KoriEllis
09-16-2004, 01:35 PM
Kidd's knees prime concern in Blazers trade dialogue
Microfracture surgery helps a "super clot" to replace cartilage, but critics say the replacement tissue is not as durable
Thursday, September 16, 2004
GEOFFREY C. ARNOLD
www.oregonlive.com/sports...537320.xml (http://www.oregonlive.com/sports/oregonian/index.ssf?/base/sports/109533598537320.xml)
Jason Kidd's calling card, the ability to run a fast break at breathtaking speed, could be severely hampered by recent knee surgery.
The condition of Kidd's knee is a concern as the Portland Trail Blazers explore trade talks with the New Jersey Nets for the 31-year-old All-Star point guard.
The surgical procedure performed on Kidd's left knee July 1 is vastly different from the more common arthroscopic surgery. Microfracture surgery, as it is known, is more invasive, and some NBA players have experienced longer recovery periods, reduced quickness and lingering pain.
"You have to be really careful with this type of surgery," said Anfernee Hardaway, a New York Knicks guard who underwent the surgery in May 2000. "You really have to give the procedure a chance to work and for the knee to heal. If you don't, you're asking for trouble."
Kidd, Hardaway, Sacramento Kings forward Chris Webber, New York Knicks guard Allan Houston and Los Angeles Clippers guard Kerry Kittles are among NBA players who have had the surgery.
Microfracture surgery is prescribed primarily for knees that have cartilage damage, but not every doctor is convinced the procedure works.
"If the microfracture procedure worked, we'd never have to do knee replacement surgeries," said Dr. Paul D. Ruesch, an orthopedic surgeon at the Milwaukee Orthopedic and Sports Medicine clinic, who said he has performed the procedure. "The results were not that spectacular."
Ruesch said the man who pioneered the surgery more than 20 years ago, Dr. Richard Steadman, has achieved a higher success rate at his clinic in Vail, Colo.
The process involves putting multiple holes -- microfractures -- about three to four millimeters apart into the exposed bone inside the knee. Bone marrow cells and blood from the holes are supposed to combine to form a "super clot" that covers the damaged area. The clot eventually matures into firm repair tissue (sort of a scab), called fibrocartilage, that replaces the lost cartilage and serves as a cushion between bones.
The recovery time is usually about six months. But the recovery period can last longer depending on the location and size of the injury and whether another surgical procedure is performed at the same time, according to the Steadman-Hawkins Clinic.
Kidd could return to the court in December, according to published reports. Hardaway, one of the first NBA players to have the surgery, said it took a long time for him to develop confidence in his knee. He missed the 2000-01 season.
"I don't think six months was enough time for it to heal," Hardaway said. "I'm just now feeling like I'm getting back to where I was."
Microfracture surgery was performed on Webber's knee in June 2003. A 6-foot-10, 245-pound power forward, Webber returned to the court nine months later with little ability to push off the knee. He appeared in 23 games for the Kings.
Jamal Mashburn had the surgery in November 2003, keeping him from playing in the New Orleans Hornets' first 44 games. He played 19 games in January but return to the sideline complaining of knee pain. Hornets officials have said they aren't sure if Mashburn will be healthy in time for their 2004 training camp, Oct. 1.
Ruesch said he's not surprised some players experience discomfort long after the surgery.
"The replacement fibrous tissue -- it's basically scar tissue -- isn't the same or as strong as the original cartilage you were born with," Ruesch said. "The new tissue will fall apart much faster, causing pain and swelling."
What seems apparent is the procedure seems to take some of the explosiveness and quickness away from players, particularly after the initial recovery period.
Houston, another player mentioned in Blazers trade talks, missed 32 games last season with ailing knees after undergoing microfracture surgery in summer 2003. Houston has said he still needs more strength in his left knee, which wore down due to compensation from an earlier surgery on his right knee.
Considering the constant pressure Kidd applies to his knees during a game, a December return could be optimistic. Even if he does return, there will be questions about whether he can perform at his usual level.
