WebMD Health News
Louise Chang, MD
April 16, 2008 -- Golfer Tiger Woods had arthroscopic knee surgery on his
left knee yesterday to correct cartilage damage. The surgery was successful,
and Woods is expected to return to competition in four to six weeks, according
to Woods' web site.
"I made the decision to deal with the pain and schedule the surgery
for after the Masters," Woods says on his web site, which notes that he had
been having knee pain since the middle of last year.
This is the third time that Woods has had surgery on his left knee. In 1994,
doctors removed a benign tumor from that knee, and in 2002, Woods got
arthroscopic surgery in that knee, according to his web site.
WebMD spoke with Allan Mishra, MD, about arthroscopic knee surgery, the
rehabilitation process, and how golf and other sports affect the knees. Mishra
is a clinical assistant professor of orthopaedic surgery at Stanford University
Medical Center and spokesman for the American Association of Orthopaedic
Surgeons. Mishra isn't familiar with the details of Woods' diagnosis or
I think the easiest way to say it is it's a minimally invasive procedure
that can be done to affect significant changes within the knee. So if you had a
torn piece of cartilage, you would remove or partially resect that, possibly
repair it. [Woods] may have also had something called chondroplasty that's like
a smoothing of the cartilage. I don't know what Tiger had.
Right. We don't know what that means. It could be either the surface or the
[Right-handed golfers] pivot on your left knee with a golf swing, so
it's not surprising that it's his left knee vs. his right knee. We've all seen
Tiger and he puts an incredible amount of torque around his body, and he's
pivoting on his meniscus, on his knee. I'm just speculating, but that may be
part of what's happening.
I'm not a golf swing coach. He's got the world's best golf swing; how am I
going to criticize Tiger Woods' golf swing? That's impossible. But maybe he's
putting too much torque around his knee.
He's a very powerful golfer, and I think it's a testimony to Tiger's
toughness that he was able to finish second in the Masters and then two days
later have surgery. Just as a golf fan, I'm impressed.
He's in phenomenal shape, and I think that also was part of the reason why
he was able to overcome that. Can you imagine yourself finishing second in a
major golf tournament knowing you needed surgery? He's just physically and
mentally amazingly tough.
Since I don't know what he had, I don't know what they're going to do. There
are about eight to 10 different things they can do inside in a knee
My guess is that he had something called a meniscectomy and chondroplasty.
If that's what he had, and that's a big if, he would likely progress to what
are called isometric knee exercises, try to reduce swelling, keep the leg iced
and elevated over the first week or so. And then likely begin working on an exercise bike with limited tension
and then progress to more weight-bearing and more loading over the course of
the next three or four weeks.
I don't know Tiger, but my guess is that his goal is to get back for the
U.S. Open at Torrey Pines in San Diego in mid-June, which is about six weeks or
eight weeks away. And if he had what we're speculating he had, he should be
able to be back for that.
We've seen with all types of athletes, however, that the rehab processes
depend upon what happened yesterday in the OR. So the only two people who
really know that are his surgeon and Tiger.
We all know Tiger. This is more as a golf fan -- he'll probably do
anything he can to be ready for the U.S. Open. And I'll make a bet -- he'll be
better. His physical conditioning prior to the surgery was spectacular. He's
going to rehab a lot faster than most of us. Elite athletes simply just do
There's a spectrum of injuries that can occur.
If you have mild pain without a lot of swelling, you can see how that goes
over a week or two, talk to your primary care doctor, maybe do some physical
therapy. But the concerning things that lead to surgery are persistent
swelling, persistent clicking, catching, locking, or sensation of instability
in your knee.
The best ways to avoid injuries to your knee is to maintain excellent
strength and flexibility -- stretching exercises
for your hamstrings, your Achilles [tendon], your quads. ... The use of an
exercise bike is a phenomenal way to strengthen your knee without impacting it.
I do this myself three or four times a week -- I will either ride a regular
bike or an exercise bike to maintain strength and fitness around my knees. And
I've taken hundreds, if not thousands, of my own patients through an exercise
bike program that I think is very valuable for maintaining that.
Soccer and skiing knee injuries are often traumatic -- you fall, you get
taken out by a slide take. Those are usually more severe.
Overuse injuries can be made better or prevented by flexibility and proper
training. ... Figure out how to maintain the flexibility of the tendons around
your knee but also change your training. Don't run in the hills five days a
week. Run on a treadmill or try to bike every other day vs. running five straight
Women's knees -- there's sort of an epidemic of injuries in women,
especially who play things like volleyball and basketball and soccer. I've
operated on more young women in the last five years because of soccer injuries
probably than almost anything else.
It's not 100% clear why. It may be more women participating at higher level
sports. It may be anatomically where their ligaments are in the knee or it
could actually even be hormone-related. People are trying their best to figure
out how to stabilize women's knees better in a preventive fashion, so they're
teaching balance and coordination preseason. There's a lot of time and effort
going into trying to better understand that question. I don't think we have a
great answer right now.
What we do have is a lot more active women, which, ironically, I'll say is
better because the more active women are, especially at a younger age, the
better they're going to build their bone. Weight-bearing or load-bearing
exercises, especially for women from their teens to probably their early
30s, is crucial for building that bone mass for later on. So I wouldn't want
them to be less active. I'd like us to figure out how to prevent them from
SOURCES:Associated Press.Tigerwoods.com.Allan Mishra, MD, clinical assistant professor of orthopaedic surgery,
Stanford University Medical Center; spokesman, American Academy of Orthopaedic
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