Damon Astorino, 18, sustained a full tear of the anterior cruciate ligament (ACL) and meniscus in his left knee during an AAU basketball game in October 2021 – but he didn’t know it until almost three months later at season’s end. With little pain to note, he continued playing on an assumed sprained knee.
He describes hearing a ’pop’ when the injury occurred but says he didn’t experience much pain.
“I would ice my knee after games, and it hurt off and on, but not too bad. By January, it hurt worse every day, and that’s when I got the MRI,” Damon says.
Nearly Nonexistent Ligaments
In February 2022, Damon and his family visited the UPMC Lemieux Sports Complex in Cranberry Township, Pa., for an MRI and an evaluation by Kelley Anderson, DO, primary care sports medicine physician, UPMC Sports Medicine. The MRI caused a double take, as at first glance it appeared Damon had no ACL at all. Dr. Anderson set up a next-day consultation for Damon with orthopaedic surgeon Dharmesh Vyas, MD, PhD.
Dr. Vyas examined both knees and noticed the left knee shifted drastically as he moved it. He looked at the MRI with Damon and his family, pointing out the fully torn ACL and meniscus that were so damaged they barely appeared in the scan.
“I knew if I wanted to play basketball again, I couldn’t escape surgery,” Damon says. “I needed to get back, so I tried to motivate myself to get through surgery and physical therapy just to play again.”
A Prioritized Surgery
Less than two weeks later, Dr. Vyas performed ACL and meniscus reconstruction surgery on Damon’s left knee at the UPMC Outpatient Center in Bethel Park, Pa.
“It was during Dr. Vyas’ busy hockey season, but because Damon wanted to play basketball his senior year, Dr. Vyas maneuvered his calendar and got Damon in for surgery right away,” says Damon’s mom, Wendy. “He never dismissed Damon as just being a high school student or somebody who was maybe not at the same level of some of his patients. He understood that he wanted to get back to play, and he did everything he could to make that happen for him.”
The reconstructive surgery involved using part of Damon’s own patella tendon to reconstruct the ligaments in his knee, ensuring it’s as anatomically similar to his right knee as possible. After surgery, Damon would need to begin rehab right away.
Personalized Physical Therapy
Dr. Vyas requested that Damon work with Madeleine Agladima, PT, DPT, at the UPMC Lemieux Sports Complex on a physical therapy plan tailored to basketball players and designed to meet Damon’s specific needs and goals.
The plan started with visits once weekly with complementary stretching from home, then increased to 2-3 times per week for 2-hour sessions over the next few months. Maddy was Damon’s physical therapist the entire time and worked hand-in-hand with Dr. Vyas until Damon was ready for return to play testing. They worked on both legs to maintain balance and overall strength.
“I was doing multiple weightlifting and jumping exercises, as well as different stretches for six or seven months,” Damon says. “The blood flow restriction therapy (BFR) helped a lot too. I was surprised to see how much they cared about me and wanted to see me be better than before I got injured. Going through PT helped me learn a lot and even helped with my communication and talking about how I felt.”
Both of Damon’s parents shared how blown away they were by Damon’s physical therapy experience and the athlete he became post-PT.
“Maddy was instrumental in therapy, making sure that whatever he did on the left knee he also did on the right knee. Damon's legs are stronger, more muscular, more defined, more anything than they've ever been. It's amazing to see the difference in his legs, and it was because she was rehabilitating both legs as opposed to just his left,” says Wendy.
Damon’s dad, Eric, added “I've coached Damon a lot in basketball, and I always thought I knew everything with the training aspect until he worked with Maddy. She was exceptional. He put on 10 to 15 pounds of muscle. His agility, quickness, and speed improved. She helped him tremendously, not just recover from the ACL, but get back on the basketball court even better than he was before.”
After working with Damon from March to December 2022, Maddy sent him home with instructions to continue stretching, strengthening, and agility a few times a week to maintain the best shape possible.
An Eventful Return
Damon was cleared to return to play near the end of December and played his first game on the 28th. On January 6, 2023, he even earned the exciting achievement of 1,000 career points. It was quite the comeback.“My knee doesn’t even hurt now or feel weird at all,” Damon says. It feels like normal again. I don’t have my plans set yet, but I’m going to play college basketball for sure.”
His parents described this experience as ‘instrumental’ to Damon’s growth as a basketball player and the care team ‘like a well-oiled machine.’
“The coordinator Rachal and physician assistant Kevin were just as wonderful and a key part of this process. Every team member as equally as vital,” says Wendy. “I'm not an emotional person and I am very emotional talking about it. I just was overwhelmed by how much support Damon received.”
