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June 7, 2003

Under The Knife

Trouble for Unit and Vlad

by Will Carroll

Man, one Hulk-Sized Mountain Dew Slurpee with a Red Bull in it can really get you going. Enough so that I decided to join in the Saturday fun around here and do a special version of UTK for you. There's plenty to talk about, so let's get right into it:

  • There are open questions about Randy Johnson, and Friday's UTK seems to have opened quite the can of worms surrounding the reigning Cy Young Award winner. As I reported, Johnson is having a series of injections to lubricate his knee and replace the missing cushion and lubrication that should naturally be there. The substance, Synvisc, is administered in a series of three injections, with the first performed Friday, the next scheduled on Tuesday and the final probably the next Friday. There are whispers coming from multiple sources that the Synvisc injections aren't the solution, but merely a stopgap measure to try and get Johnson through the season. The underlying problem is rumored to be an osteochondral defect and the normal therapy for that is a microfracture surgery or reconfiguration of the bone through an osteotomy.

    The problem is similar to that of Mo Vaughn, but a better recent comp is Marvin Benard. Benard had microfracture surgery, took about four months to get back into competitive shape, and has had some setbacks along the way. If Johnson can be babied through to the end of the season, he could have the more extensive surgery in the off-season. Still, despite the best efforts of a good Arizona medical staff, Johnson's knee could flare up under the unusual stresses placed on the plant leg of a power pitcher. There's nothing to say that the Unit can't do it, but if you're looking at risks, Johnson's red light just started flashing.

  • In addition to the pitching problems, the Diamondbacks are placing David Dellucci on the DL after a concussion. The move is termed precautionary and was done more to add a body to the roster while Dellucci fully recovers than concern that he will take longer than expected to recover. Curt Schilling, Craig Counsell, Matt Mantei and Mike Koplove are some of the other key Diamondbacks on the DL for various lengths of time. It's not just at the major league level either--they're dropping like flies at the Triple-A level too. Remember that the arms still there, the ones not forced up to the majors by injury, are likely facing a heavier workload and more stress than expected.

  • The news on Vladimir Guerrero gets worse. The herniated L4/L5 disc is causing not only the painful immobility of his trunk and weakness and radiating pain to his legs, but there is some concern that there may be some stenosis associated with this problem. While the diagnosis of stenosis may not alter the timetable or protocol significantly, it does make it much more likely that Guerrero will be forced to undergo surgery at some point in the future. Guerrero's response to epidural injections is now crucial. He'll likely have at least two and perhaps three in hopes that surgery can be avoided. While the injury is comparable to that suffered by Ivan Rodriguez last season, the stenotic element makes this more concerning from a long-term perspective.

  • As detailed in yesterday's Expos PTP, the Expos are down to Javier Vazquez and Tomo Ohka from their originally targeted Opening Day rotation. Zach Day is on the DL with a torn rotator cuff, and if you believe the six-to-eight-week timetable, I have a major league franchise in San Juan to sell you. Day's tear is considered to be "minor" but that is only in comparison to more significant tearing in the cuff. While he likely can avoid surgery and did avoid collateral damage to his labrum, Day cannot expect to fully heal in the space of even 12 weeks, a time frame that would effectively end his 2003 season. Given the type of pitcher that he is and his good mechanics, I think he'll be able to return--just not in time to help a Montreal team that's headed for a freefall.

    There is no truth to the rumor that Jonah Keri is on suicide watch.

  • Tom Glavine is not only about to miss the first start of his career, it has come out that he has been pitching with a bone spur in his left elbow. While my Mets sources say that the bone spur was known since his pre-signing physical, it was also known that Glavine's great mechanics were the only reason it wasn't problematic. The slightest mishap--a strained groin, a blister--can throw pitching mechanics off, and wouldn't you know it, it's happened. Glavine is not only resistant to missing the start, he's completely ruled out any possibility of surgery, either now or in the off-season. Rest, ice and electricity are the best hopes for the Mets ace; the hopes of the franchise appear to rest on the tip of a small shard of bone in a 37-year-old elbow.

  • While it wasn't broken--as initially believed--the current diagnosis isn't much better for Chipper Jones. Jones has a Grade II torn ligament in his wrist that is causing him significant pain when he swings and misses right-handed. Jones is determined not only to play through the pain, he doesn't appear to be considering batting lefty against lefties.

  • Rafael Palmeiro's back symptoms are very similar to what Vladimir Guerrero reports, but there's no sign that it's as serious--yet. Palmeiro blames the injury on an awkward sleeping position (keep the Viagra jokes to yourself, please) and the spasms have gotten progressively worse. He'll continue to receive treatment. The problem is currently affecting his trunk rotation, which certainly points more to a muscular problem than a spinal disorder, so there's that in the plus column.

  • A reader wrote in--obviously one of my more medically inclined Medheads--and wanted to discuss J.D. Drew's latest problem. Drew sprained his ankle and had fluid drained from the ankle the next day. My reader was concerned that this was very unusual and in fact, argued that many doctors feel that the body swells around an injury for a reason. True, but sports medicine often differs from mainstream medicine. A draining would likely not be considered if you or I sprained an ankle, but you or I are likely not professional athletes (though there are a few major leaguers who read this). Drew needed the return of his range of motion, and bracing could adequately protect the ankle. No, Drew's ankle injury wasn't the result of a cascade; it was an awkward slide that got him this time.

  • Whoever had May 30th in the Darren Dreifort pool can collect. Dreifort will go under the knife for knee surgery on June 17th and is done for the season. The type of surgery he will undergo is not yet determined since there are multiple problems inside the knee. At the minimum, Dreifort will need about six months to recover from MCL repair. The arthritic problem may be addressed in this surgery or in a separate procedure. While Dreifort intends to come back yet again, at some point, someone needs to discuss a future outside of baseball with him.

  • Yes, it's been reported that Phil Nevin could return as early as late July. Yes, two other famous dislocated shoulder cases have come back quickly and with little lingering effects. Yes, it's possible that it could happen. No, the Padres aren't confirming this or even planning for it. Any playing time from Nevin should be considered akin to finding a $20 bill in a pair of jeans--it's great when it happens, but you can't put it into Quicken before you pull it out.

  • Quick cuts: Roger Clemens has a chest cold. I'm willing to bet he'll make his start today anyway against fellow Texan fireballer Kerry Wood...Jay Witasick is only days away from a return. He'll likely battle The Shooter, Rod Beck, for save chances on the occasions when the Padres actually have a lead...Danny Graves will miss one start with a blister on his pitching hand...Moises Alou left Friday's game with shin splints...Miguel Asencio is going to visit Dr. Lewis Yocum in California. Pitchers don't normally visit Yocum without coming home with a new scar...Ken Griffey Jr missed Friday's game with a stomach virus, not an injured arm. He'll be back once the virus passes.

  • Pedro turns against ESPN and Peter Gammons? Call him day-to-day with a case of brainlock.

I get a lot of requests for information on minor league guys and even the occasional college player. Unfortunately, I'm not the guy to ask. While I'm always happy to answer as many questions as I can, those aren't my strong suit. There are plenty of guys who cover the minors: our own Keith Scherer, John Sickels, Kevin Goldstein; and those that cover the college game--Boyd Nation and John Manuel to name a couple of my favorites--that are much better targets for those questions.

Related Content:  Surgery,  Darren Dreifort

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