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

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Joel Embiid’s partially torn meniscus is a hot topic right now, with everyone trying to guess what the injury means for the big guy and the Sixers as they try to win a title. Keeping up with the Sixers over the years has required at least some understanding of most major athlete injuries, from food allergies to shoulder issues.

Instead of pretending to be doctors ourselves, we called Dr. Mark Pollard from the Cooper University Health Care Bone and Joint Institute. Dr. Pollard specializes in the management and treatment of knee ligament and cartilage injuries, knee arthritis, shoulder instability, shoulder tendon problems and other issues. muscles and tendons of the arms and legs (biceps, triceps, patellar tendon and quadriceps and Achilles tendon). He has covered high school, college and professional sports teams in his field of work.

Here’s what a real expert had to say about the type of injury the Sixers star suffered …

PhillyVoice: What is the lateral meniscus in the knee used for and how does a lateral meniscus injury affect the area as a whole?

Dr. Mark Pollard: To begin with, eEach knee has two menisci, a medial meniscus and a lateral meniscus, and both generally function as shock absorbers and stabilizers. We believe that their main function is actually to absorb force when carrying weight on the knee. The femur is the bone in your thigh and the tibia is the tibia, and force must be transmitted through the joint. And so at the level of the joint, you have cartilage at the end of the bones. But you also have these menisci, which, if you’re into mechanics, look a bit like rings. They move a little with the knee to allow them to better distribute the force. And, like I said earlier, they also serve to stabilize things beyond what the ligaments do.

So for an athlete, in concrete terms, it is above all there to absorb.

Yes, any weight-bearing force, even stepping on it or running, that kind of force going through the joint. The meniscus helps absorb this so that the cartilage at the end of the bones does not have to take all of this force. In the long run, if this cartilage at the end of the bones is called articular cartilage, if it ends up taking too much force, as if the meniscus is removed, a lot of the time arthritis develops quite quickly, and this cartilage at the end of the bones wears out. The meniscus is therefore large enough to preserve in the long term and allow proper functioning.

In their injury updates, the Sixers called it a “little” tear. Does it mean anything in a practical sense, or is a tear a tear no matter how small it is?

Yes, there is a world of difference here, no two tears are the same. You might have what is essentially a very small tear, where only a few millimeters are involved. In this case, it doesn’t involve a lot of meniscus and it’s not a real structural problem, so the end result may be minimal. Whereas if you’ve had a bigger tear, you may have a tear that goes through the meniscus and actually makes it incompetent. And it can be devastating for a knee, requiring surgery, and sometimes in some cases, it could actually end the careers of high-end athletes.

Understood. Assuming that a small tear is something that an athlete might be trying to play or play in some form or another, after it was discovered by the medics, is there a point where it is? can be considered “safe” to play without procedure? Is it as easy as pain and symptom management, or is there more to it?

This is a somewhat slippery question. But if the tear doesn’t involve, for example, an unstable flap – a piece of the meniscus that can actually tip over and get stuck in the wrong place – and if it’s in a place that’s unlikely to spread and grow bigger. , then it is possible to continue without doing anything for it. There are probably a lot of athletes who have small meniscus tears and don’t even know it because they aren’t very symptomatic. And if they have an MRI of their knee for some other reason, then they are found out that way.

So, can this self-correct? My layman’s understanding of the meniscus is that there are two approaches to solving the problem in the case of a procedure, shorthand to “fix or remove”. Is this correct, and what are the pros and cons if it is necessary to do so?

You are right, if you are going to do an intervention on the meniscus, it will either be a repair of the meniscus, where you try to sew it up, or a partial meniscectomy where you remove the torn piece. And if you had to choose a long-term function, it is better to do the repair, you had better try to keep as much meniscus tissue as possible. In the long run, unfortunately, a lot of tear patterns don’t really lend themselves to themselves, it’s not really possible to fix them because they won’t heal. The meniscus does not have a very good blood supply, so it does not have a great healing capacity. This is a fairly small range of meniscus injuries that are amenable to repair.

However, repair is longer surgery, recovery takes much longer, but long term function is generally better with this, as opposed to the meniscectomy procedure, where you “nibble” the meniscus tissue. , which is usually faster surgery, much faster recovery to resume activities, but it increases the possibility that certain problems will develop down the road.

Most of the time for a meniscus repair, for sewing, the payback is usually three to six months or something like that. While partial meniscectomy, they remove the tissue from the meniscus, and you remove as little as possible of course, but for this kind of procedure, you step on it right away. And, you know, full activity, somewhere between three and six weeks after, in most cases.


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