Bucks Diary

Friday, September 14, 2007

What is the real story behind the Oden injury?

Something is rotten in the state of Oregon. The decision to perform microfracture surgery on Greg Oden's knee implies to me that his knee(s) has been bad for a while and the Blazers probably should have identified the condition before they drafted him.

Here is what we know. Initially, based on Oden's own blog post, it sounded as though he had torn cartilage. On his blog, Oden reported feeling a sudden, unexplained pain in his knee. That complaint would be consistent with a meniscus tear caused by long term degeneration of the knee. And, as I understand it, if the tear were merely a small one and not pervasive throughout the knee, the proper surgical procedure is a simple arthroscopic cleaning. You can't fix cartilage, so when you have a smaller tear, the best you can do is remove the damaged cartilage so it doesn't cause future problems in the knee such as swelling and locking.

Then Oden went in for surgery and things changed dramatically. After exploring his injured knee with a camera, his doctors decided that microfracture surgery was in order. That's quite a leap. Microfracture surgery is a simple yet radical and very invasive procedure. As its name implies, it actually involves injuring the patient to stimulate healing, specifically, stimulate new cartilage growth. Because it straddles the line when it comes to the Hippocratic Oath, doctors do not make the decision to do it lightly.

All of which implies that when the doctors' camera entered Oden's knee it uncovered a much worse injury than the doctors initially anticipated. Otherwise, the facts surrounding this case make no sense. Using microfracture surgery on a small meniscus tear is a little like swatting a mosquito with a sledgehammer. Moreover, the doctors had to know prior to going in with the camera that Oden had at least a little torn cartilage. So, if they planned to use microfracture to treat ordinary cartilage damage, we would have known about it earlier.

Thus, their camera must have found pervasively damaged cartilage, or, perhaps, little or no cartilage at all. That would be the only explanation for the decision to do the unscheduled microfracture procedure on such a valuable patient. The doctors must have decided he was in dire need of cartilage.

If all of that is true, it means Oden's knees were prearthritic. Having arthritis in a joint, after all, merely means you have little or no cartilage in that joint. Indeed, microfracture surgery was initially developed as a last ditch method to provide relief from the pain old people suffered because of arthritis.

If indeed the doctors found general cartilage damage throughout the knee, that is a degenerative condition. It didn't appear overnight. It would have been on-going and probably should have been detected last spring when he had his predraft physicals. Indeed, we are hearing reports indicating that at least some of the NBA's physicians detected such a condition at the time.

All of which begs the question, how did the Trailblazers management drop the ball so badly, and why aren't they fessing up to it now? It appears they purchased damaged goods. Blazermaniacs deserve an honest explanation.


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