Dr. Robert Marx on Capsular Meniscal Repair for Female Athletes With Knee Pain

Written by Laura Dyrda | January 27, 2012 | Print  |
Robert Marx, MD, an orthopedic sports medicine physician at the Hospital for Special Surgery, recently published an article on performing surgery for small medial meniscocapsular separations to treat chronic medial-side knee pain, particularly in young female athletes. Several articles in the literature show female athletes are more likely to incur knee injuries than male athletes, possibly due to a difference in their biomechanics. The problem: A few years ago, Dr. Marx began noticing a trend in some female athletes who came into his office with knee pain: they complained of chronic pain in the inside of their knee for several years, but an MRI would turn up negative. "These girls couldn't run or participate in sports, but the MRI didn't show a cause for their pain," he says. "The majority of these patients were teenage females. Usually they had seen a few physicians who diagnosed them with a temporary sprain and recommended physical therapy since the MRIs were negative."

The solution: Since the pain was persistent and an MRI didn't reveal a source, Dr. Marx decided to perform arthroscopy to explore the issue. "I thought there must be something inside of their knees that was mechanically wrong," he says. "I performed arthroscopy on a few of these girls and found a subtle detachment of the medial meniscus."

The detachment was very small, but since the patients had already failed conservative treatment and still complained of chronic pain, he decided to repair the meniscal detachment. After surgery, the patients reported pain relief, so he continued to perform surgery selectively on patients who had these symptoms for many months or years after an injury.

"The big thing is that teenage female athletes who have had an injury and then have pain on the inside of their knee with activity, and the pain has persisted for a long time, could be good candidates for meniscal capsular repair," says Dr. Marx. "Basically, you are allowing these kids to return to normal function. It's a relatively uncommon injury, but the surgery can make a big difference for these kids who have exhausted other options."

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