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Comment by teeray | Hacker News Reader

I wonder if history is any guide here. With how prone knees are to injury, I wonder what the historical outcome for those injured by ACL tears was. The gut reaction is “death,” and I’m sure that happened a lot, but I’m sure there were some who survived. How did they fare long-term?

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They'd fare just fine. You don't need your ACL. It helps to keep your knee from giving out during certain sudden movements, but a lifetime of conditioning would prevent against that. High level football players have played seasons without an ACL, for example.

They do so wearing a brace and trading chances for massive damage to the knee for finish-out out the season and getting paid. We had someone in college football do that because it was the last 2 weeks of his senior season. He suffered cartilage damage from it and wouldn't do it again.

I was thinking about players like Hines Ward, who played his entire career without an ACL.

Most players will get it repaired because at that level any small percentage performance improvement (or risk reduction) is worth it. But the body can compensate for the lack of an ACL through strengthening the surrounding musculature.

Interesting, didn't know about that. However it sounds like maybe he never had one or it snapped early on and he grew up without one, which is different than being at the height of your game and losing it. My friends who snapped ACLs in college or highschool never felt safe on those knees again and it limited what they were willing to do move wise.

There is significant evidence that Neanderthals lived in communities which supported each other, even when they were wounded. Most notably, Shanidar 1 [1] was found with hearing loss, a severed (yet healed!) arm, and broken legs, indicating that someone else must have cared for him for some time.

[1]: https://en.wikipedia.org/wiki/Shanidar_Cave#Shanidar_1

>...The sharp point caused by a distal fracture of the individual's right humerus points towards this theory of amputation. If the arm was amputated, this demonstrates one of the earliest signs of surgery on a living individual.

Deliberate amputation at 45,000 to 60,000 BCE! I suppose they could have immediately cauterized the wound, but it is incredible that someone would survive the procedure without succumbing to sepsis or blood loss. Would they have even considered a tourniquet?

People without an ACL would develop a "trick knee" and get arthritis faster, that's it. It increases your chance of screwing up your miniscus more, but it's not at all a death sentence.

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