JJ McCarthy to undergo knee surgery - out for 2024

If you’re a Vikings fan, which I’d assume most readers are, you probably hate knees. Knees have a primary function of destroying your favorite sports team, especially in Minnesota. From Daunte Culpepper to Teddy Bridgewater, a bad knee injury takes something exciting and turns it into a mess of anxiety and unanswerable questions.

Here we are again. The beacon of hope for the Vikings future is undone by a complicated string of cartilage in his leg. sh*t.

J.J. McCarthy is set to undergo surgery for a torn meniscus suffered in his very first preseason game. The extent of this surgery will affect McCarthy’s recovery timeline and the long-term effects of the injury. It’s a question we won’t have the answer to until McCarthy goes under the knife, and even then, we’ll only know what the team decides to tell reporters. So, let’s learn about our options.

I’m not a doctor, I’m only an idiot that recently figured out how to read. But thankfully for idiots like me, actual doctors have written about the basics of the topic. I don’t want to have to read medical journals, you don’t want to have to read medical journals, but here we are. Now, this (primarily) sports newsletter has to dip into biology. Don’t blame me; blame God.

What The Absolute F*ck Is A Meniscus?

Seriously, what is this thing? Why is a tiny little tear enough to blow up my favorite team’s prospects for months and kill my fantasy team? Why are knees so delicate in the first place?

Without a meniscus, your femur and your tibia would grind against each other and wear each other down. The meniscus is a tough, rubbery piece of cartilage tissue that pads the two bones. When writing about this exact god damn sh*t a few years ago, I learned to think of it like a brake pad.



In some extreme cases, patients can experience an injury that leaves little to no tissue in their meniscus. If untreated, simply walking or adjusting your leg would be immensely painful. Your knee would swell up and become extra sensitive. Your meniscus is important.

The meniscus is not a load-bearing ligament like the more common knee injuries you’ll see in the NFL. Some players can play on a hurt meniscus like Adrian Peterson famously tried to in his final year as a Viking. Without the proper ligaments, you lose stability and strength, and athletics become impossible. With a meniscus injury, it becomes painful.

Pain, however, turns to stiffness. Inflammation reduces flexibility, which we refer to as arthritis. In these extreme cases, that arthritis would be debilitating. An untreated meniscus tear will only get worse over time as the structural integrity of the cartilage continues to degrade. To fix it, they have to cut into that thing and dig around.

What The F*ck Happened Then?

McCarthy’s meniscus could have torn in any number of moments during Minnesota’s preseason opener against the Raiders. The way cleats grip turf, one wrong rotation can start a small problem and cause some soreness.

But not all meniscus tears are the same. We have to define a bunch of different kinds of this sh*t. What’s worse, nobody can know which kind McCarthy has until they open up his knee - and even then, they probably won’t tell us.





Here are four different common kinds of tears - a bucket handle tear (top left, Fig. 1), a flap tear (top right, Fig. 2), a radial tear (bottom left, Fig. 3), and a degenerative tear (bottom right, Fig. 4).

Radial tears are the most common, and they happen on the inner ring of the meniscus. These are bad news because that part of the meniscus doesn’t get a lot of blood flow. The outer part of the meniscus has more vascularity, meaning it gets more blood flow and can heal on its own. For that reason, some meniscus tear patients just need to wear a knee brace for a while.

That high-vascularity region of the meniscus is called the red zone. Further inside, where there is little to no blood flow, is called the white zone. White zone tears won’t heal on their own and require surgery.



If McCarthy had a tear in the red or red-white zone, he may not need surgery at all. The fact that the Vikings already intend to put McCarthy under the knife implies a white zone tear.

What Kind Of Bullsh*t Do We Have To Do Now?

There are two common surgical procedures for meniscus tear patients. Kevin O’Connell referred to these in his press conference announcing the news. Which procedure McCarthy receives depends on the location and extent of the tear.

The more common procedure is a meniscectomy. That means cutting out the damaged part of the meniscus to prevent that damage from spreading further. You’ll hear that referred to more often as a “trim” and is a more minor surgery.

They literally cut that sh*t out with scissors and an arthroscopic camera. Arthroscopic surgery carries a much shorter recovery time. Most patients can put full weight on that leg right away after surgery and only need crutches for a week. For normal patients, they recommend a 4-8 week recovery timeline.

It also carries long-term effects. With a piece of meniscus missing, the rest of your meniscus experiences more stress. That puts you at a higher risk of arthritis down the road, especially with a high-stress athletic lifestyle.

If McCarthy’s tear is small, the trim might not be that big of a deal. It may not be worth missing his whole rookie season to save a few square millimeters of meniscus, and O’Connell has indicated that the Vikings are prioritizing long-term health over a shorter return to play. If there’s any discomfort with the long-term risks, they’ll go for a full repair.

The repair is a more invasive procedure. Instead of cutting out damaged cartilage, the surgeon will use sutures to stitch the meniscus back together. After the surgery, it’s critical to keep the meniscus stabilized while that low-vascularity tissue heals at a snail’s pace. That typically means six to eight weeks in a knee brace and a 6-9 month recovery timeline.

The repair isn’t always possible. If the meniscus tear is large enough and in the white zone, sutures might not get the job done, and the trim will be the only option. Considering that McCarthy finished his part of the preseason game with his injury already sustained, I’m holding out hope that it’s not that severe.

There’s a third, more extreme option called a total meniscectomy. That’s for patients with such a f*cked up meniscus that they have to remove the thing entirely and replace it with one from a cadaver. That’s invasive open surgery that comes up in, for example, older patients with degenerative damage.

I Didn’t Want To Read All That Medical Sh*t, So I Scrolled Down To This Part

The dissatisfying conclusion is that as of this writing, we can’t know just how bad McCarthy’s injury is. Maybe he’ll only be out four weeks if it’s minor, or maybe he’ll have to miss his entire rookie season. They can’t know until they get an arthroscopic camera in there and assess the damage.

The location of the tear and the extent of the damage will determine their position. If there is any risk at all of long-term complications, I would hope they lean toward the repair. It means we have to wait longer to see J.J. McCarthy, but unless you are an infant incapable of perceiving time more than six months into the future, you should be fine with that trade-off to secure McCarthy’s long-term health.

Sorry to Arif’s infant readers, I didn’t mean to offend you. I’ll learn from this and be better in the future.

Ed Note: He won’t.