March 17, 2015
Menisectomy vs Mensical Repair
If you are a Bull’s fan or Chicagoan in general the news of Derrick Rose’s recurring meniscal tear has already sent you into the first stage of grieving. So, now what? A lot of medical professionals and former athletes will be on the airwaves today comparing and contrasting injuries, surgical techniques, and prognoses. The main questions will be: 1. Repair vs removal and 2. Will Rose ever be the same?
The meniscus is a C-shaped cartilage that sits on the top of the tibia. Its primary responsibility is to provide a cushion between the femur and tibia. The meniscus is generally injured by a compression and twisting injury. When injured, people can feel pain, lost range of motion, popping, and occasionally locking of the knee.
A meniscal repair is an arthroscopic procedure where the surgeon will suture down the injured tissue to allow it to heal. This type of surgery only occurs if the tear is a clean longitudinal tear on the periphery of the tissue because this area has blood flow to allow healing. A menisectomy, on the other hand, is an arthroscopic procedure where 10% of the meniscus is removed.
Meniscal Repair Considerations:
Decreased arthritis Slower healing time: Months
Improved mechanics Very specific tear
Non-weight bearing for 4-6 weeks
Healing time: 4-6 weeks Increased risk of arthritis
Common tears Altered mechanics
Physical Therapy for either procedure includes improving range of motion, controlling swelling, increasing strength, and fixing any movement faults that could have predisposed the injury. In addition, physical therapy has been shown to be just as effective as surgery in patients with meniscal tears. A Functional Movement Screen should be used before returning any client to sports to decrease the chance of re-injury.
In regards to if Rose will be doing this again. The injury itself and the general rehabilitation should be easy enough. However, the psychological hurdle will be the most difficult. Rose will need to again be explosive, with great jumping and landing mechanics, without hesitation. This is no simple feat, and as anyone who watched Rose at the first of the year knows, it was a work in progress.
For more information or to schedule physical therapy visit www.makovickapt.com or call (402) 933-3036.
– Dan McCutchen, PT, DPT, OCS