Bure's Knee Surgery a Success; Dr. Feldman Discusses Procedure
/ New York Rangers
The New York Rangers announced today that right wing Pavel Bure underwent successful arthroscopic surgery this morning to repair a posterior tear of the medial meniscus in his left knee. While repairing the meniscus cartilage, the Rangers forward’s anterior cruciate ligament (ACL) was examined and found to be in tact and fully functional. In addition, the exploratory arthroscopic surgery conducted on his right knee revealed no damage to Bure’s anterior cruciate ligament (ACL). The procedure was performed by team physician Dr. Andrew Feldman and Dr. Tony Maddalo at St. Vincent’s Hospital. The rehabilitation process for Bure is expected to last four weeks.
“The procedure performed on Pavel this morning went extremely well,” stated Dr. Feldman. “He will begin his rehabilitation program immediately and we are extremely optimistic that he will return to full form.”
Bure sustained the posterior tear of the medial meniscus, as well as a Grade I medial collateral ligament (MCL) sprain to his left knee in the second period of the December 6 match vs. the Buffalo Sabres at Madison Square Garden. On September 26, he underwent successful arthroscopic surgery to repair a posterior tear of the medial meniscus in his right knee.
Bure currently ranks first on the Rangers with 14 goals and third with 21 points in 27 games this season. Since joining the Rangers on March 18 last season, he has registered 26 goals and 15 assists for 41 points in 39 contests. _______________________
Following the surgery, Dr. Feldman discussed the procedure and what the arthroscopy revealed.
Q: When you performed the surgery was there anything wrong with the right knee?
Dr. Feldman: Basically when you do an arthroscopic procedure you look at everything. You do not just go to the area that the MRI may show as problematic. So when you scope the knee you make a checklist in your brain about what to look for and what is normal vs. abnormal. And everything looked normal except for one area. He did, near the joint, have a small piece of scar tissue, also called adhesion, and that can come from any number of things. It can come from trauma, it can come from a past surgery, etc. But that seemed to be rubbing slightly in his knee. Now the good news about the knee and what we were fearing and what did not actually show was new cartilage damage, miniscule damage, and maybe the ACL had been torn or something going on with the graph, etc. But what we did find was an intact graph, which is great. So we did not have to deal with anything there and the meniscus that had been partially removed the last time was completely unchanged. In other words he had no new miniscule damage. Virtually the knee was the same as it was during the last surgery, except the scar tissue.
Q: What do you do with the scar tissue?
Dr. Feldman: Just clean it out. It shouldn’t be there and it is not structure that you need. You just take a little smoother and get rid of it.
Q: And the other knee?
Dr. Feldman: Again you have to have broad vision. What we basically did was a diagnostic arthroscopic surgery and look at all the structures. Our fear was that he potentially tore the ACL, but he had not. The way you know that is that you take your probe and you pull on it and if it feels tight you are in good shape. If it feels like a piece of spaghetti then you are in trouble. His felt nice and tight so we were happy about that. He did have a tear in the meniscus, which is a very common problem, very easy to take care of. It doesn’t require any type of reconstruction and basically what we did was take a small cleaner or shaver and smoothed out a piece.
Q: Why did you fear those things?
Dr. Feldman: Firstly, when you have an injury in somebody who is elite an athlete who is doing a lot of stopping and starting, and they say my knee twisted the first thing you always fear is an ACL tear because that is a problem. Then what you basically do is use your intuition or any type of information that the patient is giving you, and here are the pieces of information that are always important when making a diagnosis: firstly, the history. If you have it on videotape you watch the twist and you can see which may give you a certain understanding of what may be going on. Secondly, is the physical exam. There are two different phases to the physical exam; the acute physical exam the minute he gets hurt which is why we have a medical staff here all the time and then what happens a few days later. Then we get x-rays and MRI’s and basically what you do is put the whole thing together and you come up with a complete definite diagnosis or what we would call a preliminary diagnosis. I can give you another example -- when Dvorak tore his ACL. It was highly evident the minute we saw him in the training room, and the MRI was a highly positive so there was no question. With Pavel, the exam was so-so. So we were suspicious but we weren’t really terribly worried at that point. And the MRI, which is not real accurate test for ACL tears, said, “well we think something is funny but we really don’t know.” The real true test is the arthroscopic test. And when we did the arthroscopic test and pulled on the ACL we realized that that was not a problem.