Monday Morning MD: Aaron Rodgers and the truth about ACLs

Top 10 Aaron Rodgers Highlights of 2015 | NFL

The Packers superstar made news with his comments about his 2004 anterior cruciate ligament (ACL) surgery.One of the NFLs best and most athletic quarterbacks attributed some of his success to his cadaver donor being a fast SOB as he shaved almost 3/10ths of a second off his 40-yard dash time after surgery.

Known to have a unique sense of humor that even fools teammates,Rodgers comments were surely made tongue-in-cheek. It wouldnt be the first time a player was kidding the media as Danny Trevathan joked about having someone elses kneecap last year.In any case, Rodgers quotes give us a good chance to separate the realities from the myths of ACL surgery.

Was Rodgers cadaver donor a fast SOB?

There would be no clear way for Rodgers to know whom the donor was. The only cadaver information typically available to the surgeon is the age, s*x, cause of death and dimensions of the graft. Upon expiration, donors are screened for diseases before being deemed viable for tissue harvesting. There is no direct tissue typing or matching to the recipient. Details of the donors life, ethnicity, occupation or athleticism are not considered or available. In fact, Rodgers ACL graft donor could have been female.

Could someone elses ACL make you faster post surgery?

No way the graft itself makes anyone faster. First, the actual ACL from a cadaver is never directly harvested for use due to size and geometry limitations. Commonly, the patellar tendon (with two attached bone blocks), Achilles tendon (with bone on one side) or all soft tissue grafts (like posterior tibialis tendon) are used. Second, the ACL functionally cant make one faster. It serves to stabilize the femur to the tibia and thus actually could be said to slow the knee down to prevent shifting.

Is it feasible to decrease ones 40-yard dash time after ACL surgery?

Rodgers said he was a 4.95 (40-yard dash) guy and then ran 4.66 after ACL surgery.Yes, ACL rehab can make someone faster/quicker if the athlete was not performing maximally prior to injury. A fully trained athlete cant be made faster; however, a sub-optimally functioning player can be helped. In fact it is possible for an uninjured player to go thru ACL rehab style training and have performance improve. I personally witnessed Philip Rivers become a better athlete after ACL surgery in 2008. I wish I could take credit for his increased speed/mobility but it was a result of his hard work with top Chargers athletic trainers. Rodgers is downplaying his own dedication to rehab post-surgery here.

How is it possible to play football for multiple years without an ACL?

Playing through an ACL tear is possible in certain circumstances. Rodgers played high school, junior college and into his time at Cal with a torn ACL. Rivers played in the 2008 AFC Championship Game six days after arthroscopic surgery with a torn ACL.

The ACL is like an internal seat belt for the knee. Just like it is possible to drive a car with the seat belt broken, one can function without the ACL. However, when racing NASCAR, your seat belt better be working, just like your ACL is needed for the aggressive running/jumping/cutting of football. Without an ACL it is playing Russian roulette with your knee as there can be permanent cartilage damage if the knee gives out.. Rodgers was able to play through with a brace at lower levels of competition. Rightfully, his ACL surgery was done before exiting college and advancing to the NFL.

Is cadaver the best ACL graft like Rodgers recommends?

Certainly, the cadaver ACL worked for Rodgers. However, that would not be my (or most NFL physicians) first recommendation. Fortunately, disease transmission risk with cadaver grafts is small. Even so, autograft (own tissue) patellar tendon with bone on each end is the most popular graft choice in the NFL. Bone-tendon-bone (BTB) graft is the strongest and most likely to succeed. Cadaver can work but has the higher re-tear rate over hamstring and BTB autografts. Using cadaver leads to less post-operative soreness and makes for a quicker recovery but may not be worth the significant (up to 30% per the ACL Study Group) re-tear rate. The cadaver failure rates are highest for younger and more active patients. Remember, missing a second consecutive season likely means the end of an athletes career.

Why is cadaver a potentially weaker graft choice?

All ACL grafts are scaffolds for ones own tissue to grow into. Logic would tell you that your own tissue grows best into your own tissue versus someone elses. A graft that does not incorporate and ligamentize is doomed to failure. There is no true rejection, as that is an immunologic response and cadaver patients dont need to take special medications like organ transplant patients. Perhaps when technology arrives to tissue type and match to donor to recipient, cadaver failure rates will improve.

Can the ACL be stronger after surgery?

