Understanding Kevin Durant’s Bone Graft

The worst case scenario for Kevin Durant and the Thunder has finally emerged. The lingering soreness in his problematic right foot has been diagnosed as a regression in the healing process and a third surgery will required. The reigning MVP will not play again this year and is expected to miss at least four-to-six months recovering.

When the injury was first reported, InStreetClothes.com detailed the problems associated with the Jones fracture and presented a list of those to suffer setbacks following their initial surgery. Durant will now be included on the list as he heads under the knife for the third time.

In his first surgery, a surgical screw was inserted into the fractured fifth metatarsal. The screw is intended to unite the bone fragments and help promote the formation of a true union. However a second procedure was required to replace the screw as its head had begun to rub against the neighboring cuboid bone, causing Durant pain and soreness. At the time Oklahoma City stated that the bone formation at the fifth metatarsal was progressing nicely. However the pain persisted and Durant was removed from basketball activities. Now, specialists have determined that the metatarsal has regressed and the best treatment option will be a proactive approach. Durant is slated to undergo a bone graft procedure at some point next week.

In the bone graft procedure, a portion of bone taken from elsewhere in the body (likely the tibia) will be grafted over the fracture site. The graft will help stimulate the growth of new bony tissue in the area as bone is capable of regeneration. Clippers forward Glen Davis underwent a similar procedure when the hardware in his fifth metatarsal fracture failed.

With the graft in place the Thunder medical team will spend the next six months analyzing the injury site and Durant’s biomechanics. The treatment and, more importantly, the time off should allow Durant to return to a high level of play. In the two seasons since Davis’ graft, he has not reported problems in his foot. However like the initial surgery, nothing is guaranteed and only time will determine Durant’s fate. Brooklyn center Brook Lopez suffered multiple hardware failures in his fifth metatarsal before opting for a first metatarsal osteotomy. In this procedure, bones in Lopez’ foot were surgically reshaped to divert force and stress away from the outside of his foot and reduce the odds of a re-injury. While this is an extreme case, nothing has come easy for Durant throughout this process and now the Thunder simply have to wait to see how the face of their franchise responds to treatment.

Understanding Terrence Jones’ Pneumothorax

Houston Rockets forward Terrence Jones has endured a tough season. He missed 41 games early in the season after suffering a peroneal nerve contusion in his right leg. Now, with the NBA playoffs on the horizon, Jones will miss additional time with a rib injury that included a partially collapsed lung.

The injury occurred when Kenneth Faried kneed Jones in the side while the two scrambled for a loose ball. The injury was initially classified as a rib injury though Jones was required to spend the night in a local hospital. Tests performed at the hospital revealed a pneumothorax.

The partially collapsed lung likely occurred in conjunction with the rib injury. The impact of the collision damaged the pleural cavity of the lung, causing the space outside the lung and the chest cavity to fill with air. This air creates the pneumothorax and collapses the lung. If blood fills into the space the injury is classified as a hemothorax.

The rate of recovery depends on the size of the pneumothorax. If it is large, than a chest tube to remove the air may be necessary. Other than that, time remains the best treatment option to let the lung and any other accompanying rib injuries heal. Fortunately for the Rockets, Jonathan Feigen of the Houston Chronicle is reporting Jones did not suffer a rib fracture.

Determining a specific time frame is difficult as the injury is uncommon in the NBA. The only recently reported case of a collapsed lung occurred during the 2008-09 season when Gerald Wallace was injured following a flagrant foul from Andrew Bynum. Wallace fractured his fifth rib and 30 to 40 percent of his left lung collapsed. He required a chest tube to drain the air from around the lung and missed seven games recovering.

Jones is currently expected to miss at least one week though a lengthier time off seems probable. The injury is just the latest setback for a Rockets team that has spent a majority of the season without the services of Jones and center Dwight Howard.

