-- President Clinton is expected to recover fully from knee
surgery, although he will need a brace and crutches for several
weeks, and he'll have to undergo careful rehabilitation.
50-year-old Clinton caught his heel on a step at the Florida
estate of Australian golfer Greg Norman early Friday, tearing
the quadriceps tendon connecting the kneecap to the muscle of
the upper thigh in his right leg.
injury is common, especially in sports, and about 7,000 people
a year in the United States are hospitalized by it.
who examined the president say more than 50 percent of his tendon
was torn, but it was not completely severed.
heard a very loud pop'
major muscles that descend from the thigh come together at the
quadriceps tendon, which connects to the kneecap then extends
below that to the top of the lower leg.
function of the muscles and tendon is to straighten out the
leg with each stride, and they are essential to normal walking
or jogging. When going down steps, as the president was doing,
the muscles may be subjected to force equivalent to three times
a person's body weight, doctors say.
Clinton stumbled, the sudden muscle contraction as he tried
to catch himself likely overloaded the tendon. "He heard
a very loud pop," one aide said.
time can vary
said the surgery to repair such a tendon tear is common and
good surgeon can do the job in just a half hour or so,"
said Dr. Kenneth Fine, director of the George Washington University
sports medicine center. "It is not very complicated."
number of sutures allow it to heal," orthopedic surgeon
Dr. Drew Miller added. In the president's case, the surgery
lasted two hours.
had a "regional" anesthetic that numbed him approximately
from the mid-section down, so that he was never rendered unconscious,
White House spokesman Mike McCurry said. Doctors said he was
alert most of the time.
tendon is repaired by drilling holes into the top of the kneecap
and attaching the tendon to the bone with thread or wire anchored
in the holes. The leg is then put into a cast or brace to keep
it perfectly straight, to put the least amount of pressure on
injuries by the numbers
5 million people visit orthopedic surgeons in the United
States each year because of knee problems.
than 3 million of the visits are injury-related; the rest
are due to arthritis or other illnesses.
1.4 million people go to the hospital emergency room for
7,000 hospital visits are recorded each year for torn
quadriceps tendon, and 25 percent of those patients were
45-64 years of age.
1994, there were more than 300,000 knee procedures done
in the United States.
American Academy of Orthopedic Surgeons
should be out of the hospital in a few days and will be able
to get around using crutches and a knee brace. Rehabilitation
will begin with range-of-motion exercises.
exercises will be slowly added to gradually rebuild muscle strength.
Middle-age people typically recover fully, although in older
patients it is not uncommon for there to be a residual stiffness
in the knee.
could be 12 weeks before a person is back jogging again,"
Andrew Holtz contributed to this report.