Orthopedic injuries are a hazard of the job for professional athletes. Yet, most athletes are able to undergo treatment — sometimes surgery — and then return to an elite level of play.
This past week, New York Knicks All-Star Carmelo Anthony underwent a patella tendon debridement and repair after suffering chronic issues with his knee. Answorth Allen, MD, performed the procedure and Mr. Anthony could spend a few months in rehabilitation.
"The patellar tendon was too damaged to repair on its own. The procedure was to remove the damaged portion of the patellar tendon and then repair the rest," says Derek Ochiai, MD, an arthroscopic surgeon and sports medicine physician in Arlington, Va. "The knee cap tendon is degenerative, so they cleaned out the degenerative part of the tendon and attached the graft to the knee cap."
There is some new innovation in tendon repair, the FAST procedure — focused aspiration of scar tissue — that has been performed successfully on other professional athletes with a similar condition. This office-based procedure uses a needle with high energy untrasonic energy at the tip to debride the tendon without cutting it.
While the Knicks' season may continue a downward slope after losing their star player indefinitely, there's little to fear. The injury is relatively common in basketball players; in fact, its nickname is "jumper's knee" and while a vast majority of these types of injuries are treated non-surgically, surgical intervention is required.
There was some criticism thrown at Mr. Anthony's decision to undergo surgery mid-season. Mr. Anthony announced he would play in the 2015 All Star game last weekend before undergoing surgery, which some fear could put him at higher risk of additional injury. But, there really wasn't much to fear.
"This isn't the type of injury where he needed surgery immediately," he says. "Having the surgery now or a few months from now wouldn't impact his long-term prognosis. The knee wouldn't have degenerated further from playing in the All Star game."
Mr. Anthony hopes to return to training during the summer months to prepare for the 2015 preseason, but there isn't a guaranteed timetable.
"Every athlete is different and will respond differently," says Dr. Ochiai. "Typically, they are able to return to play within two or three months after surgery, but the time could be longer. It's about trying to optimize the tendon enough so it will respond to physical therapy and gain strength back. Then they're looking for range of motion to return and the athlete must trust the knee enough to use it like normal."
Another basketball star a few miles to the west knows this all too well. After suffering two significant knee injuries — and two surgical repairs — Chicago Bulls' Derrick Rose took a long road to recovery. Although he's played since the beginning of the 2014 season, and spent the summer playing with the U.S. Men's Team, Mr. Rose is still learning to trust his knee enough to return consistently to form.
By contrast, Minnesota Vikings star Adrian Peterson underwent a similar knee surgery and returned to the field — explosive as ever — in eight months.
"Bodies heal at different rates, and athletes have to find the right balance to push themselves but not over extend," says Dr. Ochiai. "The physical therapist and athletic trainers are a vital part of the recovery team and helping the athletes return to play after surgery. There is a gradual progression. Pushing themselves too fast can undo the benefits of surgery and pushing too slow could mean they'll never reach their potential."
Most high-level athletes are very motivated to return to play and partner with their specialists to train and return at the elite level.