Profiling the 2015 NCAA Tournament: East Regional Injury Report

You don’t amass a 32-2 record if injuries are an issue. Villanova, the top seed in the East Regional, had seven of its top eight players play in all 34 games this season. Leading scorer Darrun Hilliard was the only one in the group to miss a game, sitting out a December contest with a concussion. Junior forward Ryan Arcidiacono, the co-Big East Player of the Year, is nursing a rib injury that may be the culprit behind his recent cold spell.

Virginia’s Justin Anderson has been plagued by the injury bug and his health will go a long way towards the second-seeded Cavaliers advancing. Anderson originally missed time with a fractured finger but underwent an appendectomy while sidelined. He returned for the final two games ACC tournament but failed to score in either game.

Oklahoma appears to be getting healthy at the right time as multiple players have been banged up at various points of the season. Isaiah Cousins played through a painful sprained wrist and his back up Frank Booker was bothered by a slightly herniated disc in his back for a majority of the year. Sophomore starter Jordan Woodard suffered a hip pointer in late February but remained a fixture in the lineup. While these injuries may limit their offensive production, the Sooners remain dangerous on the defensive end.

Louisville’s problems haven’t been health-related. Starting point guard Chris Jones was dismissed from the team in late February for disciplinary reasons. The same can’t be said for their opponent UC Irvine. The Anteaters lost three different starters at various points of the year as Mamadou  Ndiaye (foot), Luke Nelson (face) and Alex (foot) sustained injuries. Reserve John Ryan completed the foot injury trifecta and is questionable entering the tournament. Guard Dominique Dunning is also a question mark with a knee injury.

If Northern Iowa falls victim to the dreaded 5-12 matchup, it won’t be because of health. The Panthers’ top nine players played in all 33 of their games and they will face Wyoming at full strength. The Cowboys will be waiting led by a fully healthy Larry Nance Jr. Nance battled mononucleosis during February. Wyoming did lose sophomore Trey Washington for the year following a preseason ankle injury but remain a real threat after winning the Mountain West title.

The Providence Friars received a big boost this year from a player recovering from injury. After rehabbing a torn labrum sophomore Kris Dunn is dishing out assists at a remarkable rate. However knee injuries have affected those on the receiving end of those passes with Carson Desrosiers and Ted Bancroft missing time and Rodney Bullock sitting for the year with a torn ACL. Desrosiers is the biggest cause for concern as his knee has been drained multiple times throughout the year. The Friars will take on a Dayton team that outlasted a Boise State squad decimated by injury on Wednesday. The Flyers have played a majority of the season without reserve point guard Ryan Bass who is recovering from concussion-related symtoms.

After being ravaged by injuries last year, the Michigan State Spartans endured another season of sprains, strains, and breaks. Senior Branden Dawson suffered a non-displaced wrist fracture but was able to return after missing two games. Dawson also missed time with a head injury. Alvin Ellis recovered from an early season ankle sprain but the team lost freshman Javon Bess to a stress fracture in his foot.

The Spartans will get little sympathy from their opponent as Georgia has struggled with injuries of their own. The Bulldogs starters last 20 games to injury this season. Marcus Thornton missed a pair of game with a concussion and an Achilles injury has limited Juwan Parker since mid-January. Parker aggravated the injury against the Razorbacks and, along with guard Kenny Gaines (foot sprain), enters the postseason likely limited. A healthy Georgia squad would be a handful but that hasn’t happened in months.

North Carolina State got good news just days ahead of their matchup with LSU. Guard Anthony Barber was cleared to play following a violent collision with Duke forward Amile Jefferson. The impact left Barber with spasms in his neck muscles though all scans taken of his head and neck came back normal. The Wolfpack will challenge a Tigers team that hopes Jordan Mickey has fully recovered from a shoulder injury. The sophomore forward missed the team’s regular season finale after bruising his shoulder against Tennessee and appeared limited in the SEC tournament, though foul trouble complicated things. Point guard Josh Gray has given no indication that his early season ankle sprain is a current problem.

