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Articles Tagged Surgery 

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03-26

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2

Collateral Damage: The Tommy John Brotherhood
by
Corey Dawkins and Stephani Bee

02-27

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8

Collateral Damage: Spring Training Injury Roundup: It's What's for Dinner
by
Corey Dawkins

02-20

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3

Collateral Damage: The DL Kings: Nick Johnson
by
Corey Dawkins and Ben Lindbergh

01-27

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15

The BP Wayback Machine: Money Poorly Spent, Now and Then
by
John Perrotto

01-16

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9

Collateral Damage: The Latest Offseason Surgery Updates
by
Corey Dawkins and Ben Lindbergh

01-06

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4

Collateral Damage: Rounding Up the Usual Suspects: SLAP Tears
by
Corey Dawkins and Ben Lindbergh

01-02

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3

Collateral Damage: Rounding Up the Usual Suspects: Tommy John Surgery
by
Corey Dawkins and Ben Lindbergh

12-23

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1

Collateral Damage: Rounding Up the Usual Suspects: Thumb Injuries
by
Corey Dawkins and Ben Lindbergh

12-16

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8

Collateral Damage: Rounding Up the Usual Suspects: Rotator Cuff Tears
by
Corey Dawkins and Ben Lindbergh

12-13

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2

Collateral Damage: Rounding Up the Usual Suspects: Cartilage Injuries
by
Corey Dawkins and Ben Lindbergh

12-09

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8

Collateral Damage: Rounding Up the Usual Suspects: The Torn ACL
by
Corey Dawkins and Ben Lindbergh

12-02

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5

Collateral Damage: Offseason Surgery Updates
by
Corey Dawkins and Ben Lindbergh

11-28

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8

Collateral Damage: The Season in Injuries: AL East
by
Corey Dawkins and Ben Lindbergh

11-21

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Collateral Damage: The Season in Injuries: AL Central
by
Corey Dawkins and Ben Lindbergh

11-14

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9

Collateral Damage: The Season in Injuries: NL East
by
Corey Dawkins and Ben Lindbergh

11-07

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7

Collateral Damage: The Season in Injuries: NL West
by
Corey Dawkins and Ben Lindbergh

10-10

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12

Collateral Damage: Division Series Injury Updates
by
Corey Dawkins

09-30

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4

Collateral Damage: Playoff Preview Edition
by
Corey Dawkins and Ben Lindbergh

09-26

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5

Collateral Damage: Crunch Time
by
Corey Dawkins and Ben Lindbergh

09-21

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0

Collateral Damage: A Pence for the Phillies' Thoughts
by
Corey Dawkins and Ben Lindbergh

08-31

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17

Collateral Damage: See You in September?
by
Corey Dawkins and Ben Lindbergh

08-29

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0

Collateral Damage: The Irene Edition
by
Corey Dawkins and Ben Lindbergh

08-17

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18

Collateral Damage: Giant Problems
by
Corey Dawkins and Ben Lindbergh

08-12

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8

Collateral Damage: Cracking the Morse Code
by
Corey Dawkins and Ben Lindbergh

08-10

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3

Collateral Damage: Backed into Corners
by
Corey Dawkins and Ben Lindbergh

08-10

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17

Painting the Black: What to Expect from Strasburg
by
R.J. Anderson

08-08

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16

Collateral Damage: Nicasio's Neck
by
Corey Dawkins and Ben Lindbergh

08-05

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2

Collateral Damage: Shoulder Woes
by
Corey Dawkins and Ben Lindbergh

08-03

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8

Collateral Damage: Dodger Damages
by
Corey Dawkins and Ben Lindbergh

07-29

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0

Collateral Damage: Explaining Sprains
by
Corey Dawkins and Ben Lindbergh

07-22

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7

Collateral Damage: Sticks and Stones
by
Corey Dawkins and Ben Lindbergh

07-18

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8

Collateral Damage: The Hidden Pain
by
Corey Dawkins and Ben Lindbergh

07-15

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9

Collateral Damage: Bye-Bye, Bautista?
by
Corey Dawkins and Ben Lindbergh

07-08

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4

Collateral Damage: Adding Averages
by
Corey Dawkins and Ben Lindbergh

06-15

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7

Collateral Damage: Spining Away
by
Corey Dawkins and Ben Lindbergh

05-27

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6

Collateral Damage: A Scalpel Full of Posey
by
Corey Dawkins and Ben Lindbergh

05-16

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7

Collateral Damage: Not As Seen on TV
by
Corey Dawkins and Marc Normandin

05-13

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19

Collateral Damage: Stemming the Tide
by
Corey Dawkins and Marc Normandin

05-11

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13

Collateral Damage: Elbowed Out and Shouldered Aside
by
Corey Dawkins and Marc Normandin

