Taking a Closer Look at Chris Johnson's Knee Injury and Meniscus Repair Surgery

Dave Siebert, M.D.@DaveMSiebertFeatured ColumnistMay 28, 2014

Tennessee Titans running back Chris Johnson (28) leaves the field after the Titans beat the Houston Texans 16-10 in an NFL football game Sunday, Dec. 29, 2013, in Nashville, Tenn. (AP Photo/Wade Payne)
Wade Payne/Associated Press

New York Jets running back Chris Johnson's 2013 season was one to forget—relatively, at least—but it's possible a lingering knee injury negatively affected his performance.

According to CBS Sports' Jason La Canfora, Johnson underwent meniscal repair surgery after the season ended. Jim Wyatt of The Tennessean noted that the tear occurred all the way back in Week 3, and Dr. James Andrews performed the surgery:

If the former Tennessee Titan did, indeed, undergo a meniscal repair—rather than the removal of the damaged meniscal tissue—it's not surprising the veteran will, according to ESPN New York's Kieran Darcy, likely miss the entirety of the Jets' OTAs. To understand why that is, it helps to take a closer look at the anatomy behind meniscus tears—as well as their surgical treatment.

A crescent-shaped cartilage structure within the knee, the meniscus serves as a shock-absorbing "cushion" of sorts, distributing the body's weight across a larger surface area within the joint. Each knee carries two menisci—one on the inside and one on the outside.

This diagram shows some of the structures within the knee—including parts of the two menisci.
This diagram shows some of the structures within the knee—including parts of the two menisci.Wikimedia Commons.

Like many other soft-tissue structures in the body, a meniscus can tear. It can do so due to long-term wear and tear or due to an acute traumatic event—such as an abnormal, forced twisting of the leg.

Small tears can lead to recurrent swelling and pain in the knee, whereas larger tears can cause catching or locking of the joint altogether. The loose, frayed tissue of the tear is to blame.

Athletes can play through some tears if treatment can adequately control pain and swelling—as appears to be the case with Johnson in 2013. However, meniscal tears often do not heal well without surgical assistance, and it seems likely Johnson elected to proceed with surgery as the ultimate treatment modality once an extended rehab timeline became available at the end of the season.

As mentioned above, meniscus surgeries generally fall into one of two categories: tissue removals or tissue repairs. During removals, a surgeon trims away the damaged portion of the meniscal tissue, thereby hopefully removing the source of the inflammation—as well as joint locking, if it existed. The surgery usually carries a relatively short rehab and recovery—on the order of several weeks or so—as well as good short-term outcomes.

Nevertheless, removing part of the meniscus can compromise its shock-absorbing function, possibly contributing to a higher risk of more quickly developing arthritis.

On the other hand, a meniscus repair can circumvent the above consequences. By stitching the meniscus back together in an attempt to restore its normal anatomy, a surgeon can help it retain its protective capabilities.

That said, repairs usually cost an athlete more time on the bench—sometimes over three to four months—as the body attempts to heal the surgically reinforced tear. Injuries on the outside rim of the meniscus are more likely to succeed, as the outer edge carries a more robust blood supply—a crucial factor in any healing tissue. The type, size and shape of the tear also looms large.

For Johnson, a prolonged recovery probably seemed like a small price to pay if it could afford him a longer career—especially if that recovery takes place during the earlier, less meaningful portions of the offseason.

In the weeks to come, Johnson will likely complete his rehab and return to the field—assuming no complications occurred unbeknownst to the public, that is. If all went as well as possible—which tends to occur when Dr. Andrews is the surgeon in charge—the Jets running back may return to the field in 2014 with a bit more of a spring in his step.

During this season and beyond, though, Johnson's knee will surely continue to take a beating, as all running backs' knees do. In time, he may even develop chronic knee issues such as arthritis—though there is no reason other than vague media reports to believe such a condition is already setting in.

On the contrary, Johnson's signed a new contract with the Jets—surely after a comprehensive physical exam by the excellent Jets medical staff as well as an extensive risk-versus-reward evaluation. The two-year deal suggests that CJ2K is doing just fine—for the somewhat immediate future, at least.

Dr. Dave Siebert is a resident physician at the University of Washington who plans to pursue fellowship training in Primary Care (non-operative) Sports Medicine. The above information is for informational purposes only and should not be taken as medical advice for Chris Johnson or anyone else.


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