After being notoriously tight-lipped regarding injury information all season, the New Orleans Pelicans opened the floodgates Thursday night. The team released a full medical report from Dr. Neil ElAttrache of the Kerlan-Jobe Orthopaedic Group regarding Anthony Davis and his current shoulder and knee injuries.
The report revealed Davis’ labrum tear occurred to the posterior region of the fibrocartilage rim allowing for the three-time All-Star to avoid surgery. He will continue his daily routine maintenance and is not at risk while performing basketball activities. These findings are encouraging for Davis’ long-term future and should erase any doubts that the Pelicans medical staff mismanaged this injury.
The injury information provided on Davis’ problematic knee is even more intriguing. Dr. ElAttrache’s notes disclose that in addition to Davis’ previously noted tendinosis, he also had a patellar stress reaction. A stress reaction is a precursor to a stress fracture, a much more significant injury.
The patella or kneecap is considered a sesamoid bone, meaning it is embedded within the tendon of a muscle, in this case the tendon of the quadriceps muscles. As a result of this location, the kneecap is mobile. This mobility allows the patella to increase the moment arm of the tendon throughout the knee’s functional range. This subsequently enhances the torque in the area and improves the range of motion of the knee. However for the patella to smoothly move and adequately complete this process, it is forced to come in contact with multiples aspects of the leg bones, particularly the femur. The associated compressive forces put the bone at risk for injury especially when subjected to high repetitive loads. Any additional muscle limitation or muscular weakness can further contribute to the problem.
To treat Davis’ injury Dr. ElAttrache utilized an “ultrasonic debridement” on the patellar tendon. The relatively new treatment option, known as the Tenex Health TX FAST technique, is less invasive than an open debridement. In the procedure, a small surgical probe is inserted into the damaged or diseased tendon under the guidance of ultrasound imaging. Once inserted the surgeon uses ultrasonic energy to break up and remove the problematic tissue.
In addition to the debridement, Davis’ also received a regenerative injection derived from bone marrow aspirate. These injections, similar to the platelet-rich plasma (PRP) injections that have gained popularity over the past few seasons, utilize stem cells taken from the affected individual’s bone marrow. The stem cells are harvested, often from the hip, and introduced to the injury site with the intent to stimulate the body’s natural healing response.
Davis isn’t the first NBA player to utilize ultrasound debridement and stem cell injections. Former Laker and current Bulls center Pau Gasol underwent the technique on both his knees in the summer of 2013. Dr. Steven Yoon, also a member of the Kerlan-Jobe Orthopaedic Group, performed Gasol’s procedure. Gasol has since put together two All-Star campaigns and earned All-NBA Second Team accolades and, until recently, did not report a single issue with his knees.
This is a promising precedent for Davis though the procedure shouldn’t be viewed as a cure. Discovering any underlying biomechanical issues or functional limitations that contributed to both his tendinosis and stress reaction will be key in his long-term health. Look for New Orleans to invest heavily in Davis’ recovery and take the necessary steps to insure the face of their franchise returns healthy and ready for the 2016-17 season and beyond.
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thanks for sharing.