Kristaps Porzingis out for series with meniscus tear

[BPo001]

Originally Posted by sefant77

Probably there was still solid hope he doesnt need surgery and thats why they waited

This is my thought too. Probably wanted to try rest and rehab to see how the knee responded. Glad he got it done. Back on the road to recovery.

[tap2390]

Originally Posted by DevinHarriswillstart

He should have had that sooner. He'll likely miss part of next season.

Sometimes with injuries like that it's useful to rehabilitate the knee for a bit (increasing mobility, reducing swelling) prior to surgery. It helps the surgery and post-surgery recovery go more smoothly.

[FreshJive]

Originally Posted by tap2390

Sometimes with injuries like that it's useful to rehabilitate the knee for a bit (increasing mobility, reducing swelling) prior to surgery. It helps the surgery and post-surgery recovery go more smoothly.

This could make sense, I guess, but it seems weird it would take this long for the swelling to go down.

[EricaLubarsky]

I’m basically not predicting KP to start or finish any season

[DevinHarriswillstart]

And frankly, the excuses for his knees are already starting to wear thin. If he gets another one, then we can count him out as an effective player on this team.

7 and a half weeks for swelling to go down really doesn't make much sense. More like the player doesn't want to have it done so they wait until the late minute to do it. KP hasn't dealt with his knees well at all during his NBA career.

[EricaLubarsky]

[Thespiralgoeson]

I feel like some of the takes on KP are overly harsh here. We knew he was injury prone when we got him. The Mavs signed up for this. I feel like it's a good time to remind everyone that after he took roughly the first half of the season to adjust and figure out how to play with Luka, he was f*cking awesome from the month of February onward, and he was especially awesome in the bubble.

KP from Feb.1 to end of season-

26.3 pts 10.4 reb 2.5 ast 2.2 blk .461 fg% .371 3p%

KP in the bubble-

30.5 pts 9.5 reb 2.2 ast 1.5 blk .476 fg% .381 3p%

He seems to have really figured out his role. I was really worried for a while that he wouldn't. Now we just need to cross our fingers and hope he can stay healthy for a playoff run or three.

[EricaLubarsky]

Originally Posted by Thespiralgoeson

I feel like some of the takes on KP are overly harsh here. We knew he was injury prone when we got him. The Mavs signed up for this. I feel like it's a good time to remind everyone that after he took roughly the first half of the season to adjust and figure out how to play with Luka, he was f*cking awesome from the month of February onward, and he was especially awesome in the bubble.

KP from Feb.1 to end of season-

26.3 pts 10.4 reb 2.5 ast 2.2 blk .461 fg% .371 3p%

KP in the bubble-

30.5 pts 9.5 reb 2.2 ast 1.5 blk .476 fg% .381 3p%

He seems to have really figured out his role. I was really worried for a while that he wouldn't. Now we just need to cross our fingers and hope he can stay healthy for a playoff run or three.

Really hoping he keeps it up. Surgery in both knees has gotta be tough, but yeah he was good in the playoffs until the injury.

He also has to stay healthy.

[Thespiralgoeson]

Any word on what KP's recovery time is? With the 2021 season starting before Christmas, it looks like he might miss some time. Or not? It seems like it depends on what kind of surgery he had. Meniscus repair surgery can take 4-6 weeks to recover from or 4-6 months. No word from the Mavs yet, and that makes me nervous.

[EricaLubarsky]

Originally Posted by Thespiralgoeson

Any word on what KP's recovery time is? With the 2021 season starting before Christmas, it looks like he might miss some time. Or not? It seems like it depends on what kind of surgery he had. Meniscus repair surgery can take 4-6 weeks to recover from or 4-6 months. No word from the Mavs yet, and that makes me nervous.

I'd give him a 0% chance of starting the season

[Thespiralgoeson]

Originally Posted by EricaLubarsky

I'd give him a 0% chance of starting the season

I'm fine with him not starting the season, but there's a big difference between missing a few weeks and missing 3-4 months.

