Reference no: EM133877221

Question

Part III-The Follow Up

The next morning, John and his parents were waiting in the examination room at the doctor's office. John had just had his MRI and they were waiting on Dr. Pearson to come in and explain the MRI scans. The whole family was anxiously awaiting the results. "Well, John, it looks like you have a torn meniscus. This is your knee," said Dr. Pearson as he showed John and his family the MRI image (see Figure 1 below). "Do you see this white area circled on the scan?"

Figure 1. MRI medial view of injured knee indicated damaged meniscus.

John carefully looked at where Dr. Pearson was pointing. "Yes, I see it."

"Well," said Dr. Pearson, "that white area isn't present in a normal knee scan; it's actually fluid leaking in through the meniscus tear. The menisci are semicircular discs of cartilage that provide a cushion between the femur and the tibia and help stabilize the knee when it's in motion. Due to your injury, the meniscus on the medial side is not currently attached, and the 'flap' is just moving around. This is what's getting stuck when you move your knee, causing the locked feeling."

John looked nervous and blurted, "Am I ever going to be able to play sports again?!" Dr. Pearson explained to John and his family that surgery would be the best option to fix his knee.

Dr. Pearson suggested surgical repair of the meniscus, which would provide minimal setback in ability, function, and recovery time, while also stabilizing the knee. He also warned John that he would be able to play sports again only if he allowed adequate time for repair, followed by physical therapy and strength straining before returning to competition. John sighed with relief knowing that he would be able to play sports again. John exclaimed, "I'm ready. Let's do this!" John's parents agreed, and the surgery was scheduled.

Questions

1. What are menisci and what is their function at the knee?

2. What other structures help stabilize the knee joint? How does each structure contribute to stabilizing the knee?

3. Compared to other joints, why does the knee require extra support?

4. How is a torn meniscus identified on an MRI?

5. After hearing from Dr. Pearson, what do you think is causing the locked feeling in John's knee?

Part III-The Recovery

After the surgery, John was given post-op instructions that were recommended for proper recovery. Included with the instructions, Dr. Pearson supplied John with a list of exercises to start 24 hours after surgery. The exercises, including straight leg raises, ankle pumps, and quad flexes, were intended to re-strengthen the muscles surrounding the operative knee. John was instructed to do the given exercises at least three or four times per day until his post-op visit.

Questions

1. Which muscles flex and extend the leg at the knee?

2. What is muscle atrophy? Does John need to be concerned about muscle atrophy? How can muscle atrophy be prevented?

3. Why does John need to start exercising the knee so soon.