Athletes who have had meniscus injury
Quarterbacks
Meniscus Debridement
| Quarterbacks | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Zack Wilson (2022 preseason) | 3 | 15.3 | 19.8 (+4.5) | 9.6 (-5.7) | |
| Jameis Winston (2019 offseason) | 0 | 23.3 | N/A | N/A | N/A |
| Ben Rothlisberger (2016 week 6) | 1 | 22.6 | 18.9 (-3.7) | 18.6 (-4) | 13.7 (-8.9) |
| Average | 2 | +0.4 | -4.9 | -8.9 | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 1/2 (50%) | 1/2 (50%) | 0/1 (0%) |
Running Backs
Meniscus Debridement
| Running Backs | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Benny Snell Jr. (2019 week 8) | 3 | 2.1 | 10.8 (+8.7) | 7.7 (+6.6) | 5.5 (+3.4) |
| Kerryon Johnson (2019 week 7) | 8 | 13 | 4.8 (-8.2) | 11.3 (-1.7)* | N/A |
| Darius Guice (2019 week 1) | 9 | 5.3 | 13.4 (+8.1) | 15.5 (+10.2) | 4.2 (-1.1)* |
| Joe Mixon (2018 week 2) | 2 | 11.7 | 19 (+7.3) | 11.5 (-0.2) | 16.5 (+4.8) |
| Average | 5.5 | +4 | +3.7 | +2.4 | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 3/4 (75%) | 3/4 (75%) | 3/4 (75%) |
Meniscus Repair
| Running Backs | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Jeff Wilson Jr. (2021 offseason) | 8 | 13.2 | 2.8 (-10.4) | 3.8 (-9.4) | 8.2 (-5) |
| Adrian Peterson (2016 week 2) | 11 | 9.8 | 1.8 (-8) | 3.7 (-6.1) | 9.9 (+0.1) |
| Average | 11.7 | -9.2 | -7.8 | -2.5 | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/2 (0%) | 0/2 (0%) | 1/2 (50%) |
Wide Receivers
Meniscus Debridement
| Wide Receivers | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Kadarius Toney (2023 preseason) | 0 | 9 | 0.5 (-8.5) | ||
| Danny Amendola (2021 week 12) | 4 | 3 | 28.8 (+25.8) | N/A | N/A |
| Michael Gallop (2019 week 2) | 2 | 9.7 | 20.8 (+11.1) | 5.9 (-3.8) | 15.1 (+5.4) |
| Average | 3 | ||||
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 2/3 (66%) | 2/2 (100%) | 2/2 (100%) |
Meniscus Repair
| Wide Receivers | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Kelvin Benjamin (2017 offseason) | 0 | 6 | 1.5 (-4.5) | 6.7 (+0.7) | 3.6 (-2.4) |
| Average | 0 | -4.5 | +0.7 | -2.4 | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/1 (0%) | 1/1 (100%) | 1/1 (100%) | ||
| Average | 0 | -4.5 | +0.7 | -2.4 | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/1 (0%) | 1/1 (100%) | 1/1 (100%) |
Tight Ends
Meniscus Repair
| Tight Ends | Games Missed | PPG Prior to Injury | PPG 1st Game After Injury | PPG Games 2-3 After Injury | PPG Games 4-6 After Injury |
|---|---|---|---|---|---|
| Irv Smith Jr. (2021 preseason) | 17 | 10.2 | 0 (-10.2) | 8.2 (-2) | N/A |
| Average | 17 | -10.2 | -2 | ||
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/1 (0%) | 0/1 (0%) | |||
| Average | 17 | -10.2 | -2 | N/A | |
| Number of Players Who Have Met Their Baseline at Current or Previous Time Points | 0/1 (0%) | 0/1 (0%) | N/A |
Anatomy of a meniscus injury
The meniscus is a cartilaginous structure in the knee joint, meant to absorb shock and assist in stabilizing the knee. Each knee contains two menisci in the shape of a “C.” The meniscus generally has a poor healing potential as about 70-75%1 of the meniscus does not have a good blood supply. The outer portion of the meniscus may heal as this area undergoes less weight-bearing, so it has a better blood supply.1
Cause of a meniscus injury
The meniscus is often injured when the knee twists while bending simultaneously. The meniscus can be torn by itself, and/or it may be torn in conjunction with an ACL or MCL tear.1 In football players, we typically see these injuries during a quick change of direction or cutting motion. As we can see above, this certainly pre-disposes running backs to this type of injury compared to wide receivers and tight-ends.
