Analyzing Chicago Bears Tight End Zach Miller’s Knee Injury

By Midwest Orthopaedics at Rush 

November 1, 2017

Will Chicago Bears tight end Zach Miller ever play in the NFL again?zach miller knee injury

Miller suffered one of the more gruesome injuries you will see in professional sports while trying to make a touchdown catch. Miller, a longtime NFL veteran, came down awkwardly on his left knee, suffering not only ligament damage, but also a torn popliteal artery that required emergency vascular surgery to repair.

Dr. Charles Bush-Joseph and Dr. Nikhil Verma, both sports medicine orthopedic surgeons at Midwest Orthopaedics at Rush, joined local Chicago news affiliates to discuss Miller’s injury and what the recovery process will be like. Dr. Bush-Joseph says that the odds of Miller playing football in the NFL again are “very small.”


ABC 7 Chicago

Dr. Charles Bush-Joseph sat down with ABC 7 Chicago’s Christian Farr to analyze Zach Miller’s knee injury.


FOX 32 Chicago

Dr. Nikhil Verma joined Good Day Chicago on Fox 32 Chicago to discuss Chicago Bears Zach Miller’s devastating injury to the knee.

Hear related interview with former Chicago Bear Otis Wilson in Episode 17.30 

Patient Completes Ironman after Knee Replacement

Photo 2.jpg

Several years ago, lifelong swimmer Laura Parker, now 47, of St. Charles, IL, took an interest in running because some friends were competing in a local triathlon. Training for this event got her hooked on competing and since 2009 she has completed four Ironman triathlons – the most difficult of all triathlons.

Her fourth triathlon was very special.

In an Ironman, competitors complete a 2.4-mile swim,112-mile bike and 26.2-mile run. – a total of 140.6 miles.

It’s all about training and committing to a process. “Training is harder than the race,” says Parker. “It’s not about racing against them, it’s a race against yourself.”

The training did take a toll on her body, however. Her first Ironman left her with knee pain that made it difficult to walk. She went for an MRI, which revealed that she had end stage arthritis in all three compartments of her left knee.

Heeding her doctor’s recommendation, Laura did physical therapy for six weeks to strengthen her vastus medialis oblique (VMO), a muscle located just above the kneecap.  She then went back to training but the pain worsened.

Eventually, even though she did two more Ironman competitions, it became increasingly harder to train, walk and perform every day activities. Then, in 2016, her doctor recommended a total knee replacement.

Laura immediately began her research to find the best surgeon for this procedure. One of her cycling friends had great success at Midwest Orthopedics at Rush, so she started there.

She discovered Dr. Craig DellaValle, a top ranked hip and knee replacement doctor, set up an appointment, and felt confident to that he was an excellent choice. She was excited to get back to pain-free training, but exactly what kind, she wasn’t yet sure. She was hoping to compete in another Ironman competition and discussed this in detail with Dr. DellaValle.

Laura’s knee replacement surgery went very well and she began stretching, lifting lightweights and was eventually able to start fully training again. She did so well that, eventually, Dr. Della Valle approved her to compete as long as she walked in the running portion of the races.

Laura did accomplish her goal of competing in yet another Ironman. She successfully completed her fourth in January 2017, a year and a half post- surgery.


“Being able to say you did an Ironman after surgery is a great reward,” she explains.


Next up for Laura is the biking season.  She will take a year off from the Ironman, but plans to resume them again in 2019.

Photo 3.jpg

“Getting your knee replaced is not a death sentence when it comes to your activity at all,” she explains. “Adjust your expectations and commit!”


For more information on keeping your knees healthy, visit www.kneesforlife.org. For an appointment with Dr. Craig Della Valle, call 877-MD-BONES. Visit www.dellavalleortho.com for more information.

Is Knee Pain Affecting Your Game?

golfer

Join Midwest Orthopaedics for breakfast and a free informational session where experts will give advice regarding painful knee arthritis.

TUESDAY, OCTOBER 03, 2017
Time: 8:00AM
Location: Briar Ridge Country Club 123 Country Club Dr., Schererville, IN 46375
Cost: $0.00


(8:30am – 9:15am) Degenerative Arthritis of the Knee: An Update on Nonsurgical and Surgical Management

Denis Nam, M.D., M.Sc.
Hip & Knee Reconstruction and Replacement Orthopedic Surgeon
Midwest Orthopaedics at Rush

dr denis nam

(9:15am -9:45am) Return to Golf Following Joint Replacement

Kevin McGuire, PT, DPT
Physical Therapist
Midwest Orthopaedics at Rush

kevin mcguire

 RSVP by Monday, October 2 to Paul Strandquist at 708.236.2661 or paul.strandquist@rushortho.com

Counsel patients, parents on concussion risks in football

iStock-471035985.jpgDrs. Anthony Romeo and Gregory Cvetanovich co-authored this articlein Orthopedics Today about the rising awareness and reported incidences of concussion and how parents, athletes and coaches should be more careful about making informed decisions about play and return to play. They added that orthopedic physicians have a responsibility to share information regarding the risks of contact sports.


