Jenny Moshak, the Lady Vols chief of sports medicine, had treated Kelley Cain throughout the season after the screws began to migrate out of the bone. Cain took at least five major blows to the knee in games and practice that left her compromised on the court because of the pain. Each shot to the knee caused the loose screws to reverberate in the bone and ignite the nerve endings.
The fact the screws were moving was actually a good sign – it meant the knee had healed and the body was rejecting the hardware. But it made for a difficult four months for Cain as she and Moshak managed the pain and awaited the end of the season.
"Drs. Greg Mathien and Russell Betcher, UT team orthopedists, performed surgery on Kelley's right knee this morning," Moshak said in a release from Tennessee on Friday. "The surgery removed the screws placed in her knee when she had a Fulkerson procedure performed on Dec. 11, 2007. Additionally, the knee joint was diagnostically evaluated via arthroscope."
Cain will be on crutches for six weeks as the holes in her bone heal. The surgery in December of 2007 realigned her right kneecap – it was congenitally tilted and tended to slip out of its groove – in a three-part procedure that involved a lateral release, plication process and Fulkerson procedure.
A lateral release means literally releasing the patella, or kneecap. The fibrous supports on the outer side of the patella are cut so that the kneecap can be placed in a better position. The plication process is done next and involves the inner side of the kneecap. The inner supports are stitched – actually tucks are made similar to pleats – to tighten them. This helps to pull the kneecap into the proper position toward the center of the knee structure and eliminate the tilt.
The Fulkerson procedure is the final step in the process. The tibial tubercle (a bony bump just below the kneecap) is cut and moved to improve the extensor mechanism, which is a primary function of the kneecap – to help the knee extend. This procedure alleviates pressure on the kneecap.
The surgery changed the biomechanics of Cain's knee. By moving the extensor mechanism her knee could now track properly and not continue to undergo subluxations.
Cain missed the 2007-08 season and endured a lengthy rehab as she basically learned to use a new knee – she described it last fall as learning to walk again. Cain came through that process well, only to have the screws from the surgery begin to migrate out of her knee.
That made Friday's surgery necessary, and she will begin rehab right away, although it will be limited as the bone heals.
"We will begin working with her immediately while also being mindful that Kelley will have six weeks of non-impact activity with her knee," Moshak said.
Cain, a redshirt freshman from Atlanta, had some stellar performances for the Lady Vols this season despite the knee issues. She played in 27 games and averaged 8.2 points, 5.3 rebounds and 1.8 blocks per game and shot 61.8 percent. She made her first career start in mid-February, and her numbers jumped to 11.3 points, 6.6 rebounds and 2.0 blocks per game with a 71.8 percent marksmanship.
"She's good in rehab and to be here this summer with Jenny will be tremendous," Summitt said. "First is to have a successful rehab and then when she's ready start working her out. I'm sure she'll get in and work with Jenny and then she'll need to spend quality time with Heather (Mason)."