The Tre’Davious White ACL Injury

There was six minutes left in the 2^nd quarter when Tre’Davious White sustained an ACL injury. Watching at home, sedated by tryptophan, video exhibited the textbook mechanism. White was able to walk to the locker room, but the sustained damage was palpable in his emotions. Hearts and prayers for a smooth recovery for the Goalie Academy founder and 1^st Team All-Pro CB.

Thigh Doctor on Twitter: “This moment. The eye contact. Seconds from performing the ACL test. McDermott praying over him. It is powerful https://t.co/zvMFFg5hgb / Twitter”

This moment. The eye contact. Seconds from performing the ACL test. McDermott praying over him. It is powerful https://t.co/zvMFFg5hgb

The Injury

ACL injuries commonly occur when the foot is planted. and the knee is slightly bent, in a valgus position, and internally rotates (1).

It is questionable if White sustained a contact or non-contact ACL injury. Upon closer review, it appears White is contacted in the knee by the Saints WR’s hip. Theoretically, even though White was in a hallmark ACL tearing position, he likely could have scathed injury if it wasn’t for the additional contact.

Thigh Doctor on Twitter: “White’s ACL injury involved contact.Looks like WR Calloway’s hip bopped the knee at the end to cause the tear.Knee was in vulnerable position, but if no contact, probably doesn’t tear#BillsMafia https://t.co/0lh8Q7Yhbb pic.twitter.com/El5T3PwcKZ / Twitter”

White’s ACL injury involved contact.Looks like WR Calloway’s hip bopped the knee at the end to cause the tear.Knee was in vulnerable position, but if no contact, probably doesn’t tear#BillsMafia https://t.co/0lh8Q7Yhbb pic.twitter.com/El5T3PwcKZ

The Surgery

What will occur next is an ACL reconstruction. The surgeon will also take care of any additional injuries sustained, which commonly include: meniscus, MCL, cartilage. At this time, it is reported to be an ACL with meniscus.

Bradley Gelber on Twitter: “According to @RapSheet on NFL Total Access, not only did #Bills CB Tre White tear his ACL, but there was also meniscus damage. Hadn’t seen that part mentioned. / Twitter”

According to @RapSheet on NFL Total Access, not only did #Bills CB Tre White tear his ACL, but there was also meniscus damage. Hadn’t seen that part mentioned.

The timing and choice of graft is always paramount. Usually, surgery will commence around three weeks after the date of injury (2). This projection has White’s surgery scheduled for on or around December 16^th. The reconstruction will likely be utilizing his own patellar tendon, which is termed a bone patellar-tendon bone (BPTP) autograft (3).

The additional injury reported for White at this time is a meniscal tear. The fix is important because the meniscus can be repaired or cut out. If repaired, it’s a slower recovery with better longevity. If cut out, it’s a faster recovery but less longevity. The biggest factor would be if he had cartilage damage, which is the worst scenario. This has not been reported, but, if it needed to be addressed, you would expect a slower recovery and less longevity.

The Recovery

Tre’Davious White will need supreme conditioning of his thighs. Adrian Peterson famously came back in eight months to play after his ACL surgery. However, the average time it takes to return to play in the NFL is 10.8 months (4). With an estimated surgical date of December 16^th, White should be back in October or November 2022. Barring an expedited recovery, White is a strong candidate to start next season on the PUP list.

Citations

1. Olsen O-E, Myklebust G, Engebretsen L, Bahr R. Injury Mechanisms for Anterior Cruciate Ligament Injuries in Team Handball: A Systematic Video Analysis. The American Journal of Sports Medicine. 2004;32(4):1002-1012.2.
2. Mayr HO Weig TG Plitz W Arthrofibrosis following ACL reconstruction‐ reasons and outcomes. Arch Orthop Trauma Surg. 2004; 124: 518‐5223.
3. Erickson BJ, Harris JD, Fillingham YA, Frank RM, Bush-Joseph CA, Bach BR Jr, Cole BJ, Verma NN. Anterior cruciate ligament reconstruction practice patterns by NFL and NCAA football team physicians. Arthroscopy. 2014 Jun; 30(6): 731-8. doi: 10.1016/j.arthro.2014.02.034. Epub 2014 Apr 3. PMID: 24704069.4.
4. Shah VM, Andrews JR, Fleisig GS, McMichael CS, Lemak LJ. Return to Play after Anterior Cruciate Ligament Reconstruction in National Football League Athletes. The American Journal of Sports Medicine. 2010; 38(11): 2233-2239.