[sefant77]

NBA starting christmas is a huuuuge stretch. Dont see this happening without another bubble

[KillerLeft]

Originally Posted by Thespiralgoeson

Any word on what KP's recovery time is? With the 2021 season starting before Christmas, it looks like he might miss some time. Or not? It seems like it depends on what kind of surgery he had. Meniscus repair surgery can take 4-6 weeks to recover from or 4-6 months. No word from the Mavs yet, and that makes me nervous.

Yeah, the 4-6 month variety is the optimal option in the long run, apparently, but since we haven’t hear anything I bet they just removed a little of the meniscus.

[Thespiralgoeson]

Why Kristaps Porzingis’ knee surgery likely isn’t serious, per NBA injury expert
By Tim Cato Oct 12, 2020 5

The Mavericks announced Friday that Kristaps Porzingis underwent lateral meniscus surgery after an injury in the first game of the first-round series against the Clippers. He almost certainly underwent that surgery well before then, given how effectively the Mavericks chose to bury the news late on a Friday afternoon before the weekend the Los Angeles Lakers won the 2020 title. (Public relations is sometimes supposed to be annoying; this isn’t me calling them out whatsoever.) But it’s the most pertinent news we’ve had since the season ended, and it’s worth addressing now.

We always knew it was possible Porzingis would require surgery ever since the injury was announced, which meant this wasn’t alarming news. But to understand more about the injury itself, I called Jeff Stotts, a certified athletic trainer and an expert in sports injury analysis. Stotts runs the website InStreetClothes.com, where you can read thorough injury breakdowns — such as this one on Zion Williamson’s meniscus tear last year. He has also built the first-ever NBA injury database and is contracted by NBA teams through his consulting firm SMART (Sports Medicine Analytics Research Team), which gives him unique context about how specific surgeries tend to affect the athletes who suffer them.

He’s @InStreetClothes on Twitter. This conversation has been lightly edited and condensed.

Regarding Porzingis’ injury. First, big picture, what is the meniscus and what exactly does it do within the knee?

You have two menisci in your knee. Each meniscus serves as the shock absorber for the knee, very similar to the discs in our spine, which helps absorb stress placed on it through the spine. They’re made up of specialized cartilage known as fibrocartilage, which allows them to absorb stress but also have a little bit of elasticity to them. And you have the medial meniscus, which is on the inside aspect, and the lateral meniscus, which is on the outside aspect. The lateral meniscus is the one that Porzingis injured, and it plays a pretty big role in joint motion. It’s mobile, but it doesn’t move a huge degree. They really are just designed to absorb stress placed through the knee.

Why would the surgery be delayed? What hope was there for a natural recovery, because it appears that’s what the Mavericks and Porzingis were initially hoping for.

When the meniscus is damaged, we treat meniscus injuries very similar to real estate: It’s all about location. It really is true because the disc is divided into these various regions that get a specific amount of blood flow. If it has a decent amount of blood flow, which is on the peripheral of the disc, those can actually heal OK. But the further you get in, the more likely it is that it’s going to need surgical intervention.

We don’t know a ton of specifics regarding some of Porzingis’ injuries. We know it was a lateral meniscus tear. We know if occurred in Game 1 of (the first round of) the playoffs. We know it was a contact injury. We don’t know the size or shape of the tear, the location of the tear. But we do know he was able to play two games, which was a good sign that it was likely a small, peripheral tear. The fact that they gave him a PRP (platelet-rich plasma) injection in hopes of potentially calming that down and getting him to come back and play is another good indication that it wasn’t a complex tear.

When you have a PRP injection, you sometimes have to wait a bit before you can have surgery to ensure the knee is ready and prepared for surgery. Sometimes, you’ll even do things where you’re treating some of the associated symptoms with the injury, (such as) making sure the range of motion is as good as it can be, or minimize the swelling in the area. Basically, (you’re) prepping the knee for surgery. That might be what’s going on here. We know Porzingis was still working out and still able to do some things. But I think the decision was made that this minor tear needed to be addressed surgically, and he underwent surgery, and now we just play the waiting game in terms of what that’s going to look like long-term.

