Tip:
Highlight text to annotate it
X
This is Doctor Robert Israel. I am an orthopedic surgeon, specializing in sports medicine.
I did my orthopedic training at the Hospital for Joint Diseases in New York City. I did
a senior fellowship in sports medicine at the Hospital for Special Surgery also in New
York City. After I completed my basic orthopedic training I did a fellowship in sports medicine
for 10 months. 6 months I worked at the University of Oklahoma school of medicine with the Doctor
who took care of the University of Oklahoma football team and for 4 months I worked in
New York City at Lenox Hill Hospital with the doctor that took care of the Jets.
After I completed my fellowship, I was asked to return to the Hospital for Joint Disease
in New York City and to run the sports medicine service. I did this for 3 years and then I
went into practice outside the hospital, still specializing in knee surgery and sports medicine.
Okay great. Looking at this first photograph, can you tell me a little bit about what this
patient came to you complaining about?
First photograph is actually the photograph of a normal knee as viewed through the orthoscope.
The upper part of the photograph shows a small part of the femoral condyle, the lower part
shows an image of the tibial condyle and the semicircular area is a meniscus. This is a
normal knee. In contrast, the second photograph shows a knee with a torn meniscus. Again the
upper half, the very white area, is the medial condyle, the lower part shows the meniscus
and in contrast to the earlier picture where you saw it was semicircular and smooth, you
can see that it is torn and the fragment is flipped up on itself and caught in between
the femoral condyle and the meniscus. On the extreme left when you're looking at it, you
see senovian, that's the pink area that is part of the lining of the knee. And on the
right you can make out the lower surface of the knee, the tibia, with a smooth articular
surface.
The symptoms someone with this condition might have is the knee would be locked and stiff
and the person would experience something catching inside the knee, which you could
imagine from just looking at the picture.
So what would your recommended therapy be for this patient?
The only treatment for this type of injury is arthroscopic surgery. Arthroscopic surgery
is when you make some very small holes in the knee, usually 2-3 millimeters wide. One
of the millimeters is for the insertion of an arthroscope, which is a camera with magnification
that's connected to a TV screen and the other is for an instrument and you would introduce
the instrument into the knee and the area that is flipped up on itself would be trimmed
away and the remaining edges of the meniscus would be shaved and contoured so that nothing
would get torn when you moved your knee.
Great, and then what can someone who has this arthroscopic surgery performed successfully,
what can they expect to experience? Immediately after surgery you will have some
pain, not very much, it'll feel a little stiff and it might get swollen. In the course of
rehabilitating the knee, which means regaining normal motion and normal strength, you can
anticipate full resolution of any of the symptoms you experienced beforehand and you can anticipate
the resumption of all activities, including very vigorous sports activities.
This has been Doctor Robert Israel on sports medicine injuries. Please feel free to contact
me should you require additional information.