"You can never, ever replace the ligament once you lose it," Ruesch said. "It will have an effect."
Microfracture surgery helps a "super clot" to replace cartilage, but critics say the replacement tissue is not as durable
Thursday, September 16, 2004
GEOFFREY C. ARNOLD
www.oregonlive.com/sports...537320.xml (http://www.oregonlive.com/sports/oregonian/index.ssf?/base/sports/109533598537320.xml)
Jason Kidd's calling card, the ability to run a fast break at breathtaking speed, could be severely hampered by recent knee surgery.
The condition of Kidd's knee is a concern as the Portland Trail Blazers explore trade talks with the New Jersey Nets for the 31-year-old All-Star point guard.
The surgical procedure performed on Kidd's left knee July 1 is vastly different from the more common arthroscopic surgery. Microfracture surgery, as it is known, is more invasive, and some NBA players have experienced longer recovery periods, reduced quickness and lingering pain.
"You have to be really careful with this type of surgery," said Anfernee Hardaway, a New York Knicks guard who underwent the surgery in May 2000. "You really have to give the procedure a chance to work and for the knee to heal. If you don't, you're asking for trouble."
Kidd, Hardaway, Sacramento Kings forward Chris Webber, New York Knicks guard Allan Houston and Los Angeles Clippers guard Kerry Kittles are among NBA players who have had the surgery.
Microfracture surgery is prescribed primarily for knees that have cartilage damage, but not every doctor is convinced the procedure works.
"If the microfracture procedure worked, we'd never have to do knee replacement surgeries," said Dr. Paul D. Ruesch, an orthopedic surgeon at the Milwaukee Orthopedic and Sports Medicine clinic, who said he has performed the procedure. "The results were not that spectacular."
Ruesch said the man who pioneered the surgery more than 20 years ago, Dr. Richard Steadman, has achieved a higher success rate at his clinic in Vail, Colo.
The process involves putting multiple holes -- microfractures -- about three to four millimeters apart into the exposed bone inside the knee. Bone marrow cells and blood from the holes are supposed to combine to form a "super clot" that covers the damaged area. The clot eventually matures into firm repair tissue (sort of a scab), called fibrocartilage, that replaces the lost cartilage and serves as a cushion between bones.
The recovery time is usually about six months. But the recovery period can last longer depending on the location and size of the injury and whether another surgical procedure is performed at the same time, according to the Steadman-Hawkins Clinic.
Kidd could return to the court in December, according to published reports. Hardaway, one of the first NBA players to have the surgery, said it took a long time for him to develop confidence in his knee. He missed the 2000-01 season.
"I don't think six months was enough time for it to heal," Hardaway said. "I'm just now feeling like I'm getting back to where I was."
Microfracture surgery was performed on Webber's knee in June 2003. A 6-foot-10, 245-pound power forward, Webber returned to the court nine months later with little ability to push off the knee. He appeared in 23 games for the Kings.
Jamal Mashburn had the surgery in November 2003, keeping him from playing in the New Orleans Hornets' first 44 games. He played 19 games in January but return to the sideline complaining of knee pain. Hornets officials have said they aren't sure if Mashburn will be healthy in time for their 2004 training camp, Oct. 1.
Ruesch said he's not surprised some players experience discomfort long after the surgery.
"The replacement fibrous tissue -- it's basically scar tissue -- isn't the same or as strong as the original cartilage you were born with," Ruesch said. "The new tissue will fall apart much faster, causing pain and swelling."
What seems apparent is the procedure seems to take some of the explosiveness and quickness away from players, particularly after the initial recovery period.
Houston, another player mentioned in Blazers trade talks, missed 32 games last season with ailing knees after undergoing microfracture surgery in summer 2003. Houston has said he still needs more strength in his left knee, which wore down due to compensation from an earlier surgery on his right knee.
Considering the constant pressure Kidd applies to his knees during a game, a December return could be optimistic. Even if he does return, there will be questions about whether he can perform at his usual level.
"You can never, ever replace the ligament once you lose it," Ruesch said. "It will have an effect."