Case of the month

A Champion Marathon Runners Road to Recovery

  • Dr. Vikram Mhaskar
    MS(Orth), MCh(Orth)(UK)
    AOA, ISAKOS Fellowship Knee Surgery (Australia, France)
    Consultant Knee & Shoulder Surgeon
    Max Smart Superspeciality Hospital, Saket

    A 22 yr old athelete, a Marathon runner, not able to run anymore presented with pain in the knee.. The very declaration made me feel the pain of this athlete , world champion marathon runner who was unable to persist with his passion. He had been evaluated elsewhere. He said he had been seen by numerous Ethiopian and Eritrean orthopaedic surgeons and had also been to Italy, where the orthopaedic specialist said he was absolutely normal. It was rather astounding to his ears as he wasn’t able to run which is a normal activity for a 22 yr old.

    His MRI had already revealed to me a loss of cartilage, about the size of a 1 cent coin on the weight bearing aspect of his lateral femoral condyle (thigh bone) where all the weight of the body passes.The cartilage is a layer of polish on the femur (thigh ) bone which is one half of the knee joint. The cartilage reduces friction between the two bones when they rub against each other as well as acts as a shock absorber, preventing excess pressure over the underlying bone that it covers. When cartilage of this size gets rubbed off in the weight bearing aspect of the bone, all the body weight passes to the bone directly and causes pain.

    My plan in these cases being an exclusive knee specialist is a procedure called arthroscopic Mosaicplasty. This involves taking the patients own cartilage from a non weight bearing portion of the thigh bone and transplanting it to the defect. This provides the patients natural cartilage back in the defect and the necessary cushioning to prevent pain.

    I did explain these details to Abraham and he was thrilled to have got a diagnosis. He said he would come to me in India for the surgery very soon. We shared a great moment where both doctor and patient saw hope when till moments ago Abraham was a dejected athlete who couldn’t do what he does best. He said if you make me run “Ill dedicate my next Marathon win to you doc”.

    Abraham came to India on the 1 st of Apr, was operated by me via key hole surgery (arthroscopic surgery)., where I took a cartilage piece , the same size as the defect from the non weight bearing part of the lateral femoral condyle and transplanted it to the defect. He was discharged home the next day, walking. He was given my rehabilitation protocol and was already bending his knee fully just a couple of hours post surgery with absolutely no pain. In his own words “ Im already feeling a lot better doc” !brought a smile to my face!! God bless Abraham and may you win many more medals and laurels.