Kaya Turski's right on track
The day after Christmas, Kaya Turski marked the occasion by taking laps through the Mammoth Mountain mini park. But it wasn't the holiday season she was celebrating. It was an anniversary. Four months earlier, on Sept. 26, Turski, 25, underwent surgery to repair the ACL in her left knee.
It was her third ACL reconstruction in six years and the second on her left knee. In the past, aggressive rehab had her back on skis seven months after surgery and competing in slopestyle competitions nine months post-op.
But there she was on Dec. 26, standing at the entrance to the park and preparing to hit a few small jumps, rails and boxes, her knee feeling stable and strong. "The way this recovery has gone, I gain so much every week," says Turski, a three-time X Games Aspen gold medalist and the current ski slopestyle world champ. "Looking back and seeing how much I've gained in the past five weeks makes competing five weeks from now seem possible. It's remarkable."
The five weeks from now Turski is referring to is Feb. 11, 2014, the date of the inaugural ski slopestyle competition at the Winter Olympics. (Unlike U.S. athletes, who compete in qualifier events in order to earn spots on the Olympic team, Turski, a Canadian, pre-qualified onto Canada's team with a win at the world championships in Voss, Norway, last March.) Turski also plans to compete in just a few short weeks at X Games Aspen, taking place Jan. 23-26. If all goes well, X Games will be her first contest since having surgery.
But even more remarkable than Turski's quick return to skiing is the fact that, thanks to a revolutionary repair using a synthetic ligament paired with a cadaver graft, her initial return to snow on Dec. 10 -- three and a half months post-surgery --was according to schedule. At least, that's what Turski and her surgeon, Dr. Bob Litchfield, hoped when he devised this experimental repair.
In early August, almost six months to the date before the 2014 Winter Games, Turski was in Mount Hood, Ore., working on a new trick in the park. It was one she'd landed before but was still working to master, an unnatural rotation left-side 720. "It's still not a comfortable trick for me," she says. "Sometimes I lose my air sense."
On this attempt, she spun late and felt her skis making contact with the snow a half rotation too early and before her legs were prepared to take the impact of a landing. "I was so lost in the air," she says. "When I hit the ground still rotating, I felt my ACL go. I knew I blew it. I know what it feels like."
Turski had torn the ACL in both of her knees previously. She knew all too well what the pop and pain meant not only for her knee, but for her future. Surgery. Swelling. Pain. Grueling rehab. And more time off than she could afford. With both previous injuries, her ligament had been reconstructed using a piece of her hamstring, a technique that required additional healing time and, in her experience, a minimum of nine months to be competition-ready. She had less than six until the Olympics. So she began researching alternative repair techniques, knowing she had little time to weigh her options.
"At my first consultation, the surgeon said, 'If you repair this knee, you're not going to the Olympics,'" Turski says. Instead, he suggested she ski with a brace and postpone surgery until after Sochi. A few athletes on the Alpine team had taken this route in the past, but Turski wasn't sure it was right for her.
"I wasn't sure I could cope with that mentally," she says. So she went for a second opinion. And a third. That's when she flew to Ontario, Canada, to meet with Litchfield, the orthopedic surgeon for Canada's Alpine ski team.
Turski had been reading up on synthetic polyester ligaments, also known as LARS ligaments, and believed these to be her best option. (Although LARS ligaments have been used for athletes in Australia, Canada and Europe for two decades, the surgery has not been approved for use in the United States.)
But while the synthetic ligaments require short recovery time, as little as four to five months, they are also known to wear down, fragment and fall apart, requiring difficult revision surgery, or surgeries, down the road. "I wanted a short-term solution, but I didn't want to compromise the future of my knee in 20 years," Turski says.
Because it is primarily a short-term solution, Litchfield says the use of a LARS ligament is not a recommendation he makes lightly, but he believed it to be the best pre-Olympic option for Turski. She would then return to his office after the Games for a revision.
"Kaya had significant life ambitions and tight timelines, so a standard revision would have been difficult," Litchfield says. "This is her life dream, and she has a shot at a gold medal. If we had more time to work with, clearly we would have gone a different route. But with her timeline, the synthetic was reasonable."
Unfortunately, after taking an MRI of her knee, Litchfield realized using a synthetic ligament alone wasn't possible: The tunnel holes in her femur and tibia from the previous surgery were too large for the smaller LARS ligament to fill. So he went back to the drawing board.
We don’t know of another athlete who’s had this surgery. But it was the ideal solution. It was the best of both worlds.Kaya Turski
"He emailed me a couple days later and said he'd had an idea on the drive home," Turski says. He would encase the synthetic ligament in a cadaver graft to fill up the holes. "A synthetic ligament is as solid at time zero as it's ever going to be," Litchfield says. "The patient only has to heal from the cuts and drill holes used to put the ligament in."
In other words, once Turski healed from the surgery itself, her synthetic ACL would be strong and her rehab could be expedited. In addition, the cadaver tissue would continue to heal and strengthen and, in theory, contain and protect the synthetic ligament once it wears down and provide additional stability to her knee, avoiding the need for revision surgery. "We didn't know how it was going to turn out," Turski says. "We don't know of another athlete who's had this surgery. But it was the ideal solution. It was the best of both worlds."
So far, so good. Turski says the surgery, and the rehab immediately following it, was less painful than those she's had in the past. She walked without crutches in three weeks. After five weeks, she was able to perform low jumping exercises, and she was loading weight within two months.
In order to focus entirely on rehab, she moved to Vancouver, British Columbia, after her surgery to work with physical therapists five days a week and focus on mental training as much as physical.
On Dec. 9, she relocated to Mammoth, Calif., where she will continue her PT and on-snow training until she leaves for the X Games in late January. Two weeks later, if all goes according to plan, she will compete for Team Canada at the Winter Olympics.
"I'm entering crunch mode," she says. "It feels like I'm going to go to sleep and wake up in Sochi. But I feel really good. It feels like all my hard work has paid off. But whatever happens, after everything I've gone through, just making it to Sochi will be exciting." And another reason to celebrate.