Albany is one of the feel-good stories of the tournament and enters healthy and looking to continue their current seven-game win streak. The Belmont Bruins also sport a clean bill of health with high-scoring Craig Bradshaw clearly over a calf strain that cost him three games in December.

Lafayette is another team sitting at the bottom of the bracket with the advantage of good health. The team’s point guard and leading assist man Nick Lindner recovered from minor issues and will lead the Leopards upset bid over top-ranked Villanova.

Profiling the 2015 NCAA Tournament: South Regional Injury Report

With big name programs like Duke, Gonzaga, UCLA, and Georgetown scattered through the rankings, the South Region is primed with intrigue.

Coach Mike Krzyzewski and the Blue Devils have made 20 straight NCAA appearances and will now look to add a fifth national title to their impressive resume. Jahlil Okafor, a prospect projected to be the top selection in the upcoming NBA Draft, gave fans a scare in late February when he crumpled to the floor in a win over North Carolina. The injury ended up being a mild left ankle sprain and Okafor was back after a one game absence. Ankle injuries weren’t just limited to Okafor as Justise Winslow and Amile Jefferson also turned their ankles during the season though neither player missed any time. The injuries appear to be non-issues and Duke remains a title contender.

The Robert Morris Colonials will look to be the first 16 seed to knock off a top-ranked opponent after an impressive comeback win over North Florida. Reserves Lucky Jones missed time earlier in the season with a concussion but led the team in scoring Wednesday with 21 points off the bench.

Seven of the top eight players in the Gonzaga rotation have played in all 34 games. The lone exception is freshman Josh Perkins who will redshirt after suffering a broken jaw five games into the season. Transfer Eric McClellan also missed time with a broken bone in his foot but has played in 14 of the Zags last 15 games.

For the Zags to advance they will first have to beat a North Dakota squad impacted by knee injuries. The problems began when true freshman Trey Miller was forced to redshirt the season with a significant knee injury. Another freshman, AJ Jacbson, missed three weeks in December with a serious knee ailment of his own. The Bison are as healthy as can be expected and will lean heavily on Lawrence Alexander.

Iowa State has benefited from the return of an injured player as Georges Niang has been the catalyst for the Cyclones’ second straight Big 12 tournament title. Niang’s 2013-14 season ended during last year’s tournament after he suffered a fractured foot. Big 12 Defensive Player of the Year Jameel McKay has played through a back injury but it shouldn’t be an issue moving forward.

The Georgetown Hoyas appear to be at full strength after junior guard D’Vauntes Smith-Rivera missed the team’s regular season finale with weakness in his knee. The injury didn’t appear to be an issue in Big East Tournament play where Smith-Rivera averaged 36.0 minutes of playing time.

The same can’t be said for Georgetown’s opening round opponent. The Eastern Washington Eagles have succeeded come despite a myriad of injuries. Forward Venky Jois missed time with a chronic ankle injury while the team’s top scoring threat Tyler Harvey was slow to bounce back from a thigh contusion. Even worse, a knee injury prematurely ended the season of reserve Sir Washington in early February.

Utah has had their share of injuries this season. Australian freshman Jakob Poetl has impressed despite dealing with a chronically inflamed ankle while Dakarai Tucker missed the first four games of the year with a broken rib. Junior forward Jordan Loveridge missed seven games following “minor” knee surgery and Kenneth Ogbe has been in-and-out of the lineup with a nagging groin injury. Ogbe is the only player still limited and the Utes remain a dangerous team.

Stephen F. Austin will look to pull off their second straight upset when the take on the Utes. However if they do it will likely be without one of their best defenders. Florida State transfer Bobby King suffered a non-contact knee injury in the team’s win over Sam Houston State and isn’t expected to play.

