The $400,000 Knee

There was relatively little wrong with Joseph William Namath, 21, when he checked into Manhattan's Lenox Hill Hospital last week. But there was a great deal more than usual riding on the routine surgery that was scheduled for repair of the torn cartilage in his right knee. By signing an unprecedented three-year contract with the poised and polished quarterback from the University of Alabama, the New York Jets had bet $400,000 that surgery was capable of undoing the damage done by football to one of the weakest and most vulnerable joints in the human body.

In an early October game against North Carolina State, Namath had rolled out on an option play and dropped suddenly as if poleaxed. No other player had even touched him. Under the strain of a sudden stop, his tensed knee had simply collapsed. First aid consisted of ice packs, and a couple of days later Alabama Surgeon Ernest C. Brock Jr. removed some fluid ("water on the knee") by inserting a hollow needle in the swollen joint.

In the Florida game two weeks later, Namath's knee collapsed again; then it went out a third time in late-December practice for the Orange Bowl game against Texas. Incredibly, Namath, his knee taped and padded, played brilliantly through most of the game.

Dye & Air. With his fat contract in the vault, Namath flew to New York for surgery. He had felt pain mainly around the back and outer side of his knee. But at Manhattan's Hospital for Special Surgery, X rays taken after air and dye had been injected into the joint showed that the main trouble was on the inside. The medial meniscus, one of the two pads of cartilage that lie between the thigh and shinbone (see diagram), was torn and rolled back in a tight wad. This explained why Namath had not been able to straighten his leg completely: just as a folded newspaper stuck between a door and its jamb will keep the door ajar, so the ball of cartilage kept Na-math's knee hinge from swinging all the way as he tried to extend his leg. The X rays showed no other damage--only a small cyst, of no importance.

Last week the Jets' surgeon, Orthopedist James A. Nicholas, made a diagonal incision on the inner side of the kneecap and exposed the joint. When he opened the joint, he found that the medial meniscus was not simply torn: it was shredded. But he had intended to cut out this whole piece of cartilage anyway, because if any part of a damaged meniscus remains in place it causes erosion of the bone and has to be removed in a later operation. The cyst came out with the meniscus.

There was no need to put anything in place of the removed meniscus; the knee would recover as the space filled up naturally with air and fluid. But in his examination of the joint, Dr. Nicholas found that a ligament had been pulled and stretched. To shorten and thereby tighten it, he doubled it back on itself and "plicated" (pleated) it with sutures. To be sure that there was nothing wrong with the outside of Namath's knee, where he had had pain, Dr. Nicholas made a second incision and took a careful look. It was in good shape.

Lifting the Leg. No less important than the actual surgical repair of Namath's knee will be the retraining of his muscles to make his right leg at least as strong as his left. Even as he first opened his eyes after coming out of the anesthesia, the 195-lb., 6-ft. 2-in. athlete found Dr. Nicholas holding his ankle and ordering him to raise his right leg. When he tried to do so, the effort was almost as painful as his original injury. But Namath gamely kept trying. No matter how much it hurts, he will have to repeat that exercise scores of times a day. Hundreds of times a day he will have to contract the big quadriceps muscle that runs down the front of the thigh, tying together the femur, kneecap and tibia. With knee bent and also extended, he will lift weights on his right foot. By July, if all goes well, he should be ready for practice, and for the rigors of professional football.

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