Dr. Know: Bone on Bone

So Brandon Roy has no meniscus at all in his left knee. "It's bone-on-bone there," Roy told The Oregonian. It seems like there's a surgery for everything these days—can't something be done? —Kevin R.

Given recent advances, it's easy to assume there's nothing modern medicine can't do. However, a quick glance at Cher in good light should remind you that, even in 2010, there are limits to the power of the surgeon's art.

One problem is that knees suck in general. Humans have only been walking upright for about 6 million years, which makes your knees a rush job by evolutionary standards—if your skull were that recent, you'd probably have to tape your brain in place before going out in a high wind.

The other problem, of course, is that Roy is missing his meniscus, the little cartilage shim that cushions the joint. There is a surgical intervention for this—it's called microfracture surgery, the same procedure that's worked so brilliantly for Greg Oden. You can see why the Blazers aren't exactly dying to send Roy under the knife.

Microfracture surgery sounds like you're repairing hairline cracks in bone, but you're actually poking holes in the bone with a glorified carpenter's awl. Bloody goop then seeps out of these holes to form a gelatinous internal scab which, you hope, will eventually congeal into scar tissue that (sort of) resembles the lost cartilage.

Meanwhile, "meniscectomy," the operation that removed Roy's torn meniscus in the first place, is more popular than ever, especially in college. After all, college coaching staffs don't have to worry about where a player will be in four years; the important thing is getting the player back in action in time for the big game (or big tournament). Luckily, there's a surgery for everything these days.

WWeek 2015

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