Two years ago a still-green footballer scored an AFL premiership medal with Sydney. Tomorrow, awaiting his fourth knee reconstruction, Alex Johnson will be watching from the sidelines as his team battles Hawthorn for Grand Final honours.

By WILLIAM GREEN

MOST AFL players would dread the thought of snapping a knee ligament on the field, knowing knee reconstruction will sideline them for about 12 months.

Imagine lining up for a fourth knee reconstruction. Unlucky Swan Alex Johnson, 22, is preparing for yet another round of surgery, with specialists recommending the modern LARS (ligament augmentation and reconstruction system) treatment.

It’s an unfortunate turn of events for Johnson, who tasted premiership glory while still developing his game in the Swans line-up.

Just two years ago, the talented Swans defender proudly celebrated at the MCG, sporting a coveted premiership medallion around his neck.

Johnson, who went to Xavier College, had been enlisted as Swans great Craig Bolton retired and made his debut in Round 3 of season 2011.

He said he was lucky to have experienced a premiership before striking knee trouble.

“At the time you don’t appreciate it, but now when I look back after being on the bench with my knee ... it’s unbelievable," he said.

Johnson said he heard a sickening snap when his anterior cruciate ligament (ACL) first ruptured during the 2013 NAB Cup.

He opted to undergo a traditional reconstruction method, rather than LARS.

“The fact that I had won a premiership – and also my age – were probably the two things that swayed my decision,” Johnson said.

The LARS procedure was relatively new at the time, offering players a faster rehab period, but at the cost of being less predictable and reliable.

Rather than taking a graft from the hamstring or patella to use in reconstructing the knee, a man-made artificial ligament is placed in the ACL to help stabilise the joint.

By August 2013, Johnson's knee reconstruction had failed and he was suffering an infection within the knee.

“I was really close to doing LARS the first time, so I thought if I ever have to go through this again, I’ll definitely do LARS. And that’s what I did,” Johnson said.

“You’ve got physios and doctors at your fingertips so you’ve got to listen to them in terms of doing all the right things with recovery and making sure you’re almost manic about it.”

in 2008, Johnson’s teammate Nick Malceski was the first AFL player to receive LARS treatment, though his ligament ruptured three years later and he had another LARS graft. Malceski is now back in peak form and will play in tomorrow's Grand Final.

French surgeon and LARS inventor Prof Jacques Philippe Laboreau oversaw Malceski’s procedure, and the head Australian surgeon working alongside him also operated on Johnson.

“He (Malceski) understands what it takes to go through it,” Johnson said. “Drawing on their experiences helps you a fair bit.

“You look at the way he’s playing now and it gives you heaps of confidence.”

After regaining his fitness after surgery, Johnson returned to the Swans reserves in March.

Just 10 minutes into the game, he landed awkwardly and his knee popped loudly. He needed a second LARS graft.

With a long layoff ahead, Johnson took the opportunity to have a brief holiday away from the club and continue his studies in commerce and sports management. He travelled to watch the soccer World Cup in Brazil and spent some time relaxing in the United States.

“I found it really beneficial just being able to go overseas and get away from footy,” Johnson said.

“It gives you the ability to come back and be really mentally refreshed.”

But Johnson’s recovery hasn’t been smooth.

In the past week, battling an ongoing infection in his knee, he has had surgery to remove his new ligament. The treatment includes a three-week course of antibiotics to fight the infection, which he now knows has been lurking in his body since the first surgery.

“It was most likely the reason behind why the first one failed,” Johnson said.

“It’s just the fact that it’s always been there but they’ve never been able to tell me 100 per cent what it is, so that’s why it’s been so hard to kill.”

Johnson said he wanted to have another LARS operation, but admitted it all depended on the infection.

He will receive advice in the next month on whether he will go ahead with his third LARS, which is unprecedented in AFL football.

Despite Dr Peter Larkins saying it would be too much for his body, Johnson won’t let it stop his comeback and his ambitions for more success at the Swans.

“At the moment all I want to do is get back to playing consistent footy,” Johnson said.

“I’d love to achieve the ultimate again. It’s every player's dream to do it and I’d love to do it again.”