New York Yankees first baseman Mark Teixeira suffered a cartilage tear last week, according to reports, and yesterday it was divulged that he will not have surgery. Instead, he will try to rehab the knee and hope to return some time this season.
Would surgery be a better option? Probably not at first. The information is limited in regards to which cartilage in the knee was actually torn. Nonetheless, the presumption is that it is the meniscus tissue.
The menisci are cushions of cartilage on the inside and outside of the knee. They provide protection against arthritis and distribute load by a method similar to a shock absorber. A tear can occur during a traumatic event or as a result of degeneration where it may even be the first sign of arthritis.
Typically, the initial symptoms are severe pain, difficulty to bear weight, swelling and stiffness. If the torn piece is displaced or flapping around or lodged between structures, then what is called “mechanical symptoms” occur. This includes locking, where the knee is stuck and cannot straighten, or buckling, where the knee repeatedly gives out and is unstable.
The typical treatment recommendations are as follows:
- If there are recurring mechanical symptoms then arthroscopic (minimally invasive) surgery is often warranted. The procedure usually is to clean out the damaged tissue.
- If there are no mechanical symptoms then a formal course of conservative treatment is warranted including physical therapy, anti-inflammatory medications and possibly cortisone injections.
- If conservative treatment fails to relieve symptoms then arthroscopic surgery can be done to clean out the damaged tissue.
- If the patient is very young (teens or twenties) and the tear extends to the area where blood flow is bountiful then a repair of the cartilage is very important in order to preserve the cartilage and integrity of the joint.
In Mark Teixeira’s case, I presume he has a type of meniscus tear where conservative treatment should be attempted. Unfortunately, the more active the patient is and the greater physical demands, the more likely conservative treatment will not be able to alleviate all symptoms. Still, he deserves a try at avoiding surgery and the Yankees can hold onto some hope for him to return this season.
– Leon E. Popovitz, MD
NY Bone and Joint Specialists is a top rated, private Orthopedic and Sports Medicine practice in New York City. The Orthopedic Surgery, Physical Medicine & Rehabilitation, and Pain Management specialists routinely perform surgical and non-surgical treatments for professional athletes from across the United States and various other countries. Leon E. Popovitz, MD, and Michael Y. Mizhiritsky, MD, along with their team of best-in-class orthopedic physicians, are known for their exemplary orthopedic surgical skill and best-rated physical medicine and rehabilitation program. With this, along with their top in-office physical therapy and long-term sports rehabilitation processes, NY Bone and Joint Specialists work toward better overall quality of life for each and every patient.
