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On the Medical Watch, going inside the knee to see what happened in the devastating injury for Chicago Bears tight end Zach Miller. Viewers watched in horror as his knee seemed to twist in such an unnatural way.

Dr Jason Koh, an orthopedic surgeon at NorthShore University HealthSystem, says it only took an instant the entire leg was in jeopardy.

“The real concern is whether or not he’s going to be able to save his leg, not only just his return to sports,” Dr. Koh says.

What happened in Sunday’s game is extremely rare . A dislocated knee examined more thoroughly showed an even more severe injury.
The popliteal artery runs behind the knee and provides the main blood supply to the lower leg. In Miller’s case, it was torn. Without circulation, the muscle can’t live.

“He may have lost the pulses in his foot and so that’s why when this gets damaged you need to do an emergency surgery to restore circulation,” Dr. Koh says.

Vascular surgeons performed a graft procedure taking a segment of vein from his opposite leg, using it to repair the torn artery.

“They are going to be watching him very closely over the next several days to make sure the graft does not clot off so he is going to be under close observation.”
Looking ahead, Dr Koh says Miller will need more surgery to repair extensive ligament damage, but as scar tissue builds, doctors still have to wait for the vascular intervention to heal.

“They can’t move the knee in order to do the reconstruction. It’s likely that when this occurred the lateral collateral ligament, anterior cruciate ligament and posterior cruciate ligament all tore,” Dr Kho says. “The other part that we don’t know about yet is there’s actually a nerve running around here, the peroneal nerve, and that actually controls the ability of the foot to move up and down. Given the kind of injury where all this happened, there’s a high likelihood there may be some injury to that as well.”

“It’s very uncommon. Where I’ve seen it is in patients in high speed motor vehicle accidents or falls from a height like a construction worker.”
It is an accident like former Chicago Bull Jay Williams suffered when he lost control of his motorcycle. The knee was completely dislocated. He ultimately suffered nerve damage.

High school football player Jacob Rainey suffered a similar injury, with a vascular tear. He lost his leg from the knee down.

Miller will have to be stabilized so the graft has a chance to heal. Doctors should be able to gauge the success and blood flow to the leg within a few days. Total rehab will take much longer and doctors cannot promise or predict whether he will be able to play again.