05-04

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8

Collateral Damage: Loose Lips Lead to DL Trips?
by
Corey Dawkins and Marc Normandin

05-02

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1

Collateral Damage: Out at Third
by
Corey Dawkins and Marc Normandin

04-29

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16

Collateral Damage: Thoracic Park
by
Corey Dawkins and Marc Normandin

04-22

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6

Collateral Damage: Lisfrancly Speaking
by
Corey Dawkins and Marc Normandin

04-18

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5

Collateral Damage: One Step Forward, Several Steps back
by
Corey Dawkins and Marc Normandin

04-15

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22

Collateral Damage: Mauer Outage
by
Corey Dawkins and Marc Normandin

03-23

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12

On the Beat: The Sunny Side of Spring
by
John Perrotto

03-16

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15

Collateral Damage: Tragically Hip
by
Corey Dawkins and Marc Normandin

03-10

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11

Team Injury Projection: Florida Marlins
by
Corey Dawkins and Marc Normandin

03-07

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2

Collateral Damage: Duck and Cover
by
Corey Dawkins and Marc Normandin

03-04

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11

Collateral Damage: Missing the Meniscus
by
Corey Dawkins and Marc Normandin

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Tommy John surgery claims several more pitchers, and Joba Chamberlain suffers an extremely gruesome ankle dislocation.

Ryan Madson, Cincinnati Reds (Tommy John Surgery)
On Friday, one of the most surprising bits of news with the greatest impact was that Madson needs Tommy John surgery. Madson had battled elbow trouble throughout the spring, but it looked like he was turning a corner as recently as last week. Unfortunately, in the few days prior to his scheduled debut, he suffered a setback and was sent to Dr. Tim Kremchek for further evaluation. Dr. Kremchek found that the ulnar collateral ligament was torn (some of it off the bone), and that the tear appeared to be recent because of the amount of bleeding present.

Madson signed a one-year deal with the Reds over the winter after his four-year deal with Philadelphia fell through. Madson’s injury throws everything in flux for the Reds’ pitching corps, but for now, Sean Marshall is the heir apparent as closer. General manager Walt Jocketty has not ruled moving Aroldis Chapman back into a bullpen role this year but insists nothing is set in stone. The only sure thing is that Madson will miss 2012 and will have a hard time convincing teams to sign him next winter as he completes his rehabilitation.


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Spring training has just started, but already players are nursing injuries.

Spring training has only just begun, but we already have news aplenty to digest. Let’s go right to the infirmary report:

Ryan Howard, PHI (Left Achilles Surgery)
Howard’s recovery from surgery on his torn left achilles tendon has been a rollercoaster ride. He was spotted taking grounders from a stationary position as well as running late last week, but with a limp. Subsequently, it was revealed that one of the stitches had a seroma forming around it. While this sounds ominous, a seroma is merely a pocket of fluid very similar to a cyst. This far out from surgery, the stitches involved are not the ones that you see on the skin’s surface, but rather a buried stitch used to close tissues deeper under the skin; the cyst developed become the body views it as a foreign invader. The body begins to “spit the stitch,” attempting to push it out of the body. This is not at all uncommon following surgery, particularly plastic surgery or mastectomies, and is different from an abscess in that it is not infected. They can be drained, but anytime you introduce a needle into the skin there is a chance infection will set in.


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February 20, 2012 5:34 am

Collateral Damage: The DL Kings: Nick Johnson

3

Corey Dawkins and Ben Lindbergh

As the sad tale of Nick Johnson shows, a high on-base percentage doesn't help unless you can stay in the lineup

One of the most difficult aspects of injury projection is deciding how to deal with acute injuries. Athletes often acquire a “bad luck” label that follows them over the course of a season or a career, even if their injuries haven’t followed a predictable pattern. It isn’t much of a surprise that out of all the hitters in the last decade, one such injury-prone player, Nick Johnson, has missed the most days on the disabled list and the third-most of any player.

The New York Yankees drafted Johnson in the third round of the 1996 draft. Like all of the other players on the DL Kings list, when Johnson has been healthy, he’s been a productive player. In his first season in the Sally League, he displayed power, speed, and a good eye, only to improve over the next two years. He also got his first taste of the injury bug in 1998 when he dove for a ball, tore his labrum, and underwent surgery. He missed six weeks.