There has been increased awareness of sports-related concussions and risks associated with head trauma. The reported rates of concussions have doubled during the past decade, especially among youth and high school athletes. Much of the increase is attributable to greater recognition and diagnosis, as well as more media attention.

Among youth and high school athletes, American football has the highest risk of concussions, accounting for almost half of sport-related concussions in United States and the highest rate of concussions per player. Male athletes have more concussions overall due to greater participation in contact sports, however, female athletes are diagnosed with almost twice the rate of concussions compared with males in comparable sports, such as soccer. Younger athletes may have greater susceptibility to concussions, risk of recurrence, chance of second impact syndrome, as well as prolonged symptoms and recovery.

Risks of concussions

Treatment of concussions in young athletes consists of cognitive and physical rest along with symptom management. Short-term concussion risks include prolonged symptoms consistent with post-concussive syndrome and rare, but potentially fatal, second impact syndrome if the athlete sustains a second head injury too soon after the first. Patients with prior concussions are also at two- to five-times greater risk of sustaining another concussion. Long-term concerns include reported increased rates of dementia and depression potentially related to chronic traumatic encephalopathy (CTE).

In a published study, researchers analyzed the brains of 202 deceased football players. They found an overall 87% rate of CTE on neuropathology. Former high school players had a 21% rate of mild CTE, and the rates of CTE increased based on highest level of play to 99% of former National Football League (NFL) players who had predominantly severe CTE on pathology.

The study had limitations, but it was proposed that CTE may be related to repeated blows to the head in football and the severity may increase as athletes reach high levels of play. Many questions remain about the impact of early exposure to head impacts from youth football and of hits sufficient to result in clinical diagnosis of concussion vs. clinically silent subconcussive hits.

Due to these concerns, football leagues of all levels, as well as those of other sports, have made rule changes designed to reduce head injuries. Many of the interventions have had success in reducing the rate of concussions, although the effect on potential long-term cognitive effects of repeated head trauma and rates of CTE remain unknown. Some rule changes have been shown to have paradoxical increases in rates of concussions, which more likely reflect simultaneously increasing awareness of concussions among players, coaches, trainers and team physicians, rather than a causative relationship of the rule changes and increased concussions. Equipment changes, such as improved helmets and increased use of mouth guards have been made, but show mixed data on their impact on concussion rates.

Counseling patients, parents

As orthopedic sports medicine physicians, we should have a low threshold to suspect and diagnose concussions in athletes in conjunction with trainers and other health care providers. Patients should be removed from play to prevent further injury and allowed to undergo appropriate concussion treatment prior to consideration of return to play. A multidisciplinary team approach can be valuable, particularly in patients with prolonged or recurrent concussion symptoms.

Athletes recovering from concussions along with their parents, in the case of youth athletes, should be advised that certain contact sports are associated with elevated risk of concussion. This risk is inherent to contact sports despite attempts to reduce risks with rule changes, equipment modifications and coaching. Once an athlete is symptom-free and completes a concussion protocol, return to play may be considered as a shared decision with patients and parents.

Counseling patients and families on the long-term risks of single or repeated concussions is more challenging, including risks for cognitive, behavioral and mood disorders and neurodegenerative changes of CTE. Patients should be informed that the growing evidence connects CTE and its associated symptoms to football, particularly prolonged and high-level play.

Existing data make it impossible to project these risks for an individual athlete with a concussion or repeated subconcussive hits to the head. Furthermore, it is unclear how early participation in football and concussions sustained in youth and high school football influence long-term cognitive function. However, we owe it to our patients to discuss the potential risks although we cannot provide firm guidelines about number of concussions or head impacts after which they should consider not returning to play.

Despite uncertainty about long-term and patient-specific risks, the decision to participate in contact sports comes down to an informed decision by patients and parents. Orthopedic sports medicine physicians should provide information about the current understanding of the risks, which patients and parents can use to make decisions about what short- and potential long-term risks are acceptable.