RICE & MICE: Loose bodies in the knee

Chris Pronger had some “loose bodies” removed from his right knee on July 27, 2010, and he missed the first two games of the season and didn’t return to the lineup until October 11.

Pronger had surgery on Tuesday, November 29, 2011 to clear out more “loose bodies” from his left knee and is projected to be out of the lineup for 4 weeks.

The left knee was supposedly in better shape than the right knee; however it remains to be seen if the recovery time for the left knee will be less than half of what was needed for the right knee to return to playing shape.

Pronger had been battling a “virus” and had missed a few games, when they decided to have an MRI done that revealed the loose bodies. When Flyers GM Paul Holmgren was questioned on whether Pronger’s age was catching up with him, he responded: “Chris is a player who takes good care of himself, does the proper rehabilitation and conditioning to stay in top shape. I think this time, the only thing we can do is go by what the doctor tells us.”

He also called the surgery a maintenance procedure and said that the doctors said the knee was fine structurally and that the cartilage was fine.

Loose bodies of the knee can consist of a piece of torn cartilage or a bone fragment. Trauma to the knee can cause a fragment of cartilage, or a fragment of bone attached to cartilage, to come loose and float around the joint. Loose bodies may result from “osteochondritis dissecans” (OCD). OCD is a rare condition in which cracks form in the cartilage and the bone underneath it, causing loss of blood flow and death of the bone (avascular necrosis). Avascular necrosis was what affected Ray Emery’s hip and caused him to require surgery that kept him out of hockey for a year.

Loose bodies can “float” around in the knee joint and cause significant pain, swelling, and possible a locking of the knee. Swelling in the knee joint can promote instability of the joint and predispose the knee to further injury. If the loose body consists of bone, it can be seen on X-ray, however if it is only cartilage, an MRI is required in order to detect it.

A loose body should be removed surgically as soon as it is detected, since leaving it in the joint can cause further damage to cartilage. In many instances there may be several fragments in the knee.  If there is no cartilage damage and there are no other issues at the time of the surgery to remove the loose body, the symptoms will resolve within days after the surgery.