Is Lonzo's Meniscus tear likely new or old?
Lonzo Ball, reportedly has a torn meniscus in the same knee that was injured at the All-Star Break as well as at the end of the year. Reports back in March state he had a contusion to the knee after an MRI was obtained. Reports out of the NBA now report that he has a meniscus tear that will likely require surgery. Medically, that brings up quite a few questions regarding his previous diagnosis of contusion. It is certainly possible that he had a small tear in the past but it was felt that he could finish the season. I have seen this type of course of action if the athlete is believed to have a subtle tear on the outer edge of the meniscus which may not be causing significant pain or swelling and can be given a chance to heal on its own. On the other hand it is possible that he has sustained a new injury that we aren't aware of at this time. My guess is the MRI was not clear cut about a definitive tear and they opted to treat with a wait and see approach. If it is a new injury it typically occurs as a non-contact injury with a planted foot on the ground. Another type of meniscus tear, called a degenerative tear, can occur over time due to wear and tear in the knee joint. Although it is unlikely that someone as young as Lonzo would develop a degenerative meniscus tear.
Where do we go from here?
In general, the recommendation for a meniscus tear varies depending upon the type of tear, location of the tear and the age of the patient. If the tear is large and the patient is younger, the surgeon will likely attempt to repair the meniscus and allow it to heal. Younger patients have a much better chance of the meniscus healing after a repair than older patients. On the other hand, if the tear is small or the patient is older, then the surgeon will likely remove the torn part of the meniscus. The procedure for removal of the torn portion of the meniscus is called a meniscectomy. On rare occasions, if the tear is very small and on the edge of the meniscus, a conservative non-operative approach can be considered.
When can we expect Lonzo to be ready?
If Lonzo is treated with meniscectomy surgery is expected to be able to return back to full activity in about 4 to 6 weeks. Some surgeons may have an even more aggressive protocol and may return an athlete even sooner. On the other hand, if he undergoes surgery to repair the meniscus, typically he will returned back to play at 3 months. Therefore, either way he will be ready for training camp, no matter what team he is on. It is important to recognize that even though a repair would require a longer recovery time, it may be more beneficial to his future. The current data demonstrates that the more meniscus that is removed, the higher the risk for developing arthritis in the future. Although it may sound tempting to opt for the meniscectomy in order to significantly reduce down time, it may not be the best choice. If repair of the meniscus is possible and appropriate for the situation, it should definitely be considered to protect the long term health of the knee.