The NBA Finals was dramatically altered Friday when it was announced All-Star guard Kyrie Irving will miss the remainder of the series after a MRI revealed a fractured patella (kneecap). Irving is slated to undergo surgery in the coming days and becomes the second of Cleveland’s talented trio to suffer a season ending injury in the postseason. Teammate Kevin Love suffered a dislocated shoulder and torn labrum in the team’s first round sweep of the Celtics.
With Irving ruled out for the Finals, the focus instantly shifts to his long-term health. The patella is a sesamoid bone meaning it “floats” the tendon of the quadriceps muscles. As a result of this position, the knee cap is able to move and create a longer moment arm for the tendon. This in turn enhances the torque and improves the range of motion of the knee. The tendon that houses the kneecap is the same tendon involved with Irving’s previous battles with tendinitis.
However the tendinitis is an afterthought with the kneecap fracture. The type of fracture has not yet been revealed but the kneecap is vulnerable to both stress fractures and breaks following trauma. A stress injury would help explain why Irving was experiencing inflammation in the area in the first place but without confirmation from Cleveland that’s simply speculation. It’s also hard to imagine the team opting to play their All-Star guard with a significant injury like a stress reaction or fracture.
UPDATE: The Cavaliers maintain Irving’s fracture was the result of a collision with Golden State’s Klay Thompson and not the result of a stress reaction or stress-induced trauma.
What is known is that surgery will be necessary to repair the damage. This is a good indicator that the pieces of the bone displaced. Surgical wire and pins will be inserted to realign these fragments and create an environment conducive to healing. However even with surgery, the recovery process for this type of injury can be complicated due to the previously mentioned biomechanics of the joint.
As the knee is bent (flexed) or straightened (extended), the patella moves to alter the mechanics of the quadriceps muscle. In the process, the patella comes in contact with multiples aspects of the leg bones, particularly the femur. This repetitive contact and stress can prolong the healing process as special care must be given to avoid stress to the bone but maintain range of motion at the knee.
Previous NBA All-Stars, including Clippers forward Blake Griffin and Washington guard John Wall, have endured fractured knee caps. Both of these players’ injuries were stress induced though Wall did not require surgery. Griffin missed his entire rookie season recovering from surgery on his patella. Fortunately neither player has reported lingering problems from their respective injuries, providing hope for Irving’s future. Still, determining a specific recovery time for Irving remains complicated even if history shows that players that require surgery need additional time to heal. The Cavaliers have estimated he will miss three to four months recovering but expect those numbers to be fluid.