Eric Gordon Recovery Rhetoric

Published: February 21, 2013

This week, and much of this season, has been heavily focused on Eric Gordon. To some extent, much of the time since the New Orleans Hornets acquired him from the Los Angeles Clippers.

His injury history was covered by Mason, and Michael Pellissier looked at his performance this season.

I find myself wondering about another aspect . . . his recovery.

Eric Gordon had arthroscopic surgery on his right knee. It was described as a cleanup procedure specifically referring to loose cartilage particles. Typical recovery times for arthroscopic procedures are low since they are minimally invasive. This article from Johns Hopkins, a literally world-renowned hospital for those who have not had the misfortune of having to learn much about hospitals, describes these procedures generically and discusses recovery times.

Since then, he played 9 games for the Hornets last season, participated in Olympic trials, and had no reported offseason issues. Then, he was held out of training camp, including preseason games. On opening night, his scheduled season debut, it was announced that he’d be out. Clarification came in the ensuing days that he’d rehab out of town.

After returning to the team, he’s been held out of the second game of back-to-backs. His minutes per have have been increasing, but he’s missed 7 games since his return while playing in 19. There are 4 more second games of back-to-backs in the remaining 27 games.

If these restrictions remain, then Gordon is not fully recovered, by definition. He may have recovered to some degree, but he’s not fully recovered.

We’ll look at the procedure for direction on how to proceed.

For the procedure:

Arthroscopic surgery is a procedure in which the inside of the joint can be evaluated and treated using surgical instruments placed into the joint through small incisions (portals) measuring one centimeter or less (less than half an inch). The arthroscopic equipment consists of the scope and small surgical instruments which allow the surgeon to probe, cut, or shave tissues inside the knee. The scope itself is a small tube 4-5 millimeters in diameter (smaller than a pencil) which has a fiberoptic light source and a magnifying lens. Attached to this is a camera and cable which projects the image from inside the knee onto a television screen or monitor. The knee joint is filled with sterile fluid and the scope is moved around the inside of the knee joint by the surgeon so that various areas and structures can be seen and evaluated on the monitor. The small surgical instruments (biters, shavers, probes, scissors, etc.), also measuring 2 to 5 millimeters, are placed into the joint through separate incisions to remove torn cartilage, trim torn structures, or do other procedures. Two to four small incisions are usually needed for knee arthroscopy. — From the Hopkins article

So, this is pretty light in terms of surgery. It really is minimally invasive. Also, conversations with MD’s indicate that these procedures would reveal clear-and-present structural problems to the physician monitoring the scope, so there should be no overlooked injury or damage in the knee.

Being minimally invasive, recovery should be quick relative to more traditional surgeries. For the recovery time:

The recovery time depends upon many factors, namely how extensive the arthritis was in the knee and what was done at surgery. Most patients go home the same day after surgery. Crutches are used for 3 to 7 days, but weight can usually be placed on the operated leg as tolerated. Rest, ice packs, and elevating the limb are also recommended. Physical therapy is not required for all patients, but is prescribed on an individual basis.

It usually takes at least a week before patients can drive depending upon which leg had surgery and the car’s transmission. Most people can go back to a sitting job at one week after surgery, but patients who lift or walk a lot at their job may take longer. Activities are progressed according the amount of pain and swelling present in the knee. It typically takes about three weeks to recover fully for routine daily activities, but it may be two to three months before one can comfortably return to sports. Generally, the more arthritis there is in the knee, the longer it takes to recover. — From the Hopkins article

So, a year (1 year, 1 week, and 1 day . . . leap day!) seems a little long, and that is being wildly generous. This article, as do others, brings up the word arthritis. Neither Gordon nor the Hornets has ever used this term. Regardless, longer than a year to recover from a simple cleanup procedure is unreasonable. It is more reasonable to assume this other condition exists.

Gordon himself referred to a disorder, naming Andrew Bynum and Danny Granger as players with similar issues, but he professed to not know the name of the disorder that was defining his career and legacy. It’s possible that the disorder has no name, he did not want to try to repeat its name (he dropped out of college, not medical school), or that he knew it, knew it to be commonly known and scary, and declined to answer that question about his personal health.

Andrew Bynum admits to having arthritis and to having a bone bruise that was aggravated by seemingly innocuous activity (bowling).

To be clear, arthritis can take many forms, but the most common form, osteoarthrits, is a joint disorder that results in inflammation of that joint and in connected to cartilage erosion in that joint. This erosion can be the result of wear or injury.

Danny Granger has missed significant time with patellar tendinitis. This condition affects the tendon that holds the kneecap in place. It can be present to varying degrees up to and including the rupturing of the tendon.

Both arthritis and patellar tendinitis can be scary things, arthritis moreso. Let’s look at that the Hornets and Gordon have said about the topic.

