Gingerly, a single leg outfitted with an Under Armour cleat is standing on a small patch of grass. Aside from a background resembling a mad scientist’s lab, the lone giveaway that it’s not a video clip from a real-life football or soccer game is the leg itself, which is not connected to rest of any living human. It’s been sawed off of a cadaver and bolted to a hulking machine that boasts a number of levers and moving parts.

From behind the camera, a voice shouts, “OK, go ahead, Jeffrey!”

Jeffrey Compas, dutifully standing nearby, pulls a lever near the top of the contraption. The machine hisses, and the shoe stomps on the grass, as if the cadaver just planted his foot, ready to make a sharp cut back across the playing field.

“G’head,” says the same voice.

The machine starts to spin, again, mimicking the natural knee joint motion a player makes when changing direction. The dead leg keeps up for a while, that is, until the ligaments and bones of the cadaver can no longer turn.

Snap.

The leg suddenly buckles in a twisted heap. Jeffrey’s face says it all. He cringes and shakes his head, somehow vicariously feeling the cadaver’s pain.

At times, Drakos seems like a typical orthopedist, seeing patients, prescribing meds, performing surgery. But in the lab, Drakos, always drawing on his previous athletic experience, turns orthopedic research into a team sport. Though he works with a dedciated group of researchers, the stars of Drakos’ squad are his custom-built rig, dubbed the ACL Dominator, and the troves of cadaver legs that cycle through the lab for testing.

A four-year, varsity letter-winning wide receiver on Harvard’s football team, Drakos says his interest in orthopedics and sports medicine started early. “Football is the perfect petri dish for the orthopedist because there are so many injuries,” he told Wired.com, “just because of the nature of the game.”

“I always noticed that my legs were sore after playing on turf,” Drakos recalled. “A lot of the turf I played on was the old-school AstroTurf, which for all intents and purposes was like carpet.”

Artificial playing surfaces have developed over the years, and are now made mostly from plastic fibers and rubber fill. Though generally more forgiving on the body than AstroTurf, Drakos remembers how playing on any sort of turf took a toll on his body: “Even with some of the newer surfaces, my joints were a little sorer, and I’d need a bit more ice the next day.”

After finishing his football career — and picking up an undergraduate degree in biomedical engineering along the way — Drakos’ interest in biomechanics and medicine carried him through medical school and residency as an orthopedic surgeon. He started researching non-contact ACL tears — the ones where a player blows out the ligament simply turning the wrong way — which he says are more common than contact injuries. Some estimates claim that 80,000 ACL injuries sideline players each year, most of them occurring in younger players.

Previous studies have pointed to the shoe/surface interaction as the main reason for these types of injuries. But Drakos is convinced that figuring out the best shoe and surface combination is “difficult to prove” due to all the variables at play. In fact, field conditions, weather, and footwear differences all factor in, so reading case reports or doctors’ notes isn’t enough to find the root of the problem, since researchers can’t tell whether a specific tear was due to the surface they played on, the rain-soaked nature of the field after a storm, both, or neither.

So Drakos had a new idea: What would happen if you could isolate just a few of the variables and test the underlying mechanics of the ACL under controlled conditions? Could you finally put some numbers on the strains the joint encounters with different shoes and surfaces?

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Authors: Brian Mossop

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