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Prince Fielder's new deal has albatross potential, but the Tigers hope it doesn't turn out like one of John's picks for the worst contracts of the free-agent era.

While looking toward the future with our comprehensive slate of current content, we'd also like to recognize our rich past by drawing upon our extensive (and mostly free) online archive of work dating back to 1997. In an effort to highlight the best of what's gone before, we'll be bringing you a weekly blast from BP's past, introducing or re-introducing you to some of the most informative and entertaining authors who have passed through our virtual halls. If you have fond recollections of a BP piece that you'd like to nominate for re-exposure to a wider audience, send us your suggestion.

As your mind reels at the size of Prince Fielder's payday, take a look at this list of 10 free-agent deals that didn't work out well for the teams that handed them out, which originally ran on February 20, 2007.

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January 16, 2012 3:00 am

Collateral Damage: The Latest Offseason Surgery Updates

9

Corey Dawkins and Ben Lindbergh

Catching up with the surgeries on and recoveries of Nick Markakis, Alex Rodriguez, Ian Kinsler, Jason Castro, Al Alburquerque, and other players.

Before long, spring training will be upon us, and we’ll be able to watch live baseball games again. Rounding up the usual injury suspects has been fun, and we’ll go into detail about several other injuries before putting the series on hold. However, injury news doesn’t stop being made at the end of the World Series, and since our last injury roundup, more than a few injuries have come to light. Therefore, we interrupt our regularly scheduled program to bring you this important news.

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The skinny on an elusive injury that increasingly plagues pitchers.

Superior Labrum Anterior to Posterior (SLAP) tears are an increasingly common injury in baseball players. Much more common in throwing athletes than non-throwers, SLAP lesions have gained a lot more attention as baseball pitchers have been studied in greater detail.

Anatomy
As we described in a previous article, the shoulder is made up of three bones but many different soft tissues. The clavicle, scapula, and humerus serve as attachment sites for the various muscles, ligaments, tendons, and nerves in order for proper function to occur. In the case of SLAP lesions, we are most interested in the labrum and the tendon of the long head of the biceps.


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UCL injuries are less disastrous than they used to be but remain an injury to be reckoned with.

Tommy John surgery: three words that no player wants to hear. It doesn’t matter that technology, surgical techniques, and rehabilitation methods have significantly improved since the first surgery in 1974. All the injured player knows is that he’s going to be down for a while and that he’s not guaranteed to return to his pre-injury performance level. In 2011, several key players went down with Tommy John surgery (TJS), including Adam Wainwright, John Lackey, Daisuke Matsuzaka, Joba Chamberlain, Jorge De La Rosa, Brett Anderson, and Jenrry Mejia, and we also saw the return of Stephen Strasburg after TJS in 2010. We’ve touched on the surgical procedure before, but for our first installment of Collateral Damage in 2012, let’s review the ins and outs of Tommy John Surgery.

Anatomy
Unlike many of the other injuries we’ve discussed, the anatomy of TJS is fairly straightforward. The UCL arises off the medial epicondyle of the humerus and involves three major components. The anterior oblique bundle is a little over three-quarters of an inch in length and despite its small size is the main stabilizer between 20 and 120 degrees of flexion, making it the most stressed part during pitching. When the elbow is fully extended, the UCL, bony articulations, and other soft tissues like the capsule split the stress fairly evenly—roughly one-third for each.


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Thumb injuries can be just as unfortunate for baseball players as they are for hitchhikers, Roger Ebert, and the Fonz.

Some would argue that the thumb’s primary purpose is to be raised in the manner of Arthur “Fonzie” Fonzarelli from Happy Days, but we are most concerned with its role in gripping and grabbing objects in baseball. In order for that to happen, the thumb has to be working right. You can’t play baseball at a high level with your thumb sticking up in the air like the Fonz, or if you just hit it with a hammer. One of the most common injuries to the thumb involves the ulnar collateral ligament of the metacarpophalangeal joint. In today’s installment, we are going to look at a few specific injuries to the UCL of the thumb, namely Gamekeeper’s thumb and Stener lesions.

