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December 2, 2011

Collateral Damage

Offseason Surgery Updates

by Corey Dawkins and Ben Lindbergh

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Injury news is slow this time of year, but it’s not nonexistent. Almost all of the news nowadays involves surgeries that were either planned or were complete surprises and the result of a new injury.

Tim Hudson, ATL (Low back herniated disc surgery)
Tim Hudson underwent surgery on a herniated disc in his low back on November 28. His back has been bothering him off and on over the last few years but never to the point where he thought he would need surgery. During off-season workouts, his pain started to increase significantly, and not too long afterwards, he underwent surgery, which was most likely a microdiscectomy. This procedure is more successful than earlier operations and requires a much shorter recuperation period. Hudson should be able to resume throwing in about six weeks, which will give him enough time to go through his preseason program and be without limitations at the start of the season.

Josh Reddick, BOS (Left wrist surgery—TFCC tear)
Just because the season is over doesn’t mean the Red Sox could avoid more pain. Josh Reddick underwent surgery for torn cartilage in his left wrist on November 15 and began a three-week period of rest. The structure that was repaired is known as the TFCC, aka the triangular fibrocartilage complex. The TFCC is located on the ulnar side of the wrist and actually consists of six different structures to allow smooth function in the wrist. It is the main stabilizer of the joint formed by the distal forearm bones—the radius and ulna—but also contributes to stability between the distal ulna and the smaller wrist bones.

In general, the TFCC has a poor blood supply, which means it is unlikely to heal on its own, as is the case with the meniscus in the knee. Injuries to the TFCC do not always require surgery in the general population, but in baseball players, the importance of surgical repair increases. It is very important to get proper stabilization of these joints during activities that require loading with rotation of the wrist, such as swinging a baseball bat. Soon Reddick is going to begin physical therapy geared toward restoring normal motion and function between all the intricate bones of the wrist. His long-term prognosis is good, and he should be ready for spring training.

Mitch Moreland, TEX (Right wrist surgery—Pisiform bone removal)
Speaking of wrist surgeries, Mitch Moreland underwent right wrist surgery on November 30. Moreland had the pisiform bone removed, which is a small bone inside a tendon in the wrist, not too different from the sesamoids in the foot. After the surgeons reach and remove the bone, the tendon that the bone sat in must be repaired, which requires a longer time to heal than it would if the bone were a loose body. His wrist was placed into a soft splint, but he can’t start the rehabilitation process for another week or so to ensure that the tendon has started healing where it was cut and sutured back together. Typically, recovery takes about three months, which means he may be a little delayed in spring training.

Logan Morrison, FLO (Right knee surgery)
Logan Morrison is going to have surgery on his right knee on Monday, the same knee that has been giving him problems throughout the year. His pain first started in May with some tendinitis and continued until later in the summer, when he collided with the wall while chasing down a foul ball. The collisions likely caused some mild damage to the cartilage in the knee, possibly knocking off a small piece of cartilage in the process. During the surgery, the surgeons will check the ACL, PCL, both menisci, and the articular cartilage to make sure there isn’t any damage not seen on MRI. After the surgeons repair everything that needs to be addressed, Morrison will be placed into a brace or on crutches for at least a very short period of time. He should be ready in about six weeks, unless there are unexpected findings inside the knee.

Chris Marrero, WAS (Left hamstring surgery)
Marrero tore his hamstring off the bone while stretching for a ball a few weeks ago but did not think it was severe until he met with the Nationals doctors a few days later. He had surgery and is expected to miss several months. The prognosis is really hard to determine without knowing whether or not the tendon itself was torn or if it was an avulsion fracture of one of the hamstring attachments. Avulsion fractures actually have a better chance of full recovery, because bone usually heals better than a tendon injury. Marrero believes he won’t miss the entire season, but regardless, he unlikely to be 100 percent by the start of the year.

Flesh Wounds
Mariano Rivera
is going to have surgery this Friday to remove polyps from his vocal cords. He will have to avoid talking for one week, but he should make a full recovery. In the interim, one cutter on the corner means “yes,” two cutters on the corner mean “no”… Prospect Robbie Grossman underwent wrist surgery earlier in the month to remove the hamate bone in his wrist. He should be ready for the start of next season… Another prospect, Jefry Marte, also underwent wrist surgery earlier this month for a distal radius fracture he suffered recently… Taylor Teagarden had his knee scoped shortly after the season, but it was a very minor procedure, and he will be ready for spring training.

Corey Dawkins is an author of Baseball Prospectus. 
Click here to see Corey's other articles. You can contact Corey by clicking here
Ben Lindbergh is an author of Baseball Prospectus. 
Click here to see Ben's other articles. You can contact Ben by clicking here

Related Content:  Logan Morrison,  Surgery,  The Process,  Mitch Moreland

5 comments have been left for this article. (Click to hide comments)

BP Comment Quick Links

Scott44

Any news on how Howard's recovery is proceeding and his likely return date?

Dec 02, 2011 09:46 AM
rating: 0
 
BP staff member Corey Dawkins
BP staff

He's off crutches and in a walking boot so seems to be in line with original estimates. So far so good.

Dec 02, 2011 12:43 PM
 
Lloyd Cole

What do three cutters on the corner mean? "Sit down"?

Dec 02, 2011 13:39 PM
rating: 7
 
BillJohnson

The path forward for Morrison seems surprisingly onerous. I assume the surgery will be arthroscopic, right? If it's really nothing but cartilage damage, why the crutches? I've had both knees scoped, with cartilage/meniscus damage in both, and for the second one, five years after the first, was walking the next day -- not so well with the first one, but surgical technique has advanced since then. If a decrepit old guy can be back on his feet quickly from such a procedure, why not a young, fit ballplayer? Or did I just luck out?

Dec 03, 2011 10:29 AM
rating: 0
 
BP staff member Corey Dawkins
BP staff

The crutches depend on what surgical technique was done. A lot can be done arthroscopically for cartilage repair including microfracture surgery and a lot of it involves requiring crutches for a longer period of time. Unless they perform a simple chondroplasty (smoothing out articular cartilage) or minimal partial meniscectomy (removing a piece of the meniscus) he will likely need crutches for at least a short time.

Plus you probably did luck out a little bit. Even with the simplest procedures most patients I've seen need crutches for a few days.

Dec 03, 2011 11:02 AM
 
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