Derrick Rose: Meniscus tears, prognosis and the road to recovery

Chicago Bulls fans learned yesterday that all-star guard Derrick Rose will once again require knee surgery and is out indefinitely. The reality is it could have been worse.

Rose, Chicago's star guard was diagnosed with a medial meniscal tear in his right knee. The news comes less two years after Rose suffered a torn anterior cruciate ligament (ACL) in his left that knee required him to miss all of last season. Most sports fans at this point are aware of ACL surgery and what it means for their favorite athlete; typically the injury is season ending.

It is unclear what type of meniscal tear Derrick Rose sustained. but a big part of how much time he will miss will be determined by whether or not doctors can repair the tear with sutures. Or will they simple trim a section of it out, termed a meniscectomy?

Repairing a meniscus requires a longer recovery because the meniscus needs to heal before the athlete returns to play a process that usually takes approximately three months. The advantage is that the meniscus is preserved and not removed. A meniscectomy or trimming of the meniscus has a much quicker recovery because when a portion of the meniscus is removed there is no need to wait for healing, and therefore the athlete can engage in athletic activity much quicker-typically around six weeks after surgery.

The decision to repair or trim a meniscus is based on the type and location of the tear. The blood supply to the meniscus starts at the periphery so large peripheral or 'outer' tears are ideal for repair. The inner portion of the meniscus receives very little blood supply so tears in that area are not amenable to repair because without blood supply they cannot heal. Also, 'complex' tears or tears torn in multiple directions are less likely to be repairable as well.

It is certainly more ideal to repair a meniscus but many situations don't allow it and trimming the meniscus is the only way to alleviate pain and allow return to athletic activities. We will certainly know more after the surgery about what exactly was done and long to expect Derrick Rose's recovery to last.. Stay tuned.

Christopher C. Dodson, M.D. is an attending orthopedic surgeon at the Rothman Institute.

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