Surgical procedure for a meniscus injury
There are two main options for the surgical procedure after a meniscus tear. Option 1 is a debridement/meniscectomy or a “clean up.” During this procedure, the meniscus’s torn portion is shaved off and removed from the knee. There are not as many restrictions with this type of procedure which is great for a quick return to sport (2-6 weeks). However, long-term outcomes are not as favorable. Option 2 is a meniscus repair. During this procedure, the torn meniscus is sewn together to better allow the meniscus to heal properly. The long-term outcomes are much better with this procedure; however, the immediate post-op restrictions do not allow for a rapid return to sport (6-9 months).
Meniscus injury surgical outcomes
One study shows after partial lateral meniscectomy, there is a good level of return to sport. Of 77 athletes undergoing partial meniscectomy, all received medical clearance to return to play.2 Unfortunately, they found that only 61% of these players actually returned to gameplay at the NFL level; and 40% were still active 4.5 years later.2
There are some limitations to this study as it pertains to fantasy football. The athletes in this study only needed to play in one NFL game before surgery and return to play in one NFL game after surgery to be considered successful. This is likely the opposite of most fantasy-relevant NFL players who sustain this type of injury outside of rookies. A second significant limitation of this study is that only 8 of the 77 surgical procedures performed were only meniscectomy. Most of these procedures also included other types of surgery, the most common being an ACL tear. As we know from our ACL tear page, these injuries take significantly longer to recover from than a simple meniscectomy.
One interesting statistic in this research article is that players drafted after the 4th round were 3.7 times less likely to return to play.2 This is great news for fantasy football players, as most fantasy-relevant players will be drafted much earlier. Unfortunately, due to the relatively new increase in meniscal repairs, there is not much data available to analyze the return to sport, specifically at the NFL level. Per one study, the return to sport in high-level athletes was 81% at an average of 5.6 months after meniscus repair.3
Meniscus injury rehab process
The rehab process after a meniscus injury depends heavily on the procedure performed. Rehab from a meniscectomy is much quicker than during a meniscus repair. After meniscectomy, the primary goals are to eliminate swelling, restore range of motion, and regain strength. After surgery, the athlete may be on crutches for a few days but will quickly progress to normal walking and running. As mentioned earlier, after meniscectomy, the athlete will likely be out at least three weeks, but as soon as they are able to show adequate strength and ability, they can return to play.
Rehab after a meniscus repair is much different, and there is no agreed-upon “best” rehab protocol. In general, immediately after surgery, the athlete’s knee will be locked in extension with an external brace. They are often non or partial weight-bearing for about six weeks. They are also restricted to only 60-90 degrees of flexion range of motion. This is all done in an attempt to protect the repair.
By 6-8 weeks, the athlete should be putting some weight through their leg and progressing off crutches. Once the athlete has regained about 80% of their strength, they should be cleared to begin running (typically about 3-4 months after surgery). There are some specifics depending on the type of tear and preferences of the surgeon that may alter this timeline by a few weeks. From here on, the athlete is slowly progressed toward cutting hopping, and sport-specific drills as tolerated.
Sam Webb, PT, DPT, SCS
References
- Bhan K. Meniscal Tears: Current Understanding, Diagnosis, and Management. Cureus. 2020;12(6):e8590. Published 2020 Jun 13. doi:10.7759/cureus.8590
- Aune KT, Andrews JR, Dugas JR, Cain EL Jr. Return to Play After Partial Lateral Meniscectomy in National Football League Athletes. Am J Sports Med. 2014;42(8):1865-1872. doi:10.1177/0363546514535069
- Spang Iii RC, Nasr MC, Mohamadi A, DeAngelis JP, Nazarian A, Ramappa AJ. Rehabilitation following meniscal repair: a systematic review. BMJ Open Sport Exerc Med. 2018;4(1):e000212. Published 2018 Apr 9. doi:10.1136/bmjsem-2016-000212