Paco's Journey: From Ankle Surgery at University Medical Center New Orleans to Preakness Victory

The moment Paco Lopez hit the ground, he knew something was wrong. 

Betty's Dance, his horse, had clipped heels with another runner mid-race at New Orleans' Fair Grounds, a split-second misstep that sent both Lopez and the filly tumbling. In the chaos, the horse came down on his ankle. 

“I could see the bone inside the skin,” said Lopez, a dominant circuit force who's amassed more than 4,400 career wins during a nearly 20-year career. 

The fracture hadn’t broken through the skin, but it was visible beneath the surface — a severe injury by any standard, potentially career-altering for a jockey. Every stride runs through the ankle, which has to stabilize, absorb impact, and make split-second adjustments at full speed. 

Within hours, Lopez was on his way to the ER at University Medical Center, the academic medical center of LCMC Health. There, he would be treated by a team, led by orthopedic surgeon Robert Zura, MD, experienced in managing complex, high-impact fractures.  

What happened at University Medical Center in February would determine not just how well Lopez' ankle healed, but if or when he could return to racing. 

Little did either Lopez or Zura know that the jockey was just months away from the biggest win of his career. 

Inside University Medical Center: Stabilizing a Career-Threatening Injury 

Imaging confirmed the unfortunate reality — a fracture-dislocation with a broken fibula and severe soft tissue damage requiring surgical reconstruction of three ligaments. The injury involved significant trauma to the joint, the kind of damage that, if not treated precisely, can lead to long-term stiffness, instability or loss of performance. 

The damage illustrated what Dr. Zura calls "a high energy injury," a term that emphasizes the speed and force involved. It required putting Lopez' ankle in a splint for about 10 days for the swelling to subside and soft tissue to heal before outpatient surgery could be scheduled. 

“The goal isn’t just to heal the bone,” said Dr. Zura, chairman of orthopedics at LSU School of Medicine. “It’s to restore function — especially for someone whose career depends on balance, strength and precision through that joint.” 

Dr. Zura is an old hand with severe bone breaks. He's treated numerous NFL players with similar injuries and long careers, something he assured Lopez made him confident the veteran jockey could return to riding. 

It didn't hurt that Dr. Zura is good friends with a racing industry documentary filmmaker familiar to Lopez and his trainer. The connections made Lopez more comfortable. He knew Dr. Zura respected his profession and understood the sport's physical demands. 

"I knew Dr. Zura treated elite athletes, NFL players," said Lopez. "I felt in good hands."  

In the OR, Dr. Zura and his team focused on realigning the fractured bones and securing them in place to restore the joint’s natural mechanics. Using internal fixation, the team stabilized the ankle so it could heal properly while preserving as much mobility as possible. 

Surgery was over in 1½ hours, complicated but successful. Dr. Zura advised Lopez to take it slow. 

Lopez, 40, had other ideas. 

A Different Kind of Recovery 

Traditional timelines for injuries as severe as Lopez' often stretch four to six months or longer. Dr. Zura told the jockey to not put weight on the ankle for six weeks after the surgery. 

Lopez went to Miami for rehab. Under the guidance of Dr. Zura and the Florida team, Lopez began a progressive rehabilitation process designed for early motion and delayed weight bearing and strengthening. 

Within a week, Lopez was active again. Forbidden from running, a passion, he instead did lots of non-impact movement, reducing stress on the healing joint while emphasizing mobility. 

“I was on the bike and especially in the swimming pool,” Lopez said. “I pushed it, but did everything right.” 

Lopez advanced steadily — walking, strengthening the muscles around the ankle, gradually increasing weight-bearing activity. Throughout the process, he remained in close communication with Dr. Zura and the team, adjusting as needed while avoiding setbacks. 

The progress was faster than expected. 

"Paco was way ahead of schedule," said Zura. "He surprised us and impressed us. He is beyond tough." 

Back on the Track 

By late March, just seven weeks after the February 7 injury, Lopez was back to galloping horses at Gulfstream Park. On April 1, he tested the reconstructed ankle in competitive riding at Tampa Bay Downs. 

It was an extraordinary timeline, everyone agreed, managed while his recovery was still ongoing. There was lingering swelling early on, and some limitations remained. But the essential function was there — and improving. 

Lopez charged straight into a high-stakes Grade 2 race just three days after resuming competitive riding, the $750,000 Wood Memorial Stakes. But after taking the early lead, his horse, Napoleon Solo, tired in the stretch run and finished fifth, thus missing the cut for the Kentucky Derby. He had to settle for the Preakness Stakes, still one of horse racing's most prestigious events. 

Because of the fifth-place finish, Napoleon Solo was considered a longshot for the Preakness. It seemed the only person who believed in him was Lopez. 

But Lopez played the race perfectly. He stalked the favorite, Taj Mahal, pounced on the final turn and held off a late charge to capture a $2 million classic victory. It was a breakthrough on one of racing's biggest stages. The public never saw it coming. 

No one was more surprised than Dr. Zura, who grew up in Baltimore and thus followed the Preakness more than other races. But he hadn't even known Lopez would be competing in the event. 

"Our whole team was so surprised to see him racing and then the way he won -- so active on the horse, so incredible," said Dr. Zura. "We were so proud of him and so incredibly impressed by his fortitude and resilience and skill." 

The aftermath 

Lopez acknowledged the sweetness of the victory after such adversity — "to come back so soon and win, I was very excited." 

Lopez shouted out Dr. Zura on his Instagram page, thanking him "for the magnificent surgery he performed on me, which allowed me to recover in less time than recommended. 

"Just as he told us he would, he treated me like a high-level athlete, much like those in the NFL. Thank you to everyone involved." 

Dr. Zura downplayed his role, noting that though University Medical Center’s team provided the jockey with the best possible care and most modern techniques, as it does every patient at LSU and LCMC Health, the winning difference was all Lopez. 

"Paco alone is the reason -- he is a beast," said Dr. Zura. "It is nothing short of incredible to recover from that injury and to rehab and win the Preakness. Simply unbelievable. We are so in awe of him and so proud." 

For more information about emergency care and orthopedic services at University Medical Center New Orleans, visit University Medical Center New Orleans - Comprehensive Care