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In Street Clothes

Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Breaking Down Russell Westbrook’s Latest Injury and Injury Trends in the NBA

In a season that seems to be one injury after a next, the Thunder becomes the latest team to lose a key player to injury. All-Star guard Russell Westbrook is expected to be sidelined through the All-Star break after undergoing his third arthroscopic knee surgery on his right knee.

The problems began following a collision with Houston’s Patrick Beverley in last year’s playoffs. The result was a torn lateral meniscus that needed surgery and cost Westbrook nine postseason games. Westbrook opted for a meniscus repair rather than removal, hoping to minimize the long-term effects. Unfortunately, the plan hit a minor snag as a suture from the repair caused swelling and a second surgery was needed. However, the OKC medical staff handled the situation perfectly, progressing the All-Star at a controlled pace and he returned several weeks ahead of schedule.

The latest surgery is the result of reoccurring swelling. The Thunder released the following quote in a statement provided Friday.

“Russell has been playing pain free but recently had experienced increased swelling. After consultation and consideration by his surgeon in Los Angeles, a plan was established to monitor the swelling that included a series of scheduled MRIs. On the most recent MRI, it was determined by the surgeon that there was an area of concern that had not previously existed nor was detectable in the previous procedures, and it was necessary to evaluate Russell further. The consulting physician determined that arthroscopic surgery was necessary to address the swelling that was taking place. We know that Russell’s work ethic and commitment will help him return to the level of play that we have all come to appreciate.”

The statement doesn’t provide much information regarding the specifics other than there was an area of concern that was best treated with surgery. The possible options include a Baker’s Cyst or, worse, a cartilage defect.

A Baker’s cyst develops when synovial fluid, the lubricating fluid of the joints, builds ups within the knee. These types of injuries can present without pain but can be limiting as the cyst develops. Baker’s cysts are common following meniscus procedures and multiple other NBA players including Metta World Peace and Amar’e Stoudemire have missed time treating this type of injury. Fortunately the long-term outlook is good once the cyst is surgically removed and any additional contributing factors are treated. If this is the problem plaguing Westbrook then there’s plenty of reason to believe he can continue to play at a high-level upon his return.

However if a cartilage defect is the root of the problem then Westbrook’s long-term outlook is a bit bleaker. A cartilage defect, particularly to the articular cartilage, following traumatic injury is very problematic. This specialized type of cartilage lacks an adequate blood supply and rarely heals without surgical intervention. The surgical options all depend on the location and size of the defect. Small lesions can be treated with a simple removal in a procedure known as a debridement. Larger defects need a more aggressive form of a treatment and the dreaded microfracture procedure comes into play. Microfracture surgeries are more intensive and require significant recovery time. Microfracture has altered the careers of players like Stoudemire, Kenyon Martin, and Greg Oden while extending the careers of Jason Kidd and Zach Randolph.

On the plus side, there has been no indication Westbrook needed microfracture and the team’s established timeline for recovery suggests it was not. However there’s still plenty of concern moving forward. Three knee surgeries in less than eight months are never good and his risk for future problems continues to rise. Look for the well-established Thunder medical staff to handle this situation with the utmost care and give their guard ample time to recover.

Injuries are an inherent risk in the NBA but the number of high profile players makes it appear they are appearing at an alarming rate. Westbrook’s surgery is just the latest in myriad of injuries that is defining the 2013-14 campaign. He joins a long list of sidelined former All-Stars that includes Kobe Bryant, Derrick Rose, Brook Lopez, and Marc Gasol. However a quick look through the data suggests injuries are not actually on the rise. At the quarter mark the current season was on pace to finish with approximately 4,700 games lost to injury, a tad bit higher than the 4,400 games missed average from the previous five years. (*The totals for the lockout shortened season were prorated to reflect an 82-game schedule) While the number is higher, it isn’t significantly off the norm. Furthermore the financial cost of these injuries was actually behind last year’s figures but that total will jump with the recent injuries to Kobe, Lopez, and, sadly, now Westbrook.