Category Archives: Knee

Dustin Pedroia Regrets Knee Surgery

In October of 2017, Dustin Pedroia of the Boston Red Sox had surgery for a cartilage defect in his left knee.  He was expected to return a few months into the 2018 season, but he only played a few games in the middle of the season. In recent reports Pedroia has stated that he wishes he had not chosen to have the procedure.

“No, I wouldn’t have done it,” Pedroia said. “I don’t regret doing it, but looking back and knowing what I know now, I wouldn’t have done it.”

“It’s a complicated surgery,” he added. “The cartilage in my knee is great now, but the graft is the thing. You’re putting somebody else’s bone in your body. To get that to incorporate fully, there are so many things that, going into it, I didn’t know all that stuff. I thought, ‘They were like, you tore this, we can fix it. Great.’”

This got Sports Injury Blog’s attention for several reasons. First, reports of injured athletes almost never discuss decision making. Surgery is nearly always portrayed as necessary, when in many cases it is optional.  

Second, all cartilage restoration procedures are debatable. Surgeons still haven’t fully worked out the risks and benefits. They are probably best considered experimental at this stage. Many of the treatments that professional athletes try are unproved, but that is almost never discussed in media reports. Each of us benefits from knowing the limits of modern medicine and the status of current best evidence.  

Finally, we almost never hear about the decision-making process: how athletes make choices about surgery and other treatment.  And we nearly never hear about misgivings, limited understanding, and perhaps false hope. This is an inherent part of the human illness experience. The silence on these issues among injured athletes feels somewhat dehumanizing; as if they are immune to uncertainty, limited health literacy, bias, false hope, and regret.  

Kudos to Dustin Pedroia for his openness about these often neglected aspects of the illness experience. Everyone stands to benefit from his reflections on his ongoing health journey.

UPDATE: Pedroia returned to action off of the injured list on April 9th. On Wednesday, Pedroia said he “felt a pop” in his surgically repaired knee while swinging, twisting during an at bat. The at bat was Pedroia’s first of the game in a 5-3 loss to the Yankees.

The second baseman was later placed on the 10-day injured list, but reports indicate he received positive news about his knee. Remarkably, he did not have an MRI. It is reported that the Red Sox expect Pedroia back on the field soon. Pedroia has only appeared in six games this season while recovering from the initial knee injury.

 

 

Omri Casspi Torn Meniscus

Starting January 26th, Memphis Grizzlies’ forward Omri Casspi missed three consecutive games for right knee pain. An MRI was performed on February 1st leading to a diagnosis of a meniscus tear. He chose operative treatment. The expected time to return to play is 6 weeks. In surgery, the torn part of the meniscus is usually removed.

The meniscus is a cushion between the femur (thigh bone) and tibia (leg bone). The meniscus changes with age and arthritis. It can also be injured, usually with a forceful twist. Pain from meniscus injuries usually resolves without surgery, but it can take many months. Sometimes a piece of the meniscus moves into an unhelpful position and surgery can be helpful.

When the meniscus is excised, the small arthroscopy scars only need a few weeks to heal. After that, players can return as soon as their knee is comfortable and mobile enough to be effective.

Victor Oladipo Knee Injury

On Wednesday, January 23rd, the Indiana Pacers’ starting shooting guard Victor Oladipo injured his right knee late in the second quarter of a game vs the Toronto Raptors.  The injury occurred when Oladipo planted his right foot while running after the Raptors’ Pascal Siakam on a fast break.  Oladipo had to be carted off.

He had ruptured his quadriceps tendon.  The quadriceps is the large muscle in the front of the thigh.  It straightens the knee.  The quadriceps tendon attaches the muscle to the knee cap (patella).  The patellar tendon attaches the patella to the lower leg (tibia).

Quadriceps rupture is fairly obvious on examination.  The ubiquitous “athlete MRI” that seems to be obtained routinely and largely unhelpfully can be useful in this circumstance to plan surgery.  A completely ruptured quad tendon prevents an individual from straightening the knee.  Without surgery, it would be difficult to walk let alone play basketball. This injury is ready to take force after about 6 months, but it will take a while to strengthen the muscle and get back into game shape.  Oladipo may be ready to play by the beginning of next season.  Former San Antonio Spurs starting point guard Tony Parker also ruptured his quadriceps tendon in early May 2017 during the NBA Playoffs.  He received surgery two days after the injury and returned to play six-and-a-half months later.

It is worth noting that Oladipo has missed nearly a dozen games this season due to an undisclosed right knee problem.  A normal quadriceps tendon is unlikely to rupture, so that problem may have been quadriceps tendinopathy.  Quadriceps tendon ruptures generally occur in people over age 40, with most cases occurring in people in the 50-60 age range.  Quadriceps rupture is very rare among NBA players, and 26-year-old Oladipo is relatively young for this injury.  Charles Barkley and Tony Parker both sustained the injury later in their careers at age 36 and 34, respectively.