And in that context of what you’re saying, the hope is also that the surgery was done to repair the meniscus rather than remove it because removal would be a quicker recovery time but would lead to long-term complications. Right?

Well, not quite. This is back to location, location, location. There are two options when it comes to surgery. There is a repair, and there is a meniscectomy, which is the removal. A repair can only occur if it’s in a very specific location, so if it occurred somewhere else where the repair’s not possible, that might not even be an option. It might just be a removal. Repairs do have a lengthy recovery. They tend to be measured in months rather than weeks, where if it’s a true meniscectomy, you can be back in a matter of weeks. The location of the injury is going to dictate, ultimately, what the surgeon was able to do with Porzingis’ knee.

Casey Smith and the medical team of the Mavericks is a phenomenal group and they’ve dealt with this injury before. They’ve had several Mavericks players suffer meniscus tears — J.J. Barea, Gal Mekel. They’re going to do everything they can (to ensure) that Porzingis’ short-term and long-term health is put in the best position so he’s ready to perform again at the high level we know he can play at.

I’m going to be honest, Jeff, I didn’t wake up this morning expecting to think about Gal Mekel.

Anytime you can get a Mekel reference in, it’s always fun.

It absolutely is. Just to clarify for my understanding, because I’m sure readers will be in a similar position: If there was a small tear in the meniscus, and it was in such a location that required it to be removed, that’s not a total removal of the entire meniscus. It’s just the damaged part, right?

Correct, they’ll just take out that tiny damaged piece of cartilage. It can be a very simple shaving off to take it out, which isn’t a big deal in the grand scheme of things. Are there some associated risks? Yes. Does it potentially have some long-term consequences? Absolutely. But this isn’t a career-ending injury by any stretch of the imagination.

And it’s different even than a player like Derrick Rose, who had a much larger portion or the entirety of his meniscus removed, right?

Correct. Any time you take that shock absorber out, you’re going to get to a point where you have more articular cartilage rubbing together or bone-on-bone friction. You’ve obviously seen that be impactful for guys like Dwyane Wade, Brandon Roy and Derrick Rose, like you mentioned. But those were more complex tears (than the simple tear we’ve presumed Porzingis to have), and most of those guys had multiple meniscus injuries. Even a former Mavericks player like Chandler Parsons, who had a meniscus injury when he was here in Dallas, he also had an underlying cartilage issue as well, so it wasn’t just the meniscus. A little bit more complex than it sounds like, and hopefully not what Porzingis is dealing with now.

I think that’s good news for him, and it does make sense in the context of him continuing to play games after the injury. So there are three things I’ve been writing about Porzingis and his health. I think they’re all correct, they seem correct, but I want to run them by you and make sure I’m not crazy. First, regarding Porzingis’ ACL and meniscus surgeries, I’ve said that the injuries themselves are not particularly concerning. We know how NBA players recover from ACL injuries and meniscus injuries, as we just discussed. The concern is the big picture where Porzingis is a 7’3 player and has frequently had knee injuries to both knees.

I think it would be unwise to completely dismiss his previous injury history and at least to express some level of concern that he’s now had surgery on both legs. But he’s The Unicorn for a reason. We’ve never had a guy his size do the things he does and move the way he moves. Part of that comes with a somewhat increased level of injury risk because he’s moving from the perimeter into the interior where there’s a different set of injury risks. You’re going against bigger bodies down low. The taller you are, the injury risk is elevated because you’re talking about guys falling into you. That’s what happened here. It wasn’t a non-contact injury where Porzingis was in space. No, (Marcus) Morris fell into him, and he suffered the injury.

