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Thursday, September 13, 2007

Portland's Worst Fears Confirmed: Greg Oden Has Microfracture Surgery

The nightmare scenario involving the ghosts of Bill Walton and Sam Bowie has indeed happened: Greg Oden's exploratory knee surgery revealed further damage that required him to have microfracture surgery. Based on the recovery and rehabilitation time that is typically involved with this procedure, Oden will likely miss the entire 2007-08 season.

The Portland Trail Blazers issued a statement that read, in part:

Greg had an arthroscopy and a micro fracture surgery today," said team physician Dr. Don Roberts, who preformed the surgery. "He was found to have articular cartilage damage in his right knee. The area of injury was not large and we were able to treat it with micro fracture, which stimulates the growth of cartilage. There are things about this that are positive for Greg. First of all he is young. The area where the damage was is small and the rest of his knee looked normal. All those are good signs for a complete recovery from micro fracture surgery.

As I explained in two previous posts about microfracture surgery (which can be found here and here), "the surgeon actually punctures (fractures/breaks) the patient's kneecap, with the idea being that this will stimulate the development of scar tissue that will replace the damaged, non-functioning cartilage." Except for Jason Kidd and Amare Stoudemire, most of the players that I know of who have had this procedure do not perform as well afterwards as they did previously but, as Oden's surgeon suggested, Oden's youth and the relatively small nature of his injury work in his favor; many of the players who did not fare so well after having microfracture surgery were older athletes who had sustained more severe knee injuries and whose knees already had undergone a lot of wear and tear.

Still, there is no getting around that this is a devastating blow to Oden and Portland and that Oden has a lot of rehabilitation work ahead of him before he can be a productive NBA player. If Oden is not able to play this season then he will become just the second number one overall pick since 1966 to not play in the NBA in the year that he was selected; in 1987, David Robinson did not join the San Antonio Spurs because he had to fulfill his commitment to the Navy. However, there have been several number one overall picks whose rookie seasons were impacted in some way by injuries, including future All-Stars Bob Lanier, Doug Collins and Bill Walton. Lanier actually did not miss a game during his first season but he was playing hurt and he told me, "In hindsight, what we should have done--if I had had any sense and if there was some sophistication with the powers that be way back then in Detroit--is have me sit out the first half of the season, at least, and just worked on getting my knee right, getting the swelling down, strengthening it up. But rehab wasn’t as sophisticated then and there was so much pressure to get Bob Lanier out there playing--even on one knee--because I was a No. 1 draft choice and because Detroit was a fledgling team. I think, consequently, because of that I had so many problems with my knees over the years because I started out my career that way as opposed to really getting myself together." Hopefully, Oden's microfracture procedure and rehabilitation will be 100% successful and in 2008-09 he will make a return like Stoudemire did in 2006-07.

posted by David Friedman @ 4:32 PM



At Thursday, September 13, 2007 11:35:00 PM, Blogger madnice said...

I looked forward to seeing him play this year. This microfracture surgery is a silent killer for NBA players.

At Friday, September 14, 2007 1:31:00 AM, Blogger David Friedman said...

The surgery is not really to blame. Anyone who has a knee injury severe enough to require this procedure is not going to be able to play effectively until his knee is fixed--and a cartilage tear is not something that heals on its own.

I've seen some people asking today "What did people do before there was microfracture surgery?" The answer to that is obvious: they either played at half speed as long as they could tolerate the pain (and hold on to a roster spot) or they retired. Look at the average age when players retired in the past versus today. It used to be that any kind of knee injury was a potential career ender but nowadays doctors can go in and rebuild the whole joint even if you blow out every ligament. I think that what will happen over time is that through trial and error we will learn the best ways to rehab after these injuries. I've interviewed a lot of players from the 70s and the philosophy back then after knee surgery was to take it easy; now we know that after ligament surgery it is important to vigorously rehab as soon as possible (thank you, Bernard King). Microfracture surgery is different, though, and the real aggressive rehab too early seems to backfire. Eventually, the correct balance will be found.

At Friday, September 14, 2007 1:57:00 AM, Blogger vednam said...

I am very sad to hear of Oden's surgery. I sorely miss the traditional back-to-the-basket center in today's game, and was hoping Oden would bring that back.

I too am interested in "what people did before microfracture surgery". Your comment provides some answers, but going even further, I was wondering: which basketball players over the last several decades had injuries that would today be treated by microfracture surgery? Surely there must be a long list, looking at how many players have required the treatment in recent years.

At Friday, September 14, 2007 7:16:00 AM, Blogger David Friedman said...

It would be impossible to construct a list of microfracture surgery candidates from previous eras without really knowing the details of their knee injuries. My understanding is that if a player has a certain kind of cartilage injury then "regular" surgery is called for and if he has a different kind of cartilage injury and/or other structural damage to the knee than microfracture surgery is less likely to be helpful.

I wonder if Elgin Baylor would have been a microfracture surgery candidate at some point in his career if that option had been available. He had a serious cartilage injury, among other knee problems. Doctors thought that he might not walk normally again, let alone play, but he returned to play several more seasons, albeit not at his previous level.

At Saturday, September 15, 2007 6:59:00 PM, Anonymous Anonymous said...

anymous reggie

they should of took durant, this guy is very injury prone he's not going to play long. and your never the same after haveing this. who said he was a hall of fame type center he would be great defensively thats another walton and bowie.

At Sunday, September 16, 2007 12:48:00 AM, Blogger David Friedman said...

We still have not seen Durant play even one minute of regular season NBA action so who knows whether or not he will turn out to be the best player in this year's draft?

Amare had microfracture surgery and was an All-NBA player this year so it is still quite possible that Oden will reach his full potential (or at least get very close to it).

Kidd is an older point guard who had microfracture surgery and is still one of the best players in the league, as he showed once again in the FIBA Americas tournament.

At Sunday, September 16, 2007 2:43:00 AM, Blogger vednam said...

I also had Baylor in mind. It's stunning how well Baylor continued to play while dealing with all of his injuries.

At Sunday, September 16, 2007 12:56:00 PM, Anonymous Anonymous said...

Bill Nelson, quarterback of the Cleveland Browns in the 1960s, actually played without any cartilage in either knee.

I grew up a Bob Lanier fan, haunted by what might have been had he possessed two sound knees. Later he also lost some of his shooting touch because they did a "quick and dirty" procedure on his hand. Bottom line, Greg Oden absolutely must put his health first. Rushing back doesn't benefit him or the team.


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