As a knee surgeon, I have had the opportunity to deal with extremely complex injuries, many of them in elite athletes who are looking not only to recover but also to return to the highest competitive level.
One of the most recent cases that has captured media attention is the injury of Dani Carvajal, right back for Real Madrid, who has suffered a tear of the anterior cruciate ligament, the external collateral ligament, and the popliteal tendon.
This type of injury requires a highly specialized surgical approach. The knee is a complex structure, but the lateral part of the knee, where Carvajal has suffered much of his injury, is known among specialists as the “dark side of the knee.” This is due to the difficulty it presents both in its diagnosis and its treatment. When I chaired the European Committee on Lateral Knee Injuries, we conducted a worldwide survey that revealed the lack of consensus among surgeons on how to approach these injuries.
However, after years of experience and studies, I have developed an approach that has yielded very positive results.
The challenge of surgery in Carvajal’s case
The first thing I consider when planning such a surgery is to accurately assess which structures are injured and to what degree. Each component of the knee plays a crucial role in stability and movement, so it is essential to have a deep understanding of the anatomy of this area. In my early days as an anatomist, I spent countless hours studying the structure of the knee, and that training has been essential to confidently face these types of cases.
One of the peculiarities of the knee is that the lateral part, where Carvajal has suffered the main tears, has more complex structures. Unlike the medial part, whose ribbon-like fibers allow a certain degree of spontaneous healing, the lateral structures function more like ropes; if they break, their ends will not be in contact and therefore will not heal without surgical intervention. This is one of the greatest challenges we must address in this type of injury.
Advanced Surgical Techniques for Multiple Injuries
In my career, I have developed and perfected minimally invasive techniques that allow us to perform surgeries with minimal incisions. This facilitates a faster recovery and reduces the risks associated with traditional surgeries. In cases like Dani Carvajal’s, where several severe injuries are combined, it is essential to act quickly, usually within the first few days after the injury, to repair the structures that can be restored and reconstruct those that have no chance of regenerating naturally.
While many surgeons choose to wait weeks before performing a major intervention, in my experience, we have found that early and specific treatment offers the best results. Every technical detail is vital to ensure that the surgery is not only effective but offers the athlete the best chance of success in returning to elite sport.
Is it possible for Carvajal to return to the same level?
Although the recovery time is estimated to be between 8 and 10 months, it is important to clarify that time is only one of the factors at play. In my opinion, for a complete recovery, we should not talk about less than 12 months. And what is even more crucial: the percentage of players who manage to return to their maximum level after an injury of this severity is 50-60%.
One factor that has a negative influence is the morphology of the legs of many footballers, as is the case of Carvajal, whose varus leg (bowed leg) puts greater pressure on the reconstructed ligaments. In non-athletes, we correct this deviation to avoid future problems, but in professional footballers, this correction could mean the end of their career. It is a dilemma that we must carefully manage in each case.
The mental impact on recovery
Beyond the surgery and the physical rehabilitation process, the mental state of the player plays a key role in the success of recovery. Serious injuries often bring with them frustration and fears that can affect the recovery process. It is crucial that the athlete maintains a positive and realistic mindset about his situation, something I always address in conversations with my patients. In the case of Carvajal, his personality and commitment to sport are factors that will undoubtedly help him in his recovery process.
Conclusion of the article
Surgery for complex knee injuries such as the one Dani Carvajal has suffered is a challenge that requires a precise surgical approach and long, careful rehabilitation. My main goal is to not only get athletes back to competing, but to do so with full confidence in their body. With the right surgery and a complete recovery plan, there is a high probability that Carvajal will be able to compete again at the highest level.