It’s a little bit of a loaded question because you want to make sure that there aren’t any underlying issues, which Porzingis has said the Mavericks helped him pinpoint some of the issues he had. He was playing better, moving better, and you can almost put the ACL injury behind you as long as you understand there’s still some routine maintenance that comes with it and things that we need to focus on moving forwards. And now we have the new injury, we’ve got to address it. You have to again address any underlying issues to mitigate as much injury risk moving forwards as possible.

That went right into the second thing I’ve been writing, which has been about 7’3 players and how Porzingis does have an unprecedented body type. Maybe there are players who have been 7’3 and slimmer or skinnier like Porzingis – people have mentioned Kareem Abdul-Jabbar, for example – but Porzingis plays in the modern NBA. How much do you have to take into effect with your job that in the modern NBA, with modern spacing, players are literally moving more feet, yards and miles per season?

It’s definitely something. The way the game is played changes a lot of different intrinsic factors of risk. With bigger players being asked to stretch out and extend their game to the 3-point line, we have to ask more questions: Are they covering more ground? Can they make up for some of that with their wingspan? Are there ways they can minimize having cover as much ground because they physically don’t have to move as much? It’s little things like that that are important to keep in mind and, again, that’s what makes Porzingis so unique. He moves fluidly. He doesn’t lumber up and down the court. The key is finding a way to balance the load put on these guys and the minutes and all the other things that go into, basically, what they’re subjecting their bodies to with the demands that a team wants them to do. And I think you’ve seen the Mavericks be proactive with that given how conservative they were with him throughout the year, as he was still working his way back after a year off.

And just for the record, an unprecedented player type in this era just means that we don’t have examples to fall back on. It’s not that Porzingis’ career is doomed. We just don’t have examples to refer to, good or bad.

Correct. There’s just not a guy who has had his makeup. You’ve had guys who have been tall, you’ve been guys who have been big, but it all depends on the blend of it. That’s why he’s nicknamed The Unicorn because he has such a unique skillset and body type.

The third thing I’ve been saying is that Porzingis should be very strictly rested or load managed during the regular season, no matter what’s going on with his health. Or, at least, that the Mavericks need a strict plan to minimize risk as much as is possible. It seems intuitive that him playing less games will reduce his injury risk. Is that actually how it works?

It’s part of it. The load management is the hot topic regarding player health. I’ve seen it work extremely well for some teams. San Antonio’s always been at the forefront of it and really seems to benefit from the use. For some other teams, they’ve tried, and it hasn’t worked, or perhaps they don’t have the benefit of doing that because they’re struggling to win games. It’s a fine balance to walk. I do think this is a situation where you’re going to see him get some rest games. … And they were doing this before his meniscus injury, and this is just going to try to help stress the importance of routine days off and routine maintenance.

https://theathletic.com/2132665/2020...injury-expert/

So, from what I'm reading, it seems like the tear itself was not that serious. The fact that they initially thought he could play on it and thought there was a chance that it wouldn't require surgery indicate that the injury was not severe. However, again we still don't know if the surgery was a removal or a repair of the damaged tissue. I'm just guessing here, but it seems this rosy disposition about the injury not being serious would suggest that the tissue was repaired rather than removed. Paradoxically however, it seems the less severe injury is the one that takes significantly longer to recover from.

This article sort glossed over it, but from what I've read, removal of the damaged tissue will lead to a much shorter recovery time, but will ultimately have really negative long term affects- just about everyone who has that surgery gets arthritis in that knee a few years down the road.

There's been word in the past couple of weeks that the Mavs were optimistic that KP would be ready for training camp, so maybe that means it was a removal instead of a repair? But this was before the announcement of the Dec. 22 start date, so maybe this was when they were thinking the season wouldn't start until February or March???

We also don't even know when KP had the surgery. So it's really hard to read the tea leaves here, but at least the speculation about the injury not being too serious is positive, even if it does mean he misses more time.