After one year of recovery, my patients are twice as likely to tear the other knee ACL versus re-tearing the reconstructed ACL. This is why I recommend bracing during the first year with early return to sport. The new ACL is not truly stronger, just lower re-tear risk. No, I would not recommend prophylactic ACL surgery.

Has ACL recovery gotten faster?

It sure seems that way. Rehab techniques have improved but there is no way to speed up biology. The media with Adrian Petersons nine-month return to rush for 2000 yards makes it seem like early return is something new but ACL recovery has been getting faster for over a decade. Shannon McMillian returned to play international soccer 102 days after her ACL surgeryand at four months played in the 2003 Womens World Cup for USA.

What is best thing to do for an ACL tear?

Pick a surgeon you trust and not the specific technique or graft choice. There are many ACL techniques (open, double incision, single incision, medial portal technique, all-inside) and many autograft (BTB, hamstring, quad tendon, contralateral) or allograft (BTB, Achilles, posterior tib) options. Let the chef tell you what he cooks well and the best meal to order. Let the surgeon tell you the procedure he is most comfortable with and what is best for you. Dont make a surgeon who recommends cadaver harvest a hamstring graft. In other words, when you go to Mortons get the steak. If you want fish, go to Oceanaire. Trust the recommendation or choose a different restaurant or surgeon.

Overall the joke is on us to take Rodgers comments so literally. It is very nice of Rodgers to thank and credit his ACL donor. At least this gave us a chance to discuss some of the fact and fiction about ACL surgery and recovery.

Source: http://www.nationalfootballpost.com/monday-morning-md-aaron-rodgers-and-the-truth-about-acls/

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Chicago Weather: Heavy rain, lightning possible but severe storms unlikely

Chicago"s Weather Forecast

CHICAGO (WLS) --

Pockets of heavy rain and some lightning will likely move into the Chicago area Thursday evening, but the threat of stronger storms is greatly diminished.

Rain began moving into Chicago shortly before 6 p.m. and the line of storm extends south into the suburbs. The storms are moving rapidly to the east at about 25-30 mph, according to ABC7 Meteorologist Jerry Taft.

Severe storms are increasingly unlikely, though there have been reports of heavy downpours.

The Chicago area is most likely to see that rain between 6 p.m. and 9 p.m. The Cubs are scheduled to play the Atlanta Braves at Wrigley Field at 7:05 p.m. Storms should be out of the area by 9:30 to 10 p.m.

Scott says that a cold front originating in Minnesota and moving easy could also bring some storms to the area overnight. There is only a slight risk for strong storms, and the main threats are heavy rain and high winds.

CLICK HERE to see the latest radar view from LIVE Doppler 7 MAX

While the afternoon will be hot and muggy with highs near 90, ABC7 Meteorologist Larry Mowry said cloud cover building across the area will help stabilize the atmosphere.

The Storm Prediction Center downgraded the potential for severe weather early Thursday, but all of northern Illinois, northern Indiana and southern Wisconsin remains under a "slight" risk for severe weather this afternoon and evening. A "slight" risk means that scattered severe storms are possible across the area.

Watch the latest forecast from the First Alert Weather Team:

(Copyright 2016 WLS-TV. All Rights Reserved.)

Source: http://abc7chicago.com/weather/heavy-rain-lightning-possible-but-severe-storms-unlikely/1416958/

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Demi Lovato Continues Beef With Taylor Swift by Following Calvin Harris on Twitter

Calvin Harris and Tinashe Are Not a Couple | E! News

Months later, it seems that Demi Lovato vs. Taylor Swift beef may still be alive.

MORE: Demi Lovato Talks Enjoying "Single Life"

The "Confident" singer reportedly started following Swift"s ex Calvin Harris on Twitter on Thursday, just one day after the DJ threw shade at his ex via social media.

A fan site noted that the singer began following him, but that she also started following Lin-Manuel Miranda and 5 Seconds of Summer drummer Ashton Irwin.

Fans deemed the 23-year-old"s follow of Harris particularly important considering Lovato and Swifts recent beef surrounding Keshas legal battle. Back in February, Swift donated a whopping $250,000 to help Kesha pay for her legal bills, but Lovato was not impressed. Take something to Capital Hill or actually speak out about something and then Ill be impressed, she said. Lovato later clarified her statements, explaining she often gets fired up about things of this nature.

Now, Lovato may be finding herself in the middle of the Shake It Off singers relationship with the famous DJ. Last week, in the wake of Swifts breakup with Harris, the DJ took to Twitter to throw shade at his ex and her attempts to make him look bad.

