Ask the Expert: Dr. Michael Maynard, Sports Medicine Surgeon, Answers Questions on Sports-Related Knee Injuries

by Dr. Michael Maynard
Runner with knee pain

Q1. Is it possible to have knee replacement with a rotation better than 90 degrees?  I am 64 but still active. My knee problems are the result of many years of ballet, some professional.  Do you consider this sports-related?

Yes, it is possible. In fact, the vast majority of patients treated at our hospital achieve an arc of rotation closer to 135 degrees.  The degree of flexibility achieved is dependent upon a multitude of factors—too numerous to discuss in this forum. You should consult with an orthopedic surgeon to determine the best course of treatment. I consider dance to be an athletic endeavor.

Q2. How many hours does a torn ACL surgery take to perform?

Most primary ACL reconstructive surgery, where the ACL is the only injured structure addressed, can be performed in less than 2 hours.

Q3. I twisted my knee while playing basketball and am now in pain.  How should I treat the pain?

The first thing to do is to avoid further trauma to the knee.  If the pain subsides fully with this rest, and there is no residual stiffness or swelling present, you may be able to return to play.  If stiffness and/or swelling are present, it is a good idea to have the knee examined by a physician. Consult with a physician before starting an exercise regimen.

Q4. I run 2-3 days a week, 4 miles each of those days, on pavement.  My knees feel inflamed for the past week.  Should I stop running?

Yes, a period of rest is a good idea in your case.  If the knees “quiet down” you may attempt a return to running.  To avoid a recurrence of inflammation I recommend two things:

a)     Make sure your nutrition properly supports your level of activity: a good multivitamin, a calcium with vitamin D supplement, and a wide variety of proteins are the foundations of this support

b)     Before running, warm up on a bike, rowing machine or with some other low-impact activity.

If the knees don’t return to normal, get checked by a physician. Also consult with a physician before starting an exercise regimen.

Q5. I tore my meniscus while playing soccer.  If I get surgery, what is the typical recovery time until I can play soccer again?

Dr. Michael Maynard, Orthopedic Surgeon

Dr. Michael Maynard, Orthopedic Surgeon

Return to play in this scenario, in some cases, can be as rapid as two weeks.  The time to recovery is primarily dependent upon the presence or absence of other associated damage in the knee, the avoidance of complications, and the patient’s innate ability to recover quickly. You should be evaluated by a physician before returning to play.

Dr. Michael Maynard is an orthopedic surgeon at Hospital for Special Surgery.

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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

Anthony flowers says:

How long does it take a completly torn mcl to heal? Can it heal w/o suregry?

HSS on the Move says:

Hi Anthony, thank you for your question! Dr. Michael Maynard, Sports Medicine Surgeon, says: “A completely torn knee MCL (grade 3 sprain) is often accompanied by injury to other ligaments—most often the ACL. Isolated MCL sprains of all grades, when the injury is located near where the femur attaches to the shin, have a greater than 90% chance of healing up fully within 12 weeks. All MCL injuries seen in combination with other knee ligament injuries have a higher incidence of residual instability—because support is lost from the other intact stabilizing ligaments of the knee. MCL injury by tear or separation of where it attaches to the tibia, whether isolated or combined, is usually best treated with surgical re-attachment. Combined injuries (MCL/ACL) and (MCL/PCL) often have better outcomes with surgical treatment, as well.” It is best to consult with your treating physician who is most familiar with your particular case. If you are interested in receiving care at HSS, please contact our physician referral service for assistance at 877-606-1555.

John says:

Twenty-two years ago at age 41, I was playing softball and catching when I heard the pop. I am an extremely pain tolerant person, and that is not necessarily a good thing. A couple of years later, I could stand it no longer. I talked the surgeon into doing a spinal block so I could watch the operation on a monitor. I had large sections of meniscus waving like flags, and I had two marble-like balls of meniscus inside the joint. They were both the same size, a little larger than the Pac-man type meniscus muncher the surgeon was using to clean up the mess. Pac-man ate the meniscus flags and smoothed the surface of what meniscus remained, but the doctor had a heck of a time munching up those two meniscus marbles. I think they are rare. He said he could not believe I had been able to walk at all. It is time once more to consider some kind of surgery. I told my current doctor about my meniscus marbles, and he didn”t believe me. It is true, though. I saw them with my own eyes. What is next for me at sixty-two? I say it hurts pretty bad. Cussin” pain, I call it. Others would call it excruciating, I guess…

HSS on the Move says:

Hi John, thank you for reaching out. It is best to consult with another physician to get a second opinion on your condition. If you are interested in receiving care at HSS, please call our Physician Referral Service at 877-606-1555 for further assistance. For more information on meniscus tears, visit http://www.hss.edu/condition-list_torn-meniscus.asp.

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