Leader In Meniscus Repairs Shares What To Expect After Jaylen Brown's Knee Surgery

Forbes

10 hours ago

Boston, MA - April 23 - Jaylen Brown #7 of the Boston Celtics screams out after dunking against ... More Paolo Banchero #5 of the Orlando Magic uring the third quarter of Game 2 of the Eastern Conference Finals at the TD Garden. (Photo by Matt Stone/MediaNews Group/Boston Herald via Getty Images)
Jaylen Brown spent months playing through a partially torn meniscus in his right knee. The injury surfaced in March and had a significant impact on his minutes and availability.
The 2024 NBA Finals MVP missed eight of the Boston Celtics' final 16 games. After Mar. 12, he didn't play more than 30 minutes in a matchup until the playoffs.
But when the postseason arrived, Brown's production was on par or exceeded his statistics from Boston's championship run. He averaged 22.1 points this go-around compared to 23.9 last year. He grabbed 7.1 rebounds, up from 5.9. The four-time All-Star distributed 3.9 assists, an uptick from the 3.3 he doled out the previous postseason. He also swiped a steal per contest a year after averaging 1.2 thefts.
Still, the contrast in the burst he had in the 2024 playoffs and this one was easily recognizable.
Before the Celtics bowed out the postseason, Brown delivered a Game 5 performance against the New York Knicks that should get etched into his legacy with the franchise.
The former All-NBA Second Team selection generated 26 points, 12 rebounds, and eight assists. He pressed Jalen Brunson in the backcourt, took away his airspace, and made life uncomfortable for the Knicks' star guard. Brunson finished with 22 points on 41.2 percent shooting before fouling out in the third quarter.
It was a win that captured the heart of a champion, summoning the strength for one final blow before the inevitable haymaker to a team that lost Jayson Tatum to an Achilles injury and seemingly ran out of gas.
The play epitomizing this was Brown going airborne, parallel with the parquet, as he dove into Boston's bench for a steal Joe Mazzulla told this author "changed the game."
With the season in the rearview, Brown gave his knee injury the necessary time to determine the best course of action. What that called for was an arthroscopic debridement procedure.
After previously speaking with Dr. Kevin R. Stone about Tatum's Achilles tear and recovery, Forbes gained crucial insight from him on what that entails for Brown.
Dr. Stone is an orthopedic surgeon at The Stone Clinic and a pioneer of advanced orthopedic surgical and rehabilitation techniques to repair, regenerate, and replace damaged cartilage and ligaments. He is a leader in meniscus transplants and repairs.
The following interview is edited lightly for grammar and clarity.
Bobby Krivitsky: Jaylen Brown recently underwent a right knee arthroscopic debridement procedure. Can you explain to people what that is?
Dr. Stone: Sure. So, if you think about inside the knee, there's a smooth lining of the joint called the synovium. And then there's other soft tissue like the meniscus cartilage and the ACL and the fat pad of the knee. So, each of these tissues can be injured, inflamed, or scarred.
And if something's injured or torn, often it'll produce catching in the knee, or locking, or bothersome and then cause swelling. And so when a surgeon looks inside the knee and does a debridement, it means cleaning up the torn tissue or the scarred tissue or the inflamed tissue, actually shaving it away and sucking it out of the knee.
Bobby Krivitsky: The Celtics said in a press release that they expect him to participate in training camp without limitation. I have two questions on that front: The first is if that signals to you that he likely underwent a partial meniscectomy.
Dr. Stone: So that's highly possible. It's probably the most common injury that we see. In general, it means a short recovery and a return to full sports. The problem, of course -- that so many of your readers know -- is if you take out too much of the meniscus, over time, you get forced concentration, abnormal motions in the knee, and then arthritis. And so you always need to know the bias of your surgeon if you happen to be somebody with a torn meniscus.
You want to know: is that surgeon biased toward sewing it back together? Biased towards shaping it? Or biased towards actually replacing it with a donor meniscus if you're going to lose too much tissue.
Now, I'll tell you in his case, as with almost all professional athletes, they're going to say to their doc, 'Hey, look, I'm mid-career. I want to be back on the court. I want to go full as soon as possible. I'll deal with the consequences later on in life.' And so, my practice is filled with all the patients who made that decision and then came back with arthritis later on for a new meniscus.
But it's probably the right decision for someone at that stage of their career. They're right in the middle of it. It's so important to get back quickly. Most of the time, if it is a meniscectomy, which means cleaning up or removing part of that critical tissue or cleaning up some scar tissue in the knee, most of the time, after four weeks to six weeks to eight weeks, the knee is quieted down enough that you can return to full sports. And people often even return earlier, but the knee gets a little irritated when they do.
Bobby Krivitsky: It reminds me, especially the idea that Brown might have opted for a faster return to physical activity, of our conversation about Jayson Tatum's Achilles injury and the sentiment you shared that athletes tend to cheat.
That was more in regards to the walking boots specifically, and maybe they shed it a bit faster than they should, but it's the same type of deal here, at least in spirit, where, maybe Brown and a lot of athletes in this situation, they opt for the faster road to recovery.