On February 13, 2012:

The New Orleans Hornets announced today that Hornets guard Eric Gordon will undergo arthroscopic surgery on his right knee tomorrow. The surgery is needed to fully resolve an injury that was sustained earlier in the season during a Hornets game. After that point it did not fully heal with treatment and rest. The doctors expect that Eric will be fully recovered and able to return to playing in up to six weeks.

“After consulting with our medical staff, we concluded that surgery was the best route and in the best interest of Eric for the long term. We had hoped with rest and rehab, Eric’s knee would have healed.” General Manager Dell Demps said. “Eric is eager to return to the court and we are confident Hornet Fans will get to see him soon.”

And on the 14th:

The New Orleans Hornets announced today that Eric Gordon underwent successful arthroscopic surgery to clean up his right knee this morning. As anticipated, he will be out approximately six weeks.

Later reports indicate that this surgery removed loose pieces of cartilage. This season, his personalized training was centered around strengthening the muscles around the knee.

Both osteoarthritis and patellar tendinitis can be treated with such a routine. Both involve swelling and pain in the knee, and both see benefit from its reduction. Osteoarthritis specifically involves cartilage damage, which Eric Gordon certainly faced. Patellar tendonitis, however, can be caused by joint trauma, and that trauma could have cause the cartilage damage, removing the cartilage as a potential cause. Both conditions can see improvement due to increased quadriceps strength, so this is not a discriminator.

Both conditions have other potential causes, and the above may be consistent with other conditions, as well. The point here is not to prove that Gordon has either of these conditions. Rather, the intent is to highlight exactly how little is known about an injury that was repaired, in theory, over a year ago despite the number of conversations on this topic and the stature of the patient as one of the highest paid athletes in the world.

And for those wondering if this article will disrupt a potential trade for Gordon: No. All of this information is public. It’s just being written down in one place after a year of a less-than-full recovery, and not just because the recovery is not full; it’s because the situation seems, in some ways, worse this year than last. For instance, he immediately played in a back-to-back upon his return last year (April 6, 7). His moves are clearly worse on the court, particularly his handling of the ball. Also, many stats are flagging without too any significant improvements: TS%, eFG%, TRB%, TOV%, ORtg, PER, and WS/48. This is after the `good’ rehab which came after the `not-as-good’ rehab that was good enough to get him through the Olympic trials.

Following this course leads to a bad place. Any of this have a familiar ring:

Monday’s surgery was more of an annoyance than a sign his career, and his knees, are through. He considered it a freak injury — caused by banging knees.

The surgery was described as a “cleaning out” of debris.

Both of these quotes are from an article about Brandon Roy’s most recent surgery, which happened early this season. He is now set to miss the remained of the season after a “setback” of an unspecified nature other than a knee tweak during a workout.

About how this condition limits his time:

“My biggest struggle through this whole knee process is that I probably can play just games,” Roy said. “But when a guy just plays games, his jumper is not right and his timing is off. I’ve always been able to be good because I prepared. If I struggle in a game, I can’t go work on it tomorrow. I can’t improve like other players can.

“Other players can get in the gym the next day and work on what they want to work on to get better. I haven’t been able to do that the last couple of years. I’ve been going out there the last couple of years just willing it on emotions. So that’s where my frustration is.” — CSNNW

Later, he cut back practices.

I’ve felt better since the recent surgery, but I am not all the way better. — SBNation

His stats also dropped on a percentage basis in terms of TS%, eFG%, TRB%, TOV%, ORtg, PER, and WS/48, the same categories as the drops in Eric Gordon’s statistics.

Now, Roy not getting better does not mean that Gordon will not return to form, but it’s not good to see similar stories unfolding to point. Roy’s arthritis is degenerative, so it would have started and continued on its own without the provocation of injury, for instance, if he didn’t get a bone bruise in 2010 that turned out to be the first domino to fall on the way to his inevitable retirement.

There is no conclusive evidence that Gordon has arthritis, even more, degenerative arthritis. Moreover, Roy had little cartilage left in his right knee after prior surgeries while Gordon, by all accounts, has had very little surgically removed. This is clearly a bounding case for Gordon’s situation if he has osteoarthritis, but it does provide some evidence that a pattern such as Gordon’s after a more-complex-than-expected bone bruise can be an indicator of deeper, potentially irrecoverable, trouble. Some studies have concluded that longer recovery time for bone bruises can be associated with osteoarthritis.

I do not wish any problems upon Eric Gordon, and I feel that way for a number of reasons. Sadly, the data indicates that there is some problem in that knee that is impeding a full recovery, and the biggest piece of that data is the time between the surgery and today. Maybe it’s nothing in the knee; it could just be caution with their prized asset.

No matter what today’s trade deadline has in store for the Hornets, it’s best for all parties for their to be no problem at all.

It does seem, however, that we’ll have the chance to gather more data to work with.


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