In the safest pair of hands with Dr Cruciate – Ray Moran
A one-stop shop for the full array of sporting ailments, not just those requiring surgery
Dr. Ray Moran, consultant orthopaedic Surgeon, in Sports Surgery Clinic’s 3D stop-motion laboratory.Photograph: Dave Meehan
Ray Moran picks up a plastic model of the knee, and holding it between both hands, makes one simple twisting movement from side to side, as if breaking the neck of a little bird.
“What happens is you turn, or land, or put some tension into it, and ‘snap’, it just goes,” he says, pointing to a thin, flesh-coloured fibrous strip, which looks as if it’s been threaded up through the middle of the knee, joining the thigh bone to the shin bone. “And to some extent it’s not fit for purpose. It’s certainly a bit miserable for the job it has to do.
“Because relative to the size of the knee, it’s not a big member. And it is still such an innocuous injury, in many cases involving a simple change of direction, with no contact whatsoever. I suppose that’s still the scary thing about it.”
It is the anterior cruciate ligament – more typically whispered as the ACL, sometimes going unmentioned for fear of a jinx, or else cursed out loud with a series of dirty expletives whenever that ‘snap’ is heard on the field of play. And for all the advances in sports science and strength and conditioning it can still tear apart as easy and wretchedly as putting a scissors to a piece of string.
Which is where Moran comes in: he wasn’t the first person in the world to perform surgical reconstruction on the ACL, but after 20 years in the business, he’s long since lost count of how many times he’s made the small surgical incision in the front of the knee, inserted the tiny arthroscopic camera, and with freshly stripped portions of tendon sliced from the hamstring and kneecap, begins to deftly rethread the cruciate, finishing it all off in less than an hour by stiching everything back into place – then sending the patient off to begin nine months rehabilitation.
Moran is telling me this in his consultant’s suite at the Sports Surgery Clinic in Santry, where, a couple of hundred times every year, he tells patients from a wide referral basis the same thing, possibly in more lurid detail, before calmly reassuring them it is all perfectly fixable. Still it’s hard to imagine being told this for real, especially the elite player who would miss a full season as a result. But if someone has to tell you, they don’t come better qualified than Moran.
It’s been a long learning process. After returning from a fellowship in the US, Moran was working in the A&E at Beaumont, where one night a GAA player came in with a broken arm, lining up with the other casualties. “I remember thinking ‘this doesn’t make sense’, there has to be a better way”: now, the Santry Clinic – which Moran started up in 2007 – is a one-stop shop for the full array of sporting ailments, not just those requiring surgery.
Recently they have added a running re-education system designed to improve the rehabilitation.
Yet he is their Dr Cruciate, knowing everything there is to know about that thin, flesh-coloured fibrous strip: with that Moran can also strip away the many myths from the simple realities, including the notion that ACL tears are somehow only a recent curse.