Boston Mayor Tom Menino Undergoes Emergency Surgery

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Boston Mayor Tom Menino underwent surgery Monday to repair a torn tendon in his knee. The mayor “missed a step” on Sunday while at his son’s home in Hyde Park. Menino’s orthopedic surgery, Dr. Thomas Thornhill, said the tendon connecting Menino’s thigh muscles to the top of his kneecap was completely torn away. To make the repair, Thornhill drilled holes in Menino’s kneecap and used wire to stitch the tendon back in place. The mayor is expected to be released from Brigham and Women’s Hospital on Thursday, and will require crutches for several weeks.

The knee is essentially a modified hinge joint located where the end of the thigh bone (femur) meets the top of the shin bone(tibia). The patella (kneecap) rides over the joint and is attached by the patella tendon.

The patellar tendon attaches to the front of the tibial below the knee, and is connected to the bottom of the patella. The top of the patella is attached by the quadriceps tendon to the quadriceps muscle, the large group of muscles on the front of the thigh. This structure allows the knee to flex and extend, is critical to basic functions of the leg, such as walking, standing, and running.

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When a tear or rupture of the patellar tendon occurs, the patella loses support from the tibia and moves toward the hip when the quadriceps muscle contracts, hindering the leg’s ability to extend. This means that those affected cannot stand, as the knee buckles and gives way when an attempt is made. Treatment is surgical, reattaching the tendon to the kneecap.

Mark Boguski, M.D., Ph.D. is on the faculty of Harvard Medical School and is a member of the Society for Participatory Medicine, "a movement in which networked patients shift from being mere passengers to responsible drivers of their health" and in which professional health care providers encourage "empowered patients" and value them as full partners in managing their health and wellness.

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