Anatomy
The thumb, despite its appearance, is an extremely complex group of bones, tendons, and ligaments that somehow work together to allow gripping of objects and marathon gaming sessions. It is composed of five different bones (metacarpal, proximal phalanx, distal phalanx, radial metacarpophalangeal (MCP) sesamoid, and ulnar MCP sesamoid) and three main joints (carpometacarpal, MCP, and interphalangeal). The MCP and IP joints also have ligaments on the ulnar side closest to the palm (UCL) and on the radial side on the outside of the thumb (RCL).


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A rotator cuff tears isn't a death sentence for a pitcher's career, but it's far from a positive prognosis.

Baseball pitchers and rotator cuff problems seem to go hand-in-hand despite the rotator cuff being much smaller than other muscles about the shoulder and upper back. The four small muscles that make up the rotator cuff are vital to the shoulder’s health and to a pitcher’s playing career. In fact, at one time, rotator cuff surgery was considered a career-ending sentence. That isn’t the case any longer, but it still hasn’t reached the level of relative certainty of ACL surgery or even Tommy John surgery. Without a healthy rotator cuff, a significant cascade effect culminating in shoulder instability and/or tears of the labrum is possible, if not inevitable. In today’s episode of Collateral Damage, we will be looking at the rotator cuff and ways of treating it in all of their complexity.

Anatomy
The rotator cuff is made up of four muscles that attach at different sites on the scapula, a.k.a. the shoulder blade. These four muscles are known as the supraspinatus, infraspinatus, teres minor, and subscapularis. The main function of the rotator cuff as a group is to ensure that the humeral head stays centralized in the glenoid fossa. This cannot be emphasized enough. Two of the muscles—infraspinatus and teres minor—assist in external rotation of the shoulder, while the subscapularis is the only rotator cuff muscle whose role is as an internal rotator. The supraspinatus also assists in abduction, especially early in the motion. Without that rotator cuff, the humeral head would slide all over the place and tear up the labrum, articular cartilage, and other tendons in the area.
 



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We give you the lowdown on an ailment which is becoming increasingly common and the procedures that have been developed to combat it.

We’re hearing reports of microfracture surgery, arthritis, and osteochondral and articular cartilage injuries increasingly often. Given today’s emphasis on year-round training at an earlier and earlier age, cartilage injuries are going to become only more common in the future. We’ve made numerous advances in repairing cartilage injuries, but we still aren’t 100 percent there. Local cartilage defects are more of a problem than degenerative arthritis in the young, athletic population we report on here, so in this installment, we will primarily look at focal cartilage injuries and their management.

Background Anatomy
Articular cartilage is the hyaline cartilage on the ends of the bones in a synovial joint, very similar to the white cartilage on the ends of chicken bones. It’s important to note that this is a different type of cartilage from that found in the labrum or meniscus. Typically we hear about cartilage injuries in the weight-bearing joints of the lower extremities, but there is articular cartilage throughout the remainder of the body. Synovial joints come in many different varieties, including ball-and-socket (hip and shoulder), hinged (elbow, knee, fingers, toes), gliding (wrist), pivot (top of neck), saddle (CMC joint of thumb), and condyloid (forearm to wrist joint). The cartilage gets the majority of its nutrition through the synovial fluid that is present inside the joints.


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ACL treatments have improved dramatically since Mickey Mantle's day, but they still have the power to end a player's season.

Running down the first base line, the last thing Jason Castro expected in a spring training game was that in less than a second his season would be over. It’s something he had done a hundred times before without any inkling of an injury, and yet this time, for whatever reason, he ended up paying for it. As he tried to avoid the tag by Miguel Cabrera, his knee twisted awkwardly, and before he knew it he was done. Castro tore the anterior cruciate ligament (ACL) in his knee along with his meniscus and underwent surgery early in March 2011.

Injuries to the ACL, while more common in soccer, basketball, and football, still occur in baseball across all ages and experience levels. The ACL is usually torn in a non-contact, decelerating, twisting injury that stretches the ACL until its point of failure. ACL injuries are not new; in fact, the first surgery to reconstruct the ACL intraarticularly—inside the joint—was done back in 1917. Yes, almost 100 years ago. It used to be that ACL injuries were career-ending or career-altering, but as more research and better equipment was developed, the surgery became more commonplace, and the recovery time was reduced. Now, there are about 100,000 ACL surgeries each year, and over 200,000 ACL injuries. It seems that almost everyone has known someone or known of someone who has suffered an injury to the ACL.

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December 2, 2011 9:00 am

Collateral Damage: Offseason Surgery Updates

5

Corey Dawkins and Ben Lindbergh

Catching up with players who are recuperating from their time on the operating table this winter.

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.


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