Tennessee Titans third-round draft pick Tyjae Spears will be one of the more fascinating players to watch out of the 2023 draft class.

The former Tulane running back is ridiculously explosive with the ball in his hands. Spears can cut on a dime, evading would-be tacklers and accelerating down field with 4.40 speed.

With 1,837 all-purpose yards and 21 total touchdowns in 2022, it’s easy to wonder how such an electrifying talent could fall to the third round of the draft. But Spears’ long-term health is a legitimate concern that could plague his NFL career.

Moments after Spears’ name was called as the 81st overall pick in the 2023 NFL Draft, NFL Network insider Ian Rapoport shared a concerning report on the draft broadcast. According to Rapoport’s league sources, Spears’ medical exams from the NFL Combine showed a loss of cartilage, arthritis, and believe it or not, no ACL in his knee.

This is a result of two ACL tears Spears’ has sustained over the course of his football career, with the most recent tear coming in 2020.

At the combine, new #Titans RB Tyjae Spears’ medicals showed no ACL, loss of cartilage, and arthritis in his knee (via @RapSheet)

Questions about “if his career can outlast his first contract.” That’s why a player of his caliber dropped to 3rd Round.

— Sam Phalen (@Sam_Phalen) April 29, 2023

But what exactly does that mean? He doesn’t have an ACL? How is that even possible? On the most recent episode of A to Z Sports Doc Talk, Austin Stanley and I sat down with a knee expert to break down the curious case of Tyjae Spears.

Colin Looney, M.D., is a board-certified orthopedic surgeon with the Bone and Joint Institute of Tennessee that specializes in care of the knee, hip, shoulder and sports medicine. ACL reconstruction is one of Dr. Looney’s many areas of expertise, and he was able to provide a lot of insightful context for Spears’ situation.

“There is a subset of people that are ‘ACL copers’ or ACL independent, meaning that for whatever reason, they can balance through their musculature a more stable knee,” Looney shared. "This is not common, and it’s certainly a very interesting thing in sports medicine to be ACL independent because generally, you play football without an ACL, your knee is sloppy and it’s dangerous to be out there.”

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The evidence would suggest that Spears belongs to this rare subset of individuals who are referred to as ACL copers. Spears’ incredible 2022 season at Tulane came without an ACL in his knee. Not having an ACL doesn’t mean Spears is running through pain, it means his body is able to compensate for the lost ligament and maintain a more stable knee than most humans could. Building quadricep and hamstring muscles and maintaining a strong core can go a long way to maintaining that stability.

But as it would turn out, not having an ACL might be the least of Spears’ worries. According to Looney, there is far more danger and reason for concern in the cartilage loss and arthritis that Rapoport reported.

“Usually about 15 years [after an ACL tear], you start to see X-ray findings of arthritis. What we're seeing here is very early findings of arthritis,” said Looney. “An ACL creates a very unstable knee. It's loose, and that allows for injury to the cartilage, it allows injury for the meniscus, and there's always a way to compensate and make up for things.”

“Arthritis actually makes the knee stiffer, you lose motion. So as arthritis ensues, the stiffness actually makes the knee a little bit more stable. But it comes at a huge price. It's stiffness, it’s loss of motion, it's swelling, it's inflammation, it's pain. Knee arthritis is a big problem and it's a it's a bigger problem than just not having an ACL,” said Looney.

Sports medicine professionals and fans alike will be keeping a watchful eye on Spears as the 2023 season gets underway. There are very few questions about his talent, and if all goes well, the Titans may have found a real hidden gem in the third round.

Hopefully he proves to be a "great coper" as Dr. Looney said, and can be an impact player in two-tone blue for the foreseeable future. Watch the full DocTalk episode here for more details about Tyjae Spears' knee and answers to FAQ's.