Examining Derrick Rose’s Latest Meniscus Injury

• Post By: Jeff Stotts
• Date: February 25, 2015
• Category: NBA

Injuries are an inherent part of sports. They often come at inopportune times despite countless hours of preventative care and treatment. In the NBA, injuries have robbed fans of seeing countless individuals in the primes of their career, including legends like Bill Walton and Pete Maravich as well as more recent stars like Penny Hardaway, Grant Hill, and Brandon Roy. Now it appears another name will be etched alongside those fallen stars as Derrick Rose is set to undergo the third knee surgery of his young career.

Late Tuesday night, the Bulls revealed Rose will need surgery to repair a torn medial meniscus in his right knee. Rose previously needed surgery on his right knee after tearing the same meniscus during the 2013-14 campaign, just 18 months after undergoing surgery to repair a torn anterior cruciate ligament (ACL) in his left knee.

InStreetClothes.com broke down Rose’s meniscus injury in November of 2013 but let’s review.

Between the bones of the knee sit the menisci, two fibrocartilage discs, specifically designed to absorb high amount of stress while retaining its elasticity. As a result each meniscus is able to carry out two roles, that of a shock absorber and a stabilizer. The meniscus on the inside of the knee is C-shaped and known as the medial meniscus. The outside or lateral meniscus is almost completely O-shaped. Both discs sit on the joint surface of the lower leg bone, the tibia.

The position allows each meniscus to best carry out its role. However it also leaves the discs susceptible to injury when the knee is violently twisted. When this mechanism of injury occurs, either menisci can become pinched between the tibia and the femur, resulting in a tear.  Treatment and recovery of a meniscus tear is dependent on the location of the tear and the type of tear.

Small tears on the periphery of the disc receive a steady supply of blood and can occasionally heal without surgical intervention. However as you move inward, the amount of available blood decreases. As a result tears to this area often require surgery to fix.

The type of tear also plays a role in determining the treatment options. Tear classifications include radial tears, flap tears, longitudinal tears, and several others. Longitudinal tears occur around the axis of the disc and are often repairable if located on the aforementioned outer portions of the meniscus.

Once the type and location of the tear are determined through a MRI, the exact surgery necessary can be determined. An arthroscopic meniscus repair has better long-term results than a partial or full meniscus removal, though the recovery time following surgery is often long. A three-to-six month recovery window generally accompanies a repair, though Rose was particularly cautious when returning from his medial meniscus repair. However as previously mentioned, the location and type of tear has to be just right for a repair to even be an option.

A meniscectomy, or removal, is the more common of the two procedures and has a much quicker return to play timeline. A player with a meniscectomy can usually return to activity within six weeks. Meniscectomies do increase the chances for long-term issues like osteoarthritis and other complications including cysts.

While the type and location remain unreported, it is known that Rose’s injury occurred in his medial meniscus. While, the medial meniscus does bear less of a load with activity, studies have shown that games missed due to meniscus injury amongst NBA players is independent of which meniscus was damaged.

For Rose the questions about his legacy and future have already started. Attempts to compare Rose’s situation to Thunder guard Russell Westbrook are unfair. Westbrook underwent a meniscus repair following his injury and needed two subsequent surgeries to address a troublesome stitch and reoccurring swelling. He did not, by all accounts, suffer an additional tear to the meniscus.

In fact, finding any kind of comparable situation is difficult, despite the over 100 meniscus injury entries in the InStreetClothes.com database. There have been players, like Memphis’ Tony Allen, who have torn their ACL and later torn their meniscus, but the time between surgeries was longer. Last season Eric Bledsoe underwent his second meniscus surgery in three seasons but he never tore the ACL in his opposite knee. Even the Gilbert Arenas comparisons are a bit off base as Agent Zero underwent microfracture surgery amidst his meniscus problems. It seems Rose is an unprecedented territory and only he is capable of writing the ending.

Specifics regarding Rose’s surgery will likely surface over the next few days and determining the short-term and long-term issues will become a bit easier. However plenty of questions will remain with no real answers available until Rose starts down the familiar road to recovery. Hopefully the end of the journey is different this time around.