The Bulls are once again moving forward without the services of MVP guard Derrick Rose after he suffered a torn medial meniscus in a loss to the Blazers on Friday. While he been ruled out indefinitely, the results following the non-contact injury could have been much more significant as an anterior cruciate ligament (ACL) injury was reportedly feared.
The menisci are two discs made up of a specialized type of cartilage known as fibrocartilage. Fibrocartilage is designed to withstand high amounts of stress while retaining its elasticity. This physical attribute allows the menisci to serve both as a shock absorbers and a stabilizer. The medial or inside meniscus is C-shaped while the lateral or outside is almost completely O-shaped. Both are situated on the articulating surface of the tibia, allowing for proper support. However this position also leaves the discs vulnerable to injury. When the knee is twisted, the menisci can become pinched between bony protuberances on the femur, resulting in a tear. Tears can be minor and repairable but the location remains key. Blood supply to the inner portions of each meniscus is limited and even nonexistent in some places, making natural healing extremely difficult. As a result surgical intervention is often required.
The surgeon performing the operation has two options. Repair the damage or remove the injured tissue in a procedure known as a meniscectomy. An arthroscopic meniscus repair has better long-term results than a partial or full meniscectomy though the recovery time following surgery is often long. A three-to-six month recovery window generally accompanies a repair. However the location of the tear has to be in the right spot for a repair to even be an option and the procedure comes with a noticeably high failure rate.
A meniscectomy is the more common of the two and has a much quicker return to play timeline. A player with a meniscectomy can usually return to activity within six weeks. Metta World Peace pushed those boundaries last year returning after two weeks, though the quick turnaround may be the reason for his persistent swelling in his left knee this season. Meniscectomies do increase the chances for future problems like osteoarthritis and other complications including cysts.
Rose’s injury occurred in his medial meniscus, a bit of a win for the Bulls. The lateral meniscus, shown to be more common in NBA players, may require extra time to heal, primarily because it bears as much as 80% of a lateral load. By comparison, the medial meniscus absorbs up to 50% during medial loading. The lateral meniscus is also more mobile than its counterpart and plays a bigger role in joint motion and fluidity.
Rose will have surgery in the coming days and, given the numerous aforementioned factors in play, establishing a timeline at the current moment is near impossible. A true recovery window should be provided following the procedure and the findings of the surgeon. Still it remains feasible that Rose could play again this season, something that would not have been possible has he suffered another ruptured ACL