Dr. Stone: It's really true. They do. And I'll give you a little inside the game, sort of knowledge. It puts those of us who are orthopedic surgeons caring for these athletes in a bit of a tricky situation because we know we want to help them get back. We know their contracts are on the line. We know all the pressures from the fans, but we also know that we want to do the right thing for the athlete.
And so, that conversation with the athlete, and often with their agent and with their trainer and sometimes even with their coach, it is 'OK, the quick thing gets him back here. A little longer recovery might have him back for the season after, but with a better knee.
Where does this individual want to fall? Where do they want to fall into this group?' Most of the time, we leave it up to the athlete. But we try to do a really good job of teaching them what the consequences are.
Bobby Krivitsky: And my second question related to the expectation Brown's ready for training camp is what you think his road to recovery looks like, and when you think he can resume basketball activities.
Dr. Stone: Remember, I don't know exactly what the inside of his knee looked like. So, assuming it's a simple meniscectomy and not too much tissue was removed. Assuming the surgeon handles the tissues very carefully. Generally, we have athletes back at four weeks to six weeks to eight weeks.
It really just depends: are they a sweller or not? And what that means is that some people, when you do a very minor surgery, still swell a lot, and it takes them forever, it seems, to come back. And other people, you can do a pretty major procedure, and they just don't swell at all, and they're really ready to get back sooner than you think.
What we use is a sports test, meaning when can the athlete contract their muscles? When can they jump side-to-side? When can they control their landing so that they're safe to return to the sport they want to do? So, it's much better to use a performance test than a specific timeline for each of the injuries that we repair.
Bobby Krivitsky: This next question, it's unfair. I recognize that. But given your expertise on the subject, I figured I'd ask you. Since the location of a meniscus injury is crucial, knowing that it was a partial tear, the procedure he had, and his general recovery timeline. Is that enough information for you to feel confident guessing the location of his injury?
Dr. Stone: No, you don't really know. The most common tear in the meniscus is in that back corner. Unfortunately, that's also the most important part of the meniscus for shock absorption and protection of the joint.
But we see so many athletes who tear those and so many athletes who need to have a quick recovery that I would expect he'd be back full bore without limitation. And then we'll see him later on in life, when then, he's talking to him, and we'll put back a new meniscus is the common story.
Bobby Krivitsky: Generally, when it is located in the back corner, what does the athlete look like upon returning to play?
Dr. Stone: Full full bore. They really -- as long as they train properly and rehab properly, which I'm sure he would do. What we try to do is teach athletes to use their injury as an opportunity. And the opportunity is to come back fitter, faster, and stronger -- as we like to say -- than you were before you got hurt.
You're going to have a little downtime and might as well use that downtime to train the parts of your body that you hadn't spent as much time on. And whether that's your core, your back, or your flexibility, or relatively protecting the knee while we're pushing the rest of the body hard. That's a great way to look at these injuries: that look, everybody gets injured, the best athletes come back better after that injury.
Bobby Krivitsky: That's certainly an important lesson for both Brown and Tatum to apply as they rehab here and embark on these roads to recovery.
In researching this surgery, it said this procedure is most commonly performed to help reduce the symptoms of arthritis. If Brown has arthritis in his knee, how concerning is that for his career and for a player who's known for his explosive athleticism?
Dr. Stone: Yeah, so it really depends on the degree of arthritis. So, a little bit of cartilage fraying is very mild, but sometimes it's still labeled as arthritis. When it becomes more where the bearing surface of the joint, the articular cartilage surface, that white, shiny surface when you crack open a chicken leg, that's articular cartilage.
When that bearing surface wears off and gets down to the bone -- that's a more severe arthritis that limits athletes' careers and eventually ends them. Eventually, they end up back in our clinic to have either a cartilage grafting procedure, where we regrow that cartilage, or eventually, sometimes, they'll have a partial replacement procedure where we put in a metal cap and a plastic tray.
So, in any case, as long as the arthritis is not too bad, then these days, we're treating almost everybody with mild forms of arthritis, and even more severe ones, with injections of PRP and hyaluronic acid, and sometimes some other cells and growth factors in order to accelerate their return and to protect the joint surface, hopefully, delaying the time in which they ever get arthritis, or minimizing the symptoms.
Bobby Krivitsky: Lastly, Dr. Stone, is there anything we didn't discuss about this that is important to cover?
Dr. Stone: Yeah, it's just that people should understand that these injuries have a very wide range of presentation, and you should always try to figure out what the bias of your surgeon is. We are very biased towards making an early and accurate diagnosis with an MRI, an X-ray, and a physical exam and repairing torn tissues that are critical for the knee in the long term.
So, know that the techniques have gotten really good. We've gotten quite good at regrowing articular cartilage. We've gotten quite good at replacing meniscus cartilage and repairing them when they're torn. So, being pretty aggressive about saving the critical tissues in your knee permits you to play forever, as I like to say. Our goal is to have you drop dead at age 100, still playing some sport.