“In my first varsity minute freshman year, as a shot went up, I went to box (the shooter) out and turned to face the basket. The ball didn’t go in and was rebounded, so I went to face the girl, but as I turned, my knee dislocated.” Ava Frascella, a junior at Hamilton High West, dislocated her knee at her varsity basketball game against Notre Dame on January 27, 2023. Her life stopped because of this one moment, leading to a big surgery to get her knee back in shape. With the difficulties and obstacles she faced throughout her recovery, she stayed strong regardless of when she was pushed back. I interviewed Frascella, gaining insight into her operations and her recovery.  Describe past experiences and problems regarding your knee.  Throughout my life, I've had knee problems, but we were never sure what the issue was exactly. My knee used to dislocate a lot when I was younger and still growing. As I got older, it only dislocated during certain movements and when it got fatigued. In seventh grade (2020), I had my first surgery on my left knee. At softball practice, I stepped in a divot in the grass as I was throwing, and my knee dislocated. I shook it off and practiced the rest of the time in pain. My knee was sore and extremely swollen for the next two days, but I pushed myself and played in my tournament that weekend with a brace on. I played two prior games before my knee dislocated again while I was warming up to pitch. I started the game, but I was in extreme pain and could barely walk. I eventually came out of the game and was rushed to the emergency room. I didn't get many answers from the ER, so I followed up with my orthopedic doctors at CHOP. When my mom reached out and told my normal doctor what had happened, she recommended that I go to a specialist surgeon and get an MRI. After I had the MRI, I met with the surgeon, and she explained that my kneecap was completely dislocated and on the side of my leg, which is why my leg was so swollen. She also told me that my MPFL ligament (which controls the kneecap's movements from side to side) was extremely loose, which is why my kneecap didn’t go back into place, and that a piece of cartilage had broken off when my knee dislocated. So, what my surgeon did was reset my kneecap into the correct spot where it is supposed to sit, tighten my MPFL, and remove the piece of cartilage. I was injured on October 3rd, 2020, and my surgery was on November 4th, 2020. I started physical therapy in December and finished at the end of April. During physical therapy, I was very determined to return to softball better than ever. What happened during the basketball game? Can you describe the feeling and what you were thinking when the incident occurred? During the basketball game on January 27th, 2023, I dislocated my left knee once again. It happened in my first varsity minute of my freshman year. I was defending a girl when a shot went up. I went to box her out and turned to face the basket. When the ball didn’t go in and was rebounded, I turned to face the girl again, and that’s when my knee dislocated. In that split second, my whole life felt torn apart. I knew as soon as I fell that my knee had dislocated and that I would need surgery again. I was crying in pain, not only from my knee but also from the fear of knowing I wouldn't be able to return to softball for a while. A few days later, I saw my surgeon again. When she walked through the door, she said, “We've been expecting you.” She explained that my femur (which holds the kneecap in place) was flat, causing my knee to dislocate frequently. This condition is called patellofemoral dysplasia. She then clarified that my first surgery was only a temporary fix because they couldn't perform the more extensive surgery I would need a few months later due to my age and the growth still left in my growth plate. If I had undergone that surgery, it could have severely stunted my growth and worsened my leg issues. She recommended that I see a specialist surgeon. Before meeting the new surgeon, I had to get another MRI. When I finally met with the new surgeon, he reiterated what my first surgeon had said. He also mentioned that my right knee had the same problem, but since I wasn't experiencing pain and it wasn’t dislocating, I didn’t require surgery on that knee yet. He explained the upcoming surgery to me: he would shave down my femur to create a groove for my kneecap to stay in place and tighten my MPFL ligament again. Hearing this made me feel almost relieved because I finally had an answer as to why my knees would hurt or dislocate, and there was a solution. However, I was also extremely scared about undergoing another surgery. I became very upset at the thought of not being able to play softball or any sports for a long time. What was the process of setting up for the surgery like? Can you describe the setup and surgery? Leading up to the surgery l lived my somewhat normal life, I wore a brace as I walked for extra support but I wasn't in pain because my knee was in place. The surgery was painful and uncomfortable but every day the pain got better! What was the advised therapy and exercise you had to do after surgery? After my surgery, I was given a machine that would bend my knee for me because all the muscles in my leg were extremely weak and sore. Along with the machine bending my knee three times a day, I started physical therapy two weeks later. They began by having me do small table exercises, such as bending my knee and engaging my quad muscles.  I began to walk a week after starting physical therapy, helping my bones and muscles adjust to the new alignment of my knee and femur. However, during the first month or so, I struggled to bend my knee past a certain point because my brace was still locked for day-to-day activities. This limitation caused a lot of pain, as my joints would become very stiff. Once my brace was unlocked, I was able to do so much more because my knee could bend further. As I continued with physical therapy, the exercises gradually became harder to increase strength in my entire leg. The ultimate goal was to get me back to playing sports, so they were pushing me hard to regain my strength and flexibility. How well is your knee doing now and how likely is it for you to dislocate your knee again? Now, a year and 7 months later my knee is doing fantastic! It rarely gives me pain and it is stronger than it has ever been! My knee is somewhat just like everyone else's and has a small chance of dislocating again! Ava shared that while her surgery didn’t change her lifestyle, it significantly altered her mindset. “Last summer, I was a little depressed because I wasn't making the progress I wanted, and I wanted to return to sports. But I got myself through that dark period, and now I’m happy, enjoying life, and back to playing sports!” She noted that the only lifestyle change has been