With football season returning and training camps well underway, we’re
seeing a number of players such as San Diego Chargers’ wide receiver
Stevie Johnson, who recently underwent season-ending surgery to repair
his torn meniscus, sustaining injuries that I think are important for
the public and media to learn more about. As is often the case with sports-related
articles, the focus is primarily on what the injury will do to the team’s
prospects for the season, rather than the injury itself and how the player
will recover from it. When it comes to meniscus injuries, we’ve
got to dig deeper.
Meniscus tears are among the most common knee injuries in athletes, especially
those who play contact sports. The meniscus is a thick protective cartilage
that separates the thigh and shin bones, and allows for a soft and shock
absorbing cushion between the two, making it possible to run, jump, and
move without pain. When the knee is twisted or stretched outside of its
flexibility range however, the surrounding tissue can rip or tear, rendering
the knee unstable.
Most athletes are able to immediately tell when they have suffered such
an injury to the knee. Sometimes there will be a “popping”
sound and sensation, followed by pain, stiffness and inflammation. In
the case of a torn meniscus, it is common to feel weakness in the knee
and an inability to move the knee comfortably through a normal range of motion.
Treatment for a meniscus tear is dependent on the type of tear, the size,
and its exact location. Use of X-rays, MRIs and other diagnostic tests
are used to determine the severity of the injury and aid the orthopedic
surgeon in developing the best treatment plan. Not all tears will require
surgery, and it is important to communicate with a trusted orthopedic
expert to discuss treatment goals. After examining the injury and viewing
the results of the tests, a tailored treatment plan can then be prescribed
and implemented.
In cases where a tear is small and the injury is not causing persistent
pain or knee instability, non-surgical treatment can be utilized. This
type of treatment involves rest, ice, compression and elevation (R.I.C.E.).
Keeping weight off of the injured knee is typically recommended, and one
may need to use crutches to give the knee a full rest from activity. Intermittent
icing of the affected area will minimize pain and swelling, and promote
quicker healing. An elastic compression bandage can also help with controlling
swelling, as well as elevating the knee above the level of the heart when
lying down.
For patients who have persisting symptoms that do not subside with rest,
arthroscopic surgery may be suggested to repair the tear and restore stability
to the knee. The surgery for repair of the meniscus is common, and involves
only a small incision in the knee, in which the surgeon will insert a
camera to clearly view the inside of the knee while using small surgical
instruments to repair the tear.
Depending upon the type of tear and also the overall strength of the meniscus,
the surgeon will decide to either remove the damaged portion of cartilage,
or will be able to sew the two torn ends back together. If the two pieces
of meniscus are repaired, the patient must take caution to allow ample
time for complete healing, as the pieces need to fully fuse back together
to become strong and functional again. This typically requires the patient
to remain on crutches for some time after surgery to keep weight off of
the knee while it heals. The total healing time for a repaired meniscus
is approximately 3 months, while a meniscectomy (removing the damaged
cartilage) will usually require only about 3-4 weeks for full recovery.
Casts and braces are sometimes utilized after surgery to keep the knee
from moving, which will also help to facilitate quicker healing time.
Post-surgery, physical therapy exercises play a key role in gradually
improving range of motion and rebuilding strength to safely return to
normal activity. Meniscus tears are very common in athletes, yet with
proper diagnosis and following proper treatment protocols, your favorite
athlete has excellent odds of quickly and safely returning to their normal
level of play.
Sources: http://orthoinfo.aaos.org/topic.cfm?topic=a00358
http://www.sandiegouniontribune.com/news/2016/aug/01/chargers-stevie-johnson-meniscue-knee/