RELATED: Selena Gomez Defends Taylor Swift After Kim K. Exposes Truth Behind "Famous" Lyric

Looks like Lovato has chosen her side in this battle.

Source: http://www.latina.com/entertainment/buzz/demi-lovato-follows-calvin-harris-twitter

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Rudy Giuliani Denounces "Islamic Extremist Terrorism"

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Source: http://abcnews.go.com/Politics/video/rudy-giuliani-denounces-islamic-extremist-terrorism-40686829

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"America Is the Light": Marcus Luttrell Chokes Up, Briefly Abandons Teleprompter During RNC Speech

FULL SPEECH: Gov. Rick Perry & Marcus Luttrell - Republican National Convention - LONE SURVIVOR

Lone Survivor Marcus Luttrell, a retired Navy SEAL, offered a powerful speech Monday night at the Republican National Convention, chronicling his experiences in the military and thanking Americans for allowing him to serve for 20 years.

To the large crowd of delegates, who were gathered at the Quicken Loans Arena in Cleveland for the conventions opening night, which boasted the theme Make America Safe Again, Luttrell offered a heartfelt plea on the part of veterans.

Photo by ROBYN BECK/AFP/Getty Images

I think its important to say that we got to make sure that the h**l the veterans return from is not the h**l [they] come home to, OK? he said. Thats what was promised, and thats whats deserved.

It was at that point that the former SEAL started choking up. He talked about his love for his generation, Generation X, and offered gratitude for those who create charities and programs to help wounded veterans and families of the fallen when the system doesnt take care of our boys.

Please know that I end every day on my knees thanking G*d for yall, and what you do, and how you covet my generation of veterans coming home, Luttrell said, his voice shaking.

He told the delegation that Donald Trump, the presumptive Republican nominee for president, understands what its going to take to fix the problems currently plaguing the military community.

The only way were going to keep America safe is to have an elite military, all right, Luttrell said, before going off script.

The Lone Survivor author then called on Americans to join together as a family, standing up for one another and backing each other up.

The only way we survive this is together not apart, Luttrell said. In order for any life to matter, we all have to matter, you understand?

He called on the next generation to prepare themselves to take the mantle from his generation because your war is here. He asked who in the younger generations will love something more than you love yourself and who will step up and take the fight to the enemy, challenging everyone to fight for your country.

The world outside of our borders is a dark place a scary place, Luttrell said. America is the light, and her people are the goodness that grows from that.Shell always be worth fighting for it was my greatest honor to fight for her every day of my adult life.

Ultimately, the high-profile veteran ended his remarks by thanking those in attendance for allowing him to serve in the armed forces for 20 years.

I swear to G*d Im going to spend the next 20 paying you back, he said.

Source: http://www.theblaze.com/stories/2016/07/19/america-is-the-light-marcus-luttrell-chokes-up-briefly-abandons-teleprompter-during-rnc-speech/

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The 2012 Benghazi Attack: What Happened, and Why Republicans Are Obsessed

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As Republicans take to the stage in Cleveland starting today for the Republican National Convention, viewers can rest assured that they"ll hear one recurrent phrase when it comes to talking about Hillary Clinton: "Benghazi." Just like Clinton"s email probe, for which she was cleared by FBI, the Benghazi issue has been ongoing for years and is pretty complicated.

It started in 2012 after four U.S. citizens ambassador Christopher Stevens, CIA contractors Tyrone Woods and Glen Doherty, and information officer Sean Smith were tragically killed. But what actually happened in Benghazi, Libya? Read on for an overview on everything you need to know to understand the debate.

WHAT HAPPENED?

An armed man waving his rifle as buildings and cars are engulfed in flames after being set on fire inside the US consulate compound in Benghazi on September 11, 2012.

STR/AFP/Getty

On Sept. 11, 2012, nearly a half-dozen Islamic countries held anti-US protests in reaction to a movie made by an American filmmaker that mocked the Prophet Mohammad, according to PBS. In Cairo, a mob of protesters breached a wall at the U.S. Embassy and ripped down a flag.

That same night, reports began coming in that terrorists had overrun the U.S. diplomatic compound in Benghazi, Libya, according to USA Today. Libya was still reeling from a civil war the year before and the death of its leader Moammar Gadhafi, and was unstable.

At the U.S. compound, a group of attackers opened a gate allowing armed men to enter and set fire to a building, filling it with smoke, NBC reported. The U.S. Ambassador to Libya, Chris Stevens, went to a safe room with another American, Sean Smith, and the two died of smoke inhalation there as American security guards tried to rescue them.

