An expert’s take on Derrick Rose’s meniscus tear

After tearing his meniscus last month, NBA superstar Derrick Rose underwent the third knee surgery of his short professional career. Rose also tore his meniscus in 2013, and his ACL in 2012.

What is the meniscus?
The meniscus is a “U” or “C” shaped piece of cartilage between your femur (thigh bone) and tibia (leg bone).

The meniscus acts like shock absorbers in the knee. It forms a cushion between the cartilage surfaces of the tibia and femur, with the main function to spread out the forces that are transmitted across the knee joint.

How does a meniscus injury occur?
There are two common causes – either an injury due to trauma or from wear-and-tear over time.

In younger people, a meniscus injury usually occurs due to a trauma – a twisting injury from a sport like basketball or soccer.

The majority of meniscus injuries happen as the meniscus weakens with age. When the thigh and leg bone rubs together, it can cause the meniscus to fray and degenerate over time.  Older people often end up with a tear as result of a minor injury, such as the up-and-down motion of squatting.

What does a meniscus tear feel like?
The most common symptoms include swelling, pain with squatting/bending the knee, and pain along the joint line area where the meniscus is located.

Occasionally, the knee can get stuck or locked due to a piece of the torn meniscus moving around between the bones. Other complaints can include a feeling of instability, pain with running/activity, and weakness due to the pain from the tear.

How are meniscus tears treated?
Many times the initial treatment for meniscus tears doesn’t involve surgery.

The goal is to treat the pain and swelling in the knee with rest, anti-inflammatory medications, physical therapy and cortisone injections.

If conservative care fails over four to six weeks or if the knee is locking or getting stuck, surgery may be necessary to correct the problem and alleviate the pain.

What are the surgical treatment options?
The majority of tears occur in the inner two thirds of the meniscus. Because of the poor blood supply, the tissue cannot be repaired and must be trimmed away or taken out using a surgery called a meniscetomy. This is typically performed arthroscopically. Surgeons try and avoid this type of procedures  of any portion of the meniscus can increase the risk of future knee arthritis.

When the meniscus is torn in the outer third of the meniscus, the meniscus can be repaired with stitches. This is called a meniscus repair. To repair the torn meniscus, the surgeon inserts the arthroscope camera and views the torn meniscus.  The orthopedic surgeon can then arthroscopically use sutures to sew the torn edges of the meniscus together.

What is rehabilitation like after meniscus surgery?
If the meniscus is repaired with stitches – like Rose’s first meniscus surgery – then it needs time to heal.

Usually, the rehabilitation program consists of a patient not putting weight on the knee for four weeks, not bending the knee fully for four weeks, with the full recovery and return back to sports likely between four to six months.

If the meniscus is just cleaned up with the damaged tissue removed, this is called a partial meniscectomy – Rose’s second meniscus surgery.  In this case, the recovery is much faster.  A patient can put full weight on the knee right away, bend the knee fully right away, and the full recovery is between four and six weeks.