself). If the patient requires rotational stability the ACL has to be "substituted" with something else – this is the basis of an "ACL reconstruction". The three most commonly used methods today for reconstructing the ACL are firstly using hamstring tendons, secondly using a strip of the kneecap tendon and thirdly using allograft (ie. tissue from someone else). In Ernie's case we will be using his hamstring tendons. They are held in the bone around the knee using small screws and anchors and the operation is largely arthroscopic ("keyhole").

"After last Thursday's preliminary op we now have to wait until Ernie's knee is "ready" for the reconstruction. The knee needs to regain its full range of movement, there needs to be no swelling and there should be good muscular control around the joint. As soon as Ernie meets these criteria he will be ready for the reconstruction.

"Following that operation, no braces or splints will be necessary and he will need crutches for only a few days. For the first six weeks or so after the operation the knee needs to be mobilised quite carefully as the graft construct is somewhat weak over this period. Ernie will spend a great deal of time at the gym mobilising the knee and once the wounds are healed, using a pool to regain his muscle strength. After this Ernie can start to pivot on the knee at about six weeks, and hopefully can pick up a golf club at about 8 weeks from the operation. He should be able to start playing gentle golf at 8-10 weeks and hopefully playing professionally again by 16 weeks. This compares very favourably with contact sports such as soccer or rugby where a return is delayed for 6-9 months.

"Many professional sportsmen and women have returned to a first class level following a reconstruction. A great deal of effort both physically and psychologically is needed, but there's absolutely no reason why professionals cannot return to their pre-existing standard of activity."

Thanks for that, Andrew. From my point of view it's obviously interesting to hear the full story in detail. I imagine it also answers a lot of the questions I'm sure many of you will have wanted to ask me.

Coming up this week...

One thing I do want to say this morning is a big thank you to all of you out there who sent messages of support and encouragement to me over the weekend. I'm grateful to all of you. The support I get from around the world, not just this weekend but every week of the year, means a lot to me. All of my sponsors have responded in a really positive way, too, and I'd like to thank them for their kind comments. Also, it's been great to receive messages of support from the PGA Tour, European Tour and South African Tour, and from many of my fellow tour pros.

Anyway, as I'm sure you can appreciate, there's really not a lot more to say in this week's diary. Obviously for a while my website reports might not find their usual Monday morning slot. But I'll be writing on a regular basis to give you all the latest news and keep you posted on developments. So don't stay away for too long!

Bye for now.

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