Jeremy Burnham, MD

Join our team! We are hiring an administrative assistant to join us at our new Elite location. This position is full time and will work in support of musculoskeletal and sports medicine services in Baton Rouge. Apply here: https://ochsner.wd1.myworkdayjobs.com/Ochsner/job/Baton-Rouge---Baton-Rouge-Region---Louisiana/Certified-Medical-Assistant-Sports-Medicine-Clinic--Baton-Rouge-Region_REQ_00261162?utm_id=97760_v0_s00_e0_tv6_a1dennha1xaojl

If you have ever wondered what a torn ACL actually looks like at each stage of recovery, from the MRI on day one to the hop tests at month 9, I just put the whole timeline on one page.

What the images show. What strength and hop test numbers look like at 3, 6, and 9 months. When most people stop limping, when jogging becomes safe again, and when it is actually reasonable to return to cutting sports.

It is the conversation I have in clinic every week, written down with the data behind it.

https://www.jeremyburnhammd.com/torn-acl-before-and-after-surgery-what-the-data-shows/

A standard primary ACL reconstruction runs 50 to 120 minutes of actual surgical time, averaging about 90 minutes. The full day at the surgery center, though, is closer to 4 or 5 hours.

Most of that day is not the surgery itself. It is check-in, anesthesia setup and nerve blocks, positioning, recovery, and discharge teaching. The OR portion is the smallest piece of it.

What actually moves the clock during surgery:

Graft choice. A quad tendon harvest adds 10 to 20 minutes versus a pre-prepped allograft.

Meniscus work. If we repair a meniscus tear at the same time (which we try to do whenever possible, because saving meniscus tissue protects the knee long term), that is 20 to 60 extra minutes well spent.

LET or ALL augmentation. About 15 minutes added, and in the right patient it meaningfully lowers re-tear risk.

Revision ACLR. These run 2 to 3 hours because we are often staging bone grafting and managing existing hardware.

Our team's times track closely with the 88.4 minute average reported in the 2022 AANA database for isolated ACLR. Efficient, but never rushed.

Full breakdown, including what happens in pre-op and recovery:
https://www.jeremyburnhammd.com/how-long-does-acl-surgery-take/

GLP-1 medications like Ozempic (semaglutide) and Mounjaro (tirzepatide) are helping millions of people lose weight. The results are real, and for many patients the metabolic benefits are life-changing. But there's a trade-off with these medications that I think every patient should understand.

Up to 40% of the weight you lose on a GLP-1 may not be fat. It can be muscle and bone.

A 2024 clinical trial (Hansen et al., eClinicalMedicine) studied semaglutide in adults with increased fracture risk over 52 weeks. The findings: hip bone mineral density decreased by 2.6% and lumbar spine density decreased by 2.1% compared to placebo. Bone breakdown increased while bone building did not.

Another study (Look et al., the SURMOUNT-1 DXA substudy) showed that tirzepatide reduced lean body mass by nearly 11% over 72 weeks.

This does not mean GLP-1s are dangerous or that you should avoid them. It means that if you are taking one, you should be proactive about protecting your bones and muscle mass.

Who should be especially aware? Post-menopausal women, adults over 50, anyone losing weight quickly, people who are not exercising regularly, and anyone not eating enough protein.

Four things I consider essential for patients on GLP-1 therapy: resistance training at least three times per week with compound movements like squats and deadlifts, protein intake of 1.2 to 1.6 grams per kilogram of body weight each day, daily calcium (1000-1200mg) and vitamin D3 (1500-2000 IU), and a baseline DXA scan so you know where you're starting.

The medications are a powerful tool. But the best outcomes happen when weight loss is supported by a plan that protects what you don't want to lose. Swipe through for the full evidence breakdown.