to be more careful, knowing that her right knee has the same issues as her left. When asked for advice for others going through a similar experience, Ava emphasized, “Don’t give up! It may seem like your life is ending, but it’s only a small chapter in your life. You will get through it and come out stronger than ever!” Reflecting on her journey, Ava expressed gratitude: “I am grateful for everything that has happened to me because it has made me appreciate everything and has shaped who I am!” In conclusion, Ava Frascella’s journey through the challenges of knee dislocation and surgery is a testament to resilience and determination. From her initial injury on the basketball court to her extensive recovery process, Ava has not only faced physical challenges but also navigated the emotional hurdles that accompany such life-altering events. Her story underscores the importance of seeking help, following medical advice, and staying committed to rehabilitation. Ava's positive mindset and dedication have led her to a place where she can once again enjoy the sports she loves, while also serving as an inspiration to others facing similar struggles. As she aptly puts it, “It’s only a small chapter in your life,” reminding us all that with perseverance, we can emerge stronger from our setbacks. Reach Ava Frascella's Instagram and Twitter: Instagram: @avafrasc @ a.fr ascella.2026 Twitter: @afrascella_2026

Growing up, you've probably never known the difference between a virus or bacterial infection. I know I didn't. Whenever I came down with a common cold or sickness, I simply took whatever was on hand in the medicine cabinet. "I'm sure all medicine will work the same anyway." I reassured myself. However, what will you do when nothing appears to be alleviating the flu you caught in late December, and all those antibiotics not only fail to improve your condition but actually make it worse? Well, I remember my 10th grade biology class, in which my teacher, Mrs. Magby, made it exceptionally clear that viruses are not the same thing as bacteria. You see, while one is alive, the other seems to be a debate whether it is alive or not. Bacteria Biologically, bacteria are single celled organisms, otherwise known as prokaryotes. Unlike eukaryotic human cells, prokaryotic cells lack a nucleus and membrane bound organelles, meaning that while they do have organelles, they aren't as complex as eukaryotic organelles. Bacteria have cell walls that provide strength and structure, allowing the cell to grow, reproduce, and regulate what comes in and out. Whether it be inside or outside the body, bacteria can survive on their own, reproduce on their own, and can survive in extreme heat and cold. In fact, you may believe that all bacteria are harmful, however that's far from the truth. In reality, we have plenty of bacteria in our bodies to help it function. Specifically, we have bacteria in our intestines and stomach called "gut microbiota" that work together to provide vitamins, immune defense, and digestions. On the contrary, bacterial infections are common and you can get them in any part of your body, including your gut, skin, sinuses, and urinary tract. In addition, these infections stem from bacteria entering the body through ways such as your mouth, eyes, nose, or contact with blood. All in which, when bacteria is transmitted, it is able to increase in number which causes an immune (a person's resistance to a disease) reaction. Viruses Viruses are not considered alive and can only last a few minutes without a host. They are microscopic particles, smaller than bacteria, consisting of genetic material (either DNA or RNA) inside of a protein coating. This protein coating, known as the capsid, serves as a shield for the genetic material, protecting it from environmental factors and containing surface proteins that allow the virus to attach to host cells. Viruses require a host—such as humans, animals, plants, or bacterial cells—to replicate and survive, as they cannot reproduce on their own. Essentially, they carry the genetic instructions to produce more copies of themselves within the host. This virus can spread to other parts of the body and infect new organisms. The flu, common cold, and COVID-19 are all common diseases and are life-threatening. These viruses can be contagious and some spread through the air in respiratory droplets when someone with the virus sneezes, coughs or exhales. However, not all viruses are bad either. Some viruses are used as treatments in alternative to antibiotics, such as bacteriophages. Bacteriophages can be found in the intestines to target and eliminate bacteria, including harmful ones. Some traditional vaccines even contain part a weakened form of the virus that it is trying to fight. By weakening this virus and inputting it into our bodies, it enhances our immune system's ability to fight off the actual virus if ever exposed to it in the future. Difference in Treatments Bacterial infections can be directly treated, while viruses must be managed in order to be resolved. In some cases, bacterial infections can subside on its own, however, if that is not the case, a physician can prescribe antibiotics. Antibiotics are chemical compounds designed to target and destroy the bacteria's growth by blocking a cellular process that's necessary for the bacteria to continue to grow. There are many ways to prevent bacterial infections such as antiseptics and disinfectants. Antiseptics are used on living tissues to reduce the risk of infection, such as before surgery or on minor wounds. Disinfectants are applied to non-living surfaces to kill bacteria and other pathogens, ensuring clean environments and medical instruments. Both help prevent and control bacterial infections effectively. Viruses can't be treated with antibiotics because of the protein coating that surrounds them. While bacteria have cell walls that make it possible to be attacked and destroyed by antibiotics, the protein coating allows them to be resistant. Treating your body with antibiotics at this point may cause more damage than good, as it can promote antibiotic-resistant properties. In this case, the bacteria eventually evade to the effect of antibiotics and will make it more difficult or impossible to treat in the future. The best way to manage the virus is by focusing on reliving symptoms. While your immune system combats the virus on its own, its best to rest, hydrate, and taking over-the-counter medicine. Additionally, it's also possible to use antiviral medicines to support recovery and stop viral reproduction. Bacterial and viral infections can be sometimes difficult to diagnose. Observing the varying symptoms closely can help to identify whether or not it is bacterial or viral. It helps to ask a healthcare provider and get a careful review of your symptoms and lab results to figure out the best treatment plan.