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

The History of Andrew Bynum’s Knee Woes and Examining His Potential Suitors

Exiled from Cleveland and waived by the Bulls following the Luol Deng trade, center Andrew Bynum will once again be a free agent when he clears waivers on Thursday afternoon. Reports have surfaced that at least eight teams are interested in the former All-Star, including Miami and the Los Angeles Clippers. Chris Broussard of ESPN.com reported that playing time, contention status, and, of course, money will all be taken into consideration as Bynum searches for a new team. However the level of performance of the team’s medical staff is surprisingly not included on the list, a considerable oversight for a player with a checkered medical background.

Bynum’s career began with the Lakers where his health was monitored by the respected eye of head athletic trainer Gary Vitti. Bynum’s first few years in the league were uneventful from a medical perspective as he missed just six games to injury during his first two years in the league. However it should be noted Bynum did suffer the first knee injury of his career, a right knee bone contusion, during the offseason following his rookie campaign.  It didn’t cost him any time during the year and he would play all 82 games for the only time in his career.

The real issues began during the 2007-08 season when he suffered a left patella subluxation (partial dislocation) and a bone bruise in his left knee. He would miss 46 regular season games and 10 postseason outings before it was determined he would need arthroscopic surgery to remove damaged tissue under the surface of the kneecap. He would miss the final 11 games of the postseason as the Lakers fell to the Celtics in the NBA Finals.

He would return the following season but again miss a substantial amount of time after tearing the medial collateral ligament (MCL) in his right knee. He would sit 32 regular season contests but return to help the Lakers secure a NBA title.

The 2009-10 season served as a bit of a bounce back year for Bynum as his knees held up throughout the regular season. He would miss time with other minor injuries including an Achilles strain but his troublesome knees did fine. Then, in the first round of the playoffs, Bynum suffered a torn lateral meniscus in his right knee. He would have the joint drained but did not miss a single postseason game in route to Los Angeles’ second straight championship.

Bynum eventually had the meniscus surgically treated but recovery went slower than expected and he missed the first 24 games of the 2010-11 season. During the year he suffered another bone bruise in his left knee and two more injuries to this right knee, including a hyperextension accompanied with a bone contusion. His season ended when he was ejected after shoving Dallas’ JJ Barea during Game 4 of the Lakers’ playoff loss.

The lockout-shortened season began with a four game suspension due to the shove of Barea but it was notable for another reason. The 2011-12 season marked the first reported use of Synvisc injections for Bynum. These lubricant injections are commonly used for people suffering from arthritis or osteoarthritis but can be used by an athlete to help with ailing joints. If cartilage in the knee breaks down or the body’s natural lubricant, known as synovial fluid, dries up, the joint is left stiff and inflamed and unable to move smoothly. To combat these issues Synvisc is injected to mimic healthy synovial fluid and allow the joint to properly move and absorb the various amounts of stress placed throughout it. Synvisc also displays anti-inflammatory properties and may help prevent further cartilage break down.

He would finish the season an All-Star and appear in 60 regular season games and all 12 of Los Angeles’ postseason games. However LA would send Bynum to Philadelphia in the four-team deal that involved Dwight Howard and Andre Iguodala. The Sixers took a calculated risk adding the reported malcontent but likely believed their front office and elite medical staff could handle both Bynum’s attitude and knees. However the experiment failed and Bynum never appeared in a game for Philly despite multiple Synvisc injections and a trip to Germany for the Orthokine treatment.  Bilateral arthroscopic surgery was ultimately performed and reports of degenerative issues began to surface.

Cleveland gambled on Bynum this offseason but his attitude and work ethic led to a six game suspension and his eventual trade to Chicago. Now here we sit waiting to see who will once again roll the dice.

Miami is reportedly at the top of the list and has a top-10 medical staff led by head athletic trainer Jay Sabol. However Sabol and his team are already handling one reformation projection as they try to resurrect Greg Oden’s career.

San Antonio and Oklahoma City have two of the best training staffs in the league but neither team appears interested at the moment. Atlanta also boasts a top-10 medical staff though Marc Stein of ESPN.com reports they are “unlikely” to make an offer.

Dallas is also interested and Mavs head athletic trainer Casey Smith has a great reputation around the league, serving as the AT for Team USA. However Mark Cuban can only offer a minimum level contract.

The Knicks and Nets have both registered interest but already have their hands full with injury problems of their own. The New York medical staff has finished near the bottom of the league in games missed and center has been a particularly difficult position to keep healthy. Brooklyn’s staff has been slightly better but has also had trouble keeping big men healthy, most notably Brook Lopez.

The final two teams reportedly mulling an offer to Bynum are the Clippers and Warriors. The medical staffs of both teams rank in the bottom five for games missed over the last five seasons, ranking 29th and 28th respectively. However Golden State’s medical team is under new control with AT JoHan Wang at the helm and has already shown improvement.

Whatever team elects to sign Bynum has to understand the high degree of risk associated with the big man. His numerous knee injuries appear to be linked directly to the cartilage of the area. Cartilage, particularly the articular cartilage of the knee, is very difficult, and in some cases impossible, to naturally repair. Surgical intervention like microfracture treatment can help but involves a length recovery and comes with no guarantee. Couple these issues with an apparent attitude problem and even a talent like Bynum may not be worth the headache. However the suitors will emerge when Bynum clears waivers at 5 p.m. ET and one NBA training staff will inherit a player with plenty of inherent challenges.