[KillerLeft]

I don't care if he starts the season, especially since we've had the chance to see that he CAN get back to a great level, despite the more serious injury from his time in NY. We know that he fits.

This season is likely to be more dense and condensed than any since 2011-12, so he's going to miss plenty of games, anyway, if they're smart about it. I just want him healthy for the playoffs, if at all possible.

[KillerLeft]

Good news, as the procedure seems to have been a repair and not a removal. This extends the rehab time significantly, but it's a very good thing in the long run. However, this doctor claims the injury was in the same knee as the ACL, and I swear it has been consistently reported to be the OTHER knee.

https://twitter.com/_sydneymyers/sta...638849537?s=20

[Thespiralgoeson]

Originally Posted by KillerLeft

Good news, as the procedure seems to have been a repair and not a removal. This extends the rehab time significantly, but it's a very good thing in the long run. However, this doctor claims the injury was in the same knee as the ACL, and I swear it has been consistently reported to be the OTHER knee.

https://twitter.com/_sydneymyers/sta...638849537?s=20

That can't be right, because we can see from pictures of KP that his surgery was on his right leg, and we definitely know that the previous ACL injury was his left leg.

https://www.youtube.com/watch?v=7sce--mR0kA

[DevinHarriswillstart]

Originally Posted by Thespiralgoeson

That can't be right, because we can see from pictures of KP that his surgery was on his right leg, and we definitely know that the previous ACL injury was his left leg.

https://www.youtube.com/watch?v=7sce--mR0kA

Yep. Twitter can be a dark and dangerous hole, but we really haven't heard much about the injury. I imagine KP is probably not keen on talking about his knees all the time, too.

[KillerLeft]

Originally Posted by Thespiralgoeson

That can't be right, because we can see from pictures of KP that his surgery was on his right leg, and we definitely know that the previous ACL injury was his left leg.

https://www.youtube.com/watch?v=7sce--mR0kA

Analysis of the injury was correct. He misspoke about which knee was injured. He corrected himself when I asked.

This is very consistent with other things I've heard or read on the injury.

[Thespiralgoeson]

https://pbs.twimg.com/media/EmA3UyQW...jpg&name=large

KP says he's off crutches, walking like normal, and lifting weights.

[MFFL]

Brad Townsend
@townbrad

Porzingis mentioned that he and most originally thought the season wouldn't start until February or maybe even March. That was part of the reason he delayed the surgery decision, also wanted to give time to see if surgery could be avoided.

[DevinHarriswillstart]

Originally Posted by MFFL

Brad Townsend
@townbrad

Porzingis mentioned that he and most originally thought the season wouldn't start until February or maybe even March. That was part of the reason he delayed the surgery decision, also wanted to give time to see if surgery could be avoided.

Ah good. Clarifies things.

[EricaLubarsky]

Originally Posted by Thespiralgoeson

https://pbs.twimg.com/media/EmA3UyQW...jpg&name=large

KP says he's off crutches, walking like normal, and lifting weights.

he says he's ready for Xmas against the Lakers.

I doubt Rick plays him, but its at least optimistic news.

[Thespiralgoeson]

Originally Posted by EricaLubarsky

he says he's ready for Xmas against the Lakers.

I doubt Rick plays him, but its at least optimistic news.

It's absolutely fantastic news, even though you're probably right that Rick won't play him. It means he probably only misses a small amount of time, instead of months. This really seems like it has turned out to be a best case scenario, as far as his recovery goes.

[DevinHarriswillstart]

I mean, even getting KP back by January is a win. No reason to rush him back. Gonna be a wacky season so it's important he is healthy near playoff time versus caring about early on.

[SMC0007]

Rick has already said January. Why even get hyped about him playing x mas?

[Thespiralgoeson]

Originally Posted by SMC0007

Rick has already said January. Why even get hyped about him playing x mas?

Like we said above, I don't think anyone expects him to play on christmas. But the fact that he says he's ready to just means that his recovery has apparently gone as well as anyone could have hoped.