Identical twins Abigail and Carolina Dayer share more than their birthdays and appearance. Both served as soccer team captains for a charter school in west Phoenix. During their junior year soccer season, both suffered anterior cruciate ligament (ACL) injuries in a five-week period. Within one week of each other, both underwent ACL reconstruction surgery with Heather M. Menzer, MD, who is an orthopedic surgery and sports medicine physician at Phoenix Children’s. Here’s the real kicker: Both surgeries were performed within the last few weeks of Dr. Menzer’s pregnancy.
Carolina was first to injure her ACL during a soccer match on March 3, 2019. Carolina and her mother, Julieta Dayer, were referred to Dr. Menzer for an orthopedic evaluation. Following an MRI, Dr. Menzer determined that Carolina needed ACL reconstruction, and surgery was scheduled. On April 10, just a few weeks later, Abigail suffered a similar ACL injury during soccer practice.
Fast-forward five days, as Carolina was preparing for ACL reconstruction surgery, Julieta mentioned to Dr. Menzer, “I think my other daughter just had the same injury this past weekend.” Dr. Menzer’s reply: “Oh my goodness, there’s two!” Dr. Menzer immediately authorized an MRI for Abigail. On April 15, while Carolina was in surgery, Abigail was getting an MRI.
Carolina’s surgery went smoothly. Soon after, Dr. Menzer determined that Abigail’s injury also required a similar ACL reconstruction. However, Dr. Menzer was very close to her pregnancy due date. The Dayer family really wanted Dr. Menzer to perform Abigail’s surgery. While reviewing Abigail’s MRI results, Julieta said to Dr. Menzer, “Hopefully your baby waits for mine to be fixed.”
There was no way Dr. Menzer was going to let the Dayer family down. One week following Carolina’s surgery, on April 22, Dr. Menzer performed ACL reconstruction and repaired a torn meniscus on Abigail. And just six days later, on April 28, Dr. Menzer’s daughter Olivia was born.
Two torn ACLs, one torn meniscus, two orthopedic surgeries and the arrival of a bouncing baby girl — all in the span of two months!
New quad tendon autograft enables athletes’ return to play
In ACL reconstruction, surgeons typically replace torn ligament tissue with patellar, hamstring or donor tendons. For females and young athletes, a new procedure is proving to optimize surgical results and drive longer-term outcomes. For Abigail and Carolina, Dr. Menzer recommended and performed this new procedure: quadricep tendon autografts.
“We found Dr. Menzer’s recommendation to use the quad graft very beneficial,” said Julieta. “Even though it is a newer procedure, Dr. Menzer gave us her best and honest opinion along with details about how the quad graft is a better option that will enable both girls to return to play.”
It worked. By the soccer season of Abigail’s and Carolina’s high school senior year, both girls were back on the field leading their team and playing the sport they love.
Motion and gait analysis
Abigail and Carolina may be identical twins with similar injuries, but no two ACL reconstructions or recovery processes are the same. “It can take nine months to a year for full recovery following ACL reconstruction, but timing is not always an accurate recovery measure,” said Dr. Menzer. “To more precisely guide athletes to a safe return to sports, I like to use Phoenix Children’s Motion Analysis Lab.”
The Bubba Watson and PING Golf Motion Analysis Laboratory at Phoenix Children’s, also referred to as the “Gait Lab,” uses state-of-the-art equipment to measure real 3D motion, force and muscular activity, which enables health care providers to customize treatment plans and measure improvement.
“There is always a risk of reinjury to a reconstructed ACL, and determining an athlete’s physical readiness is key to reducing that risk,” said Dr. Menzer. “The Motion Analysis Lab enables me to compare the strength, agility, flexibility and stability of a patient’s injured and noninjured joint or limb. Once there is symmetry, I can better recommend a safer return to sport.”
Results from Phoenix Children’s Motion Analysis Lab also helps build confidence in athletes recovering from injury. “Seeing motion lab results and seeing the symmetry again in their joints helps their confidence levels,” said Dr. Menzer. “Having that confidence is another key aspect to a safe return to sports and a reduced chance at reinjury.”
What did Abigail and Carolina think of the experience? “We had sensors all over that tracked our movements on a big screen. It was really cool how they could show us exactly how our knees were moving, and the differences as a result of surgery,” said Abigail.
Sharing a special connection
ACL injuries affect as many as 250,000 people in the U.S. each year, but there was nothing usual about this experience for the Dayer family or Dr. Menzer.
“Having two daughters, the same age, undergo the same surgery so close together, and right before Dr. Menzer’s baby was due, was a little scary,” said Julieta. “But we were in really good hands with Dr. Menzer and the Phoenix Children’s team. We had a great experience overall. Everyone was so nice and professional, and always took my twins’ feelings and concerns into consideration.”
“Dr. Menzer related to us on a personal level and openly shared her story of how she also tore her ACL in the past,” said Carolina.
“All the doctors and nurses at Phoenix Children’s were nice. When I was getting ready for surgery, one of them told me a joke. I actually fell asleep laughing,” added Abigail.
“Abigail’s and Carolina’s surgeries hold a special place in my heart,” said Dr. Menzer. “The Dayer family and I went through a very unique experience together around the same time my daughter was born.”
Today, Dr. Menzer continues to treat patients at Phoenix Children’s and her daughter is 1½ years old. Close by, Abigail and Carolina are taking on their next life goal: college!