03/19/09 10:58 AM ET
Lugo's surgery a routine procedure
Knee arthroscopy one of most common orthopedic surgeries performed
By Gary Gillis / Special to MLB.com
"A knee arthroscopy is probably the most common orthopedic surgery performed," according to Dr. Arun Ramappa, chief of sports medicine in the department of orthopedic surgery at Beth Israel Deaconess Medical Center. "The procedure to deal with a torn meniscus is, with few exceptions, very straightforward."
An injury like Lugo's is often referred to as torn cartilage, and while that is correct, the meniscus is just one of two types of cartilage you'll find in the knee.
"Think of the meniscus as a shock absorber," says Dr. Ramappa. "There are two C-shaped, slightly wedged structures at the top of each shin bone, or tibia. The meniscus is fibrous and somewhat rubbery. It protects the articular cartilage, which is the lining of the bony surfaces in our joints, from the everyday stresses that climbing stairs or jumping over puddles can put on the knee. You can imagine the type of pounding an athlete's knee is subjected to."
Rotational stresses like throwing across your body or swinging at a pitch precipitate a tear but often, for us mere mortals it can be difficult to pinpoint the event that led to the pain. What begins as mild discomfort escalates to more constant pain and eventually limits activity.
After getting a post-surgical update, manager Terry Francona told the assembled media in Fort Myers, Fla., that the procedure went as planned. "They repaired what they thought they were going to repair," he said, adding that after a short stay in Boston, Lugo would return to Florida in anticipation of a return to the lineup in about four weeks.
Repair can mean a couple of things, but given the timeline that Francona outlined, it's likely that the surgery involved removing a bit of tissue rather than an attempt to close up the tear. If the tear was stitched closed, the recovery could take up to twice as long. More often, especially as patients age, the procedure is a debridement -- trimming out the frayed or loose piece and allowing the joint to move freely again.
"It would be almost unheard of to use a suture to repair a meniscus in someone of your age," he said.
Fortunately, before I had a chance to push myself out of my rocking chair, a smiling Dr. Ramappa added, "it would be rare to do it in somebody my age, too ... though not unheard of. Usually the debridement is enough to get us back on track."
If it were you or me, we'd likely be back on our feet a day or two after surgery and we'd be given the green light to go for a long walk in a couple of weeks. The gym might have to wait just a little longer. With personalized rehab and access to more extensive therapy, Julio Lugo will be back in the game a bit sooner.
Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.