Q&A: Local medical experts explain Joel Embiid’s meniscus injury and the way forward

Joel Embiid Partial meniscus tear It’s the topic in town right now, everyone is trying to guess what the injury means to the big man and the 76ers because they are trying to chase the championship. Following the 76ers over the years requires at least some understanding of most major athlete injuries, from food allergies to shoulder problems.

We did not pretend to be doctors, but called Dr Mark Pollard Bone and Joint Institute of Health Care at Cooper University. Dr. Pollard specializes in the treatment of knee ligament and cartilage injuries, knee arthritis, shoulder instability, shoulder tendon problems, and other muscle and tendon problems in the arms and legs (biceps, triceps, patella and quadriceps Tendons and Achilles tendons)). His work covers high schools, colleges and professional sports teams.

The following is a real expert’s comment on the type of injury suffered by the 76ers star…

PhillyVoice: What is the role of the lateral meniscus in the knee, and how does the injury of the lateral meniscus affect the entire area?

Dr. Mark Pollard: First, eEach knee has two meniscus, a medial meniscus and a lateral meniscus, they usually act as shock absorbers and stabilizers. We believe that their main function is actually to absorb force when the knee bears weight. The femur is the thigh bone, and the tibia is the tibia, and force must be transmitted through the joints. So at the joint, there is cartilage at the end of the bone. But you also have these meniscus, if you have a mechanical tendency, they look a bit like bushings. They move a little with the knees to better distribute the force. And, as I said before, they also help stabilize things other than ligaments.

So for athletes, in fact, it is mainly for absorption.

Yes, any weight-bearing force, even walking or running, the kind of force that passes through the joints. The meniscus helps to absorb it so that the cartilage at the end of the bone does not have to bear all the force. In the long run, if the cartilage at the end of the bone is called articular cartilage, if it eventually bears too much force, just like the meniscus is removed, many times the arthritis develops quite quickly, and that cartilage is in The ends of the bones are frayed. Therefore, the meniscus is very important for long-term preservation and maintaining good function.

In their latest news about injuries, the 76ers referred to it as a “little” tear. Does this mean anything in a practical sense, or tears are tears regardless of their size?

Yes, there is a different world here, and no two tears are the same. You may have a small tear that is very tiny in nature, involving only a few millimeters. In this case, it will not involve many meniscus, nor is it a real structural problem, so the end result may be small. However, if you have a larger tear, your tear may go all the way through the meniscus, effectively rendering it incompetent. This can be devastating for the knee, requiring surgery, and sometimes in some cases, for high-end athletes, this can actually be the end of a career.

Got it. Suppose a small tear is something that an athlete might try to pass or play in some form. After the doctor discovers this, is there one thing that can be considered “safe” without surgery? Is it as simple as pain and symptom management, or is it easier than this?

This is a bit tricky question. However, if the tear does not involve, for example, an unstable flap-a meniscus can actually flip and get stuck in the wrong position-if it is in a position that is unlikely to spread and become larger, then it is possible to continue without Actually do anything. There may be many athletes who have some minor meniscus tears and don’t even know them because they are not very obvious. If they perform an MRI on their knees for some other reason, they will be found in this way.

So can this be self-corrected? My layman’s understanding of the meniscus is that there are two ways to solve the problem during the operation, namely “repair or removal”. Is this accurate, and if it is necessary, what are the pros and cons?

You are right, if you are going to have an operation on the meniscus, either it is a meniscus repair and you are trying to stitch it together, or it is a partial meniscus resection where you remove the torn part. If you want to choose a long-term function, it is best to repair it, it is best to try to preserve as much meniscus tissue as possible. Unfortunately, in the long run, the pattern of many tears does not really make oneself obedient, nor is it possible to repair them, because they will not heal. The meniscus does not have a good blood supply, so it does not have a good healing ability. The range of meniscus damage is quite narrow and suitable for repair.

However, repair, which is a longer operation, takes longer to recover, but the long-term function is usually better than a meniscus resection, where you “gnaw” out the meniscus tissue, which is usually faster operation, The rate of resumption of activity is much faster, but it increases the possibility of some problems developing.

In most cases, meniscus repair, suture, and recovery usually take three to six months or the like. With partial meniscectomy, they are removing the meniscus tissue and you obviously remove as little as possible, but with this type of surgery, you can walk on it almost immediately. And, you know, in most cases, the complete activity is about three to six weeks later.

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