Larry Brown and his SMU Mustangs haven’t had many injuries to deal with though other off-the-court concerns have hovered around the team. Former McDonald’s All-American Keith Frazier was ruled academically ineligible after 17 games and senior Justin Martin left to pursue a professional career. Prospect Emmanuel Mudiay also opted to play overseas prior to the start of the season. However Brown continues to show his worth as a coach and has the Mustangs back in the NCAA tournament for the first time since 1993.

The Iowa Hawkeyes have been one of the healthier teams this season with their core rotation missing just one game to injury when reserve Josh Oglesby sat out the team’s win over Maryland with an illness. The team will face off against a Davidson team that hasn’t been quite so lucky. The Wildcats lost point guard Jack Gibbs for nearly a month after he underwent surgery to address a slight tear in his meniscus. Gibbs, who had previously torn the ACL in the same knee, has looked unencumbered since returning and remains the team’s second best scorer. Gibbs’ injury came on the heels of a foot injury that ended the season of starting forward Jake Belford. The team has survived the loss and continues to be one of the best offenses in the tournament.

Like Davidson, San Diego State has several players that have made regular appearance in the athletic training room, including a particularly startling incident. The team lost freshman Zylan Cheatham to a Jones fracture in his foot before the season ever began. Fellow freshman Malik Pope needed time to recover from a fractured leg sustained in high school. Matt Shrigley suffered a broken left elbow in an exhibition game and missed the team’s first six outings. Senior Aqeel Quinn needed surgery to repair a fractured finger but missed just three games. However the scariest injury occurred in December when Dwayne Polee II collapsed on the court. Polee was ultimately diagnosed with a heart condition though he has since been cleared to return to the court. The Aztecs will look to challenge a St. John’s team that is struggling despite having few injury problems. Sophmore Rysheed Jordan did miss time with a right patellar strain but played well in the team’s two recent blowout losses.

UCLA’s inclusion in the tournament of 64 was perplexing to some. Proving their naysayers wrong will be difficult with freshman Kevon Looney still recovering from a facial fracture. He has yet to get comfortable with the protective mask he is required to wear and a limited Looney would be detrimental to the Bruins’ postseason success. Guard Tony Parker (no, not that one) is playing well despite missing some time earlier in the year with back spasms.

When your campus is within walking distance from the clinic of renowned orthopedist Dr. James Andrews, good health is to be expected. The UAB Blazers have been just that for a majority of the season. Williams “Ha Ha” Lee missed the first few games of the season rehabbing a knee injury but the Blazers have successfully avoided any devastating injuries.

Profiling the 2015 NCAA Tournament: Midwest Regional Injury Report

The Midwest Region is host to several marquee programs with the undefeated Kentucky Wildcats poised at the top. While it’s hard to imagine the top ranked team in the nation being even more formidable, Coach John Calipari’s team has had its share of injuries. Junior forward Alex Poythress tore his anterior cruciate ligament (ACL) in mid-December and was lost for the season. Freshman guard Tyler Ulis missed time with an undisclosed injury to his right leg and Devin Booker missed a game nursing an ankle injury. However all these injuries, including Poythress’, occurred early in the season and have not effected Calipari’s rotation. The Wildcats remain the team to beat in the region and the biggest threat to win the NCAA championship.

Another program of pedigree sits in the number two spot with the Kansas Jayhawks. However a sprained knee cost Perry Ellis, the team’s leading scorer, two late season games. The injury appeared to still be an issue as Ellis struggled in his first two outings back. He shot a combined 6-for-21 in the team’s final two games of the Big 12 tournament, including a 2-for-10 performance against Iowa State. Freshman Devonte Graham missed time with turf toe but has been a regular part of the rotation since his return. Still, Kansas’ success will hinge on the health of Ellis and that’s far from guaranteed at the moment.

Maryland senior Dez Wells has looked fine after missing seven games with a fractured wrist. Wells was leading the team in scoring before the injury and finished the season second on the squad, just behind freshman Melo Trimble. Wells’ injury will be non-factor entering tournament play.