There was a second attack on a CIA annex building nearby, and two CIA contractors, Tyrone Woods and Glen Doherty, exchanged gunfire with the attackers, but were also killed.

THE RESPONSE

Defense Secretary Leon Panetta said the U.S. did not know the attack was coming and the military was too far away from the compound to help during the attack, and on Sunday morning political talk shows that week, then-U.N. Ambassador Susan Rice suggested a link between the anti-Mohammad movie and the attack in Benghazi, according to PBS. Rice stated that the "current best assessment" was that the attack was an extension of the protests against the film happening elsewhere.

"What this began as was a spontaneous, not a premeditated, response to what had transpired in Cairo," she said.

According to NBC, Rice was telling the truth: a CIA report had concluded that was the case, but the CIA report turned out to be wrong.

THE CONTROVERSY

U.S. Republican senators Lindsey Graham, John McCain, and Kelly Ayotte speak during a press conference to discuss the Accountability Review Board report into the Benghazi terrorist attack on December 21, 2012 .

Win McNamee/Getty

Republicans in Congress said that the White House knew immediately that Benghazi was a terror attack, not part of the protests, and that they hid that information to help President Obama get re-elected in 2012. The White House said that Rice was speaking from the best information available at the time, according to PBS.

The Republicans began pressing the administration with questions such as why diplomats were in Benghazi, why security at the compound was inadequate, why the intelligence community didn"t know about the attack, why military was unable to respond quickly, and why the Obama administration spread inaccurate information in the days after the attack.

THE INVESTIGATION

Five House Committees, two Senate Committees, the FBI, and the State Department launched investigations into the Benghazi attacks to try and get answers to some of those questions.

Clinton, who was then head of the State Department as Secretary of State, testified before two of the committees in January 2013 as part of the investigations.

"The fact is, we had four dead Americans," Clinton said in her testimony. "Was it because of a protest or was it because of guys out for a walk one night who decided they would go kill some Americans? What difference at this point does this make? It is our job to figure out what happened and do everything we can to prevent it from ever happening again."

Clinton said that she took responsibility for the tragedy and agreed to improve security at diplomatic outposts in high-threat areas, but was not involved in decisions, before the attacks, about whether to bolster security in Benghazi.

CONCLUSION: The State Department Failed, But Clinton Did Not

The multiple investigations found there was inadequate security at the Benghazi compound and a series of failures within the State Department, and that Rice was given inaccurate information about the attacks, but none of the reports found fault with Clinton, according to USA Today.

Those findings, however, were not enough to satisfy Clinton and Obama"s critics. As Mother Jones quoted NPR"s Ari Shapiro in 2013, "Benghazi has become a sort of catchword. To Republicans, it symbolizes everything bad about the Obama administration" and by extension Clinton. It"s an issue her Republican rival, Donald Trump, has seized upon throughout the campaign season, and it"s likely to come up again numerous times at the RNC .

Related: Where Hillary Clinton and Donald Trump Stand on Foreign Policy

Source: http://www.teenvogue.com/story/2012-benghazi-attack-controversy-explained

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A crucial meeting in Germany for Mrs May

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So as Theresa May heads for Berlin tomorrow for her first foreign trip since becoming Prime Minister, there will be much interest in whether she and Angela Merkel get on together since this relationship will be critical to the way Britain and the EU handlethe consequences of the Brexit vote. The referendum outcome caused shock and dismay in Germany where there is no great desire to see the UK punished for leaving the club but no evident enthusiasm for helping Britain, either.

It would be nice to think Europes two most powerful leaders could strike up a friendship; but it is by no means essential. What is important is that they each respect where the other is coming from. It is too early in Mrs Mays premiership for her to be able to set out in even the sketchiest detail the likely direction of Britains negotiations with the EU. But she will want to lay down some parameters now with Mrs Merkel and with Francois Hollande, whom she is to meet in Paris on Thursday.

The EU Council is to meet in Bratislava on Sept 16 - with Britain absent for the first time - to set out the general negotiating framework for talks. In Berlin and Paris, therefore, Mrs May has her first opportunity of influencing that critical discussion. With characteristic cynicism, Charles de Gaulle, who vetoed Britains first attempts to join the EEC, once said that France had no friends, only interests. But it is also in a nations interests to have friends; and Mrs Mays task is to ensure we keep them.

Source: http://www.telegraph.co.uk/news/2016/07/19/a-crucial-meeting-in-germany-for-mrs-may/

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