[OC] How Santi Cazorla survived the ‘worst injury in sports history’ where his doctors planned to Cutoff his feet and end his football playing career : Gunners

Hi everyone,

My name is Matthew Feyissa and I am a medical student from London. With no football going on, I have been making videos on the famous football injuries of the past. This piece is on Santi Cazorla and how in 2016 he suffered an injury which became extremely difficult to manage. This injury nearly ended his career and even worse cause him to lose his foot through amputation. As per usual I have included part of the transcript below for those who prefer to read however I would encourage you to watch the video format as it includes images and pictures to help describe what happened as it was a series of 3 medical incidents that led to him nearly losing his foot. If you can provide feedback (no matter how harsh) that would be great as I am trying to make sports medicine more understandable and enjoyable to watch for sports fans.

Before we get into the piece, thanks for all the support on my latest video piece on Petr Cech and how the iconic headgear came about. Also thanks to all the new subscribers, the channel is now over 200 subs which I appreciate.

YouTube Channel: Matthew Feyissa

Video Link:https://youtu.be/l0Jb714MdLU

Transcript:

Santi Cazorla after an incredible start to the 2016 season suffered an Achilles tendon tear playing for Arsenal in the champions league in a 6-0 victory against Ludogorets. This injury alone is a terrible one to have as an athlete but things were made worse when Santi Carzola suffered from a condition called gangrene which is when the blood supply to a peripheral limb such as the feet is lost leading to the potential risk of amputation and a definite end to his career. Despite this Cazorla overcame the odds and after leaving arsenal as his contract ran out, he returned to Villarreal and has returned to form recently breaking the midfielder goalscoring record for the club.

If we look at Cazorla’s initial injury, he suffered from an Achilles tendon tear. The word tendon is used to describe the attachment between a bone and muscle. The achilles tendon specifically is an attachment between the calcaneous bone which is the heal of the foot to the calf muscle. Typically, it can get pulled or strained in sports which require a lot of sudden acceleration such a basketball or football. The actual mechanism of injury revolves around moving suddenly as you push off and lift your foot rather than when you land. It’s a common injury in sports with a player named Kevin Durant in the NBA suffered this last season in the playoffs for Golden State and has sat out the whole of this season nursing the injury.

There are different ways of managing the injury with a conservative approach of active rehabilitation and use of steroid medication with anaesthetic to slowly help regenerate the injury. In recent times this is being moved away with a recent study I read claiming the use of steroids had no significant impact in the rehabilitation of achilles tendon tears and was in fact inferior to the use of saline. This however did not help improve Cazorla’s injury and therefore he had to be admitted for surgery to repair the tendon. This is where the trouble for Cazorla started. The surgeries were not successful and were failing due to various insufficiencies in the management and treatment procedures. Many people do thing that Cazorla nearly lost his leg due to an infection and that is partly right and wrong, but infection occurred secondary to a condition called gangrene rather than being the primary cause.

When carryingout surgery you have to maintain the vascular supply to the limbs and structures being operated on. If you don’t or in the rehab process post-surgery a condition called Gangrene can arise. Gangrene is a serious condition where a loss of blood supply causes body tissue to die. It can affect any part of the body but typically starts in the toes, feet, fingers and hands. This arises primarily due to compression or obstruction of peripheral blood vessels leading to a reduction in flow. This lack of blood results in a drop-in oxygen in the circulating blood which is required for tissue respiration, which is the fundamental process to maintaining life, leading to tissue death known as necrosis.

This necrosis is what was the real threat to Cazorla. When tissue dies, much like any other living matter in the world microorganisms such as bacteria decompose and feed on it. This led to significant degradation of his Achilles tendon as the bacteria feasted on about 8-10cm. A way to visualize it, is a dead animal rotting and the decomposition of its living tissue as bacteria feast on it and cause a bare carcass to be left.

Amputation may seem drastic however if not carried out… (more information about why amputation was required and why doctors planned to cut off his foot in the video link above)

Hope you enjoyed the video and have gained some appreciation for the magician Santi Cazorla. Santi as we know was able to return to football and after leaving Arsenal is at Villarreal and became their leading scoring midfielder. A true story of a fighter against the odds.