The no. 5 seed Mountaineers limp into the tournament with two major injuries looming. Juwan Staten and Gary Browne are both recovering from lower extremity injuries that sidelined them for the entire Big 12 tournament. Staten missed four straight games with a left knee injury and Browne missed three with a high ankle sprain. Both players hope to return to face the healthy Buffalo Bulls but West Virginia’s full-court press will test both players’ injuries.

Butler’s biggest injury of the season wasn’t to a player but instead the head coach. Second-year coach Brandon Miller took a sudden leave of absence for an undisclosed medial problem in October before taking a medical leave in January. Chris Holtmann took over as coach and led the team to 22-10 record. The team did have one injury of note, a broken hand for forward Andrew Chrabascz. Chrabascz missed four games in February but returned in time to take part in the Big East Tournament.

Like Butler, the Cincinnati Bearcats had problems with their head coach’s health. Mick Cronin was forced to assume an advisory role with the team after doctor’s discovered a non-life threatening brain aneurysm. However the top eight players in the Bearcats’ rotation have avoided injury, with all eight playing in all 32 games.

Wichita State will look to improve on last season’s success and will lean heavily on their backcourt. A minor thumb and finger injury for senior guard Teleke Cotton happened early in the season and hasn’t been a problem over the last few months.

Standing in the Shocker’s way is the Hoosiers from Indiana. The Tom Crean-led team has surprisingly succeeded despite multiple off-the-court distractions.  Several players were suspended for alcohol related incidents, including one that resulted in forward Devin Davis being struck by a teammate’s car. Davis suffered a significant head injury that ended his season.

Indiana also played without junior Hanner Mosquera-Perea for multiple stretches during the season due to a troublesome kneecap. The reason for the team’s success is partially attributed to big wins without Mosquera-Perea, including 89-70 rout of Maryland. The big man hopes to play Friday after aggravating the injury but he will likely do so with a large, cumbersome brace around his suspect knee.

Purdue’s biggest injury occurred to freshman Jacquil Taylor, whose season ended after he developed a stress reaction in his tibia just five games into the season. The team remains healthy otherwise with Vince Edwards showing no lingering symptoms from his concussion in late February.

Texas lost sophomore guard Isaiah Taylor for a 10-game stretch early in the season. The fractured wrist appears to be fine as Taylor finished the regular season leading the team in both points and assists. Head injuries for Jonathan Holmes and Javan Felix also cost the Longhorns a few games but Texas is healthy and now and primed for an upset.

Valparaiso claimed their second NCAA bid in three years without the services of starting shooting guard Tevonn Walker. Walker suffered a knee injury in the team’s first game of the Horizon League tournament and has played sparingly since. Injuries have been a reoccurring issue for the Crusaders who lost starting point guard Lexus Williams to a torn ACL in August only to see his replacement, Keith Carter, dislocate his big toe. The injury cost Carter 10 games and his production since returning is down. The fact that Valparaiso is still playing is even more impressive when offseason hip surgery for E. Victor Nickerson and a recent nasal injury for Darien Walker are considered as well.

New Mexico State’s season turned around when two injured players returned to the lineup. The Aggies won 18 of their last 19 games, including 13 straight when Daniel Mullings returned from a fractured finger. Mullings return coincided with the return of big man Tshilidzi Nephawe who missed 12 straight with a nagging bone injury in his foot. Now healthy, the team will look to continue their winning ways against the Jayhawks.

Hampton would be the underdog against Kentucky regardless of health but ankle injuries to both Dwight Meikle and Quinton Chievous will only complicate things. Meikle has missed four straight outings with a high ankle sprain and Chievous left the team’s win over Manhattan with a right ankle sprain. Both are question marks moving forward.

The Northeastern and Notre Dame matchup provides a chance for two healthy teams to square off. Both squads avoided any major injuries though Notre Dame reserve V.J. Beachem did miss time with plantar fasciitis.