The commonest of
all knee injuries are minor sprains, which involve slight tearing due to
unnatural twisting or stretching of ligaments. The treatment for such sprains
consists basically of rest, exercise of the quadriceps muscle and ice packs.
Splinting is used, too, when necessary.
Many of the more
serious knee injuries also involve ligaments. In these cases the fibrous bands
may be so badly torn as to be shredded, or pulled clear away from their
attachments to bone. Injuries of this severity require an operation, and the
surgeon must stitch the torn ligaments, or overlap two of them to get a strong
one, or reinforce them with tissue from elsewhere in the leg, or drill little
holes in bone ends to get a firm anchorage—whatever is necessary in the light
of what he finds when the damage is exposed to view. A football player who has
had surgery for a major ligament injury will find few buyers at any price.
common is a totally different type of injury involving a different structure.
The heart of the knee hinge is where the bottom of the thighbone (femur) rests
on the top of the shinbone (tibia). But the bone ends are not designed to fit
closely together, and to make the whole assembly work better (perhaps to make
it last longer), nature has stuck a couple of shock absorbers in between the
two bone ends. These are made of cartilage, which is entirely distinct in its
cellular and biochemical makeup from ligament.
absorbers are called menisci, because they reminded some early anatomist of a
meniscus or lens. The one on the outside is the lateral, and that on the
inside, where the knees knock, is the medial. This medial meniscus is shaped so
obviously like a half-moon that the anatomists have called it the
"semilunar." But that is only the way the meniscus looks from above or
below. Looked at edgewise, it is wedge-shaped, much thicker on the outside of
the curve and gradually thinning toward the center. In a powerfully built man
like Joe Namath each meniscus is about ? inch thick at the edge and thins down
to about ? inch. The lateral meniscus is more nearly a complete circle than the
It was toward the
half in Alabama's Oct. 10 game against North Carolina State that Joe Namath
rolled out to his right and started to cut back. At this moment his right knee
simply "gave way on him" (even orthopedists know no classier way to
describe what happened), and he fell to the ground in agonizing pain. No one
had hit him.
Namath's knee was
iced down at once. In the dressing room he continued to complain of pain,
particularly on the outside and the back of the knee. After 48 hours the joint
was swollen with "water on the knee," and the team surgeon, Dr. Ernest
C. Brock Jr., inserted a hollow needle and relieved the pressure by withdrawing
some of the fluid.
Namath was able
to play about half the game against Tennessee on Oct. 17 and did well for
another week. Then, in the first quarter of the Florida game, at the same point
in the roll-out, the knee gave way a second time, and again no one had hit Joe.
This time the abused knee swelled more markedly, and Joe began to complain of
pain on the inside, too. And this time when the doctors aspirated fluid, it was
mixed with blood. Joe was on and off the field for weeks, had his knee collapse
a third time in late December, then crowned his college career with a memorable
Orange Bowl performance in which he almost beat Texas singlehanded and
one-legged (SI, Jan. 11).
With the Jets'
more-than-generous contract signed, it was time for surgery. The pain on the
outside suggested that the lateral meniscus was more likely the one affected.
But at New York's Hospital for Special Surgery, Drs. Robert Freiberger and Paul
Killoran used a recently perfected, ultrasensitive method for getting more
precise X rays.
Joe was fully
conscious when they administered a local anesthetic and then injected a
radiopaque dye (containing iodine) and compressed air into the joint space of
his knee. Under pressure, the air sought hollow spaces and found one in the
place where the meniscus was torn. It proved to be the medial meniscus. The
lateral looked all right. Joe's legs are like those of an oak piano, and the
powerful bones showed no sign of chips or other injuries. But lurking behind
the joint was a small, fluid-filled cyst.
Last week at
Lenox Hill Hospital, Joe was knocked out with a general anesthetic (thiopental
sodium) by 8 a.m., and at 8:11 a.m. the Jets' surgeon. Dr. James A. Nicholas,
made a three-inch incision just below and inside the kneecap. He found that the
medial meniscus had been shredded and torn away from its outer attachments. It
was crumpled into a wedge. When Joe had tried to extend his leg, this extra
thickness had kept his knee hinge from closing completely.