Under The Knife: Advances in surgery leaves past full of what-ifs
In Jane Leavy's book,
The techniques used had very poor results, according to Dr. Ralph Gambardella, head of the Kerlan-Jobe Orthopaedic Clinic in Los Angeles. "In the '50s, Dr. O'Donoghue reported on acute ACL repair in athletes. While his results were encouraging, we know the ACL repairs all failed and many people were made worse by getting a stiff knee. This is because many were splinted in knee flexion to allow the big incisions to heal, so many could not get their knees straight and walked with a limp and developed rapid onset of arthritis.
"Looking back on history, most athletes were actually 'better' by not undergoing surgery because if the surgery didn't kill you the rehab and casting the leg in flexion would still kill you. It was not until both surgical techniques and rehabilitation ideas improved that ACL surgery became consistently effective. That did not occur until the '80s."
It's easy to think of Mantle or any great athlete from the past as an exception, but it's possible that other athletes had similar results. We don't have a complete record of who had what (although I'm sure some readers have knowledge of major surgeries from the 50s, 60s and 70s that I'd love to hear about.) Mantle was one of the best players of all time, but not because he overcame a bad knee. It goes in the canon, just like "Sandy Koufax could have been saved by Tommy John surgery" and "How good would Addie Joss have been?" Leavy's book is well worth a read, if only as a reminder that in 50 years, we'll be thinking the same things about what we think of as advanced medicine now. Powered by
The Cardinals look as if they will finish the season without Holliday. He hasn't picked up a bat in over a week, and while the Cards have stayed in the chase without him, the likelihood of catching the Braves is low enough (18 percent, per
Youkilis was out of the lineup again on Tuesday night, leaving Mike Aviles best available option for the Sox. Since Youkilis isn't on the DL, this is one of those things that will escape end of the year measures of days and dollars lost, but shouldn't. Even on a sabermetric basis, it's hard to get a real measure of the cost of this injury that's useful. It's easy enough to walk into the
While Youkilis was being the Greek God of sitting, Bedard joined him quickly. Bedard hit his pitch limit in just 2 2/3 innings (76) and left his team both behind and taxed. The bullpen has pitched a lot of innings in the last month. Just look at the
It's tough sometimes to tell the severity of any injury at this time of year. The slightest thing can keep a player out, both because of the expanded roster and, for some teams, the impending playoffs. Both of those are in play with Guillen, who's barely played this season due to various maladies. Jim Leyland has been flip-flopping between Ryan Rayburn and Ramon Santiago for much of the last month, looking for his best playoff lineup. At this stage, Guillen might not even make the playoff roster and will need to be healthy over the last week to even have a chance of making it. We'll see if that happens.
The Jays placed Escobar on the DL on Tuesday. This late, there's no apparent reason to do this with rosters expanded and there's some reasons that teams don't do this that are very technical. (Trust me, you don't want a discussion of Worker's Comp rules here.) Escobar was hit by a pitch on his elbow on Sept. 7, but there was no fracture. The problem has been vaguely described, but sources tell me that there's no visible discoloration or swelling at this stage. Escobar's injury is one that reminds us that reasonable protective devices aren't something we should legislate out of the game. Odder still, the Blue Jays have indicated that they expect Escobar to come off the DL and play when eligible early next week. I'll admit that I just don't get anything about this one.
I asked Dan Wade to look into HBPs. We've had twelve injuries this season, mostly hands, wrists, and fingers, though there were two injuries to the face (Marlon Byrd) and head (Corey Patterson.) As for what the HBP "leaders" are wearing?
1. Carlos Quentin -- Sleeve
1. Hughie Jennings -- 1890s, probably had an actual suit of armor.
Would it surprise you if I told you that the Cubs had lost over $50 million to pitcher injuries over the past seven seasons? And remember, that doesn't even include the peak lost seasons of Kerry Wood. Wood's return to the Cubs has gone about as expected as far as his production, but going out with an injury suffered while actually in the bullpen isn't how Wood wanted it to end. It's unclear whether Wood will be back with the team next season given all the front office upheaval, but one source told me that Wood has been a steadying influence and a clubhouse leader. "If there's one guy I bring back on that team, it's Wood," I was told. "He did more to save the focus of the team after [the Carlos Zambrano incident] than [Mike] Quade could. Wood will have his knee scoped, but should have plenty of time to be ready for spring training if the Cubs call. If they don't, Wood has made it clear he'll retire. If you'd told me in 1998 or even in 2003 that Wood would end his career with 86 wins, I would still be laughing. That stat, as much as the dollars lost, tells you about the true cost of not preventing pitcher injuries.
Remember all the talk about Stephen Strasburg being "rushed" back from Tommy John surgery? Parker didn't have the same focus since he injured his elbow at a much lower level and didn't have the same hype, but he came back this year after missing all of '10 and is now heading to the big league club. One of the amazing things about Tommy John surgery isn't that it can return pitchers to their previous levels of effectiveness, but that young pitchers that have the surgery don't seem to "lose a year" of development time. Parker progressed quickly through the D'backs system, but the team always seemed to be aiming at having him late in '11 for a chance at the '12 rotation, even back on draft day in '07. A native of northern Indiana, he's one of the top high school pitchers I've ever seen play live and features a 97 mph fastball. It's not likely that Parker will be on the playoff roster, but it's not impossible either.