Hamilton's Knee
by ranger jim on Sep 1, 2010 9:14 AM CDT
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The news that Josh Hamilton had a Synvisc injection after last night's game is very disturbing. The fact that they turned to Synvisc and that he seems to have had an injection like this before leads to the conclusion that the cartilage damage in his knee is very advanced.
I have a bad knee and have had both Synvisc and Hylagon injections. Both are given in a series of injections a week apart. Synvisc is usually 3 injections, Hylagon 5. Each injection is progressively more uncomfortable as the knee joint is already full. The last injection feels like you just had arthroscopic knee surgery for about 24 hours.
This does not bode well for Josh' longevity in MLB, particularly as a position player. Any team should be reluctant to a long-term commitment to someone with this type of knee problem. He certainly may be a good player for several years but his knee could give out quickly too. A series of one year contracts are likely in his future.
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I've felt all along that........
………talk of signing him to a long extension was premature and foolish.
He’s a free agent following the 2012 season. Let the arbitration process play out for the next two years, and then evaluate his physical status after 2012.
"Don't confuse the outcome that a decision produces with the intelligence that went into making that decision."--Tony LaRussa
Rather have him
Teixeiraed than Greered.
"Look, we're basically on earth to shit and fuck. So unless your job's to help people shit or fuck, it's not that important, so relax."-https://twitter.com/shitmydadsays
Good comparison
Hamilton is the MVP this year. He’s awesome, obviously. But let’s see him play in 100+ games 2 or 3 years in a row before signing him to a long-term deal.
"Don't confuse the outcome that a decision produces with the intelligence that went into making that decision."--Tony LaRussa
So is the issue cartilage damage or tendonitis?
What are we at the park for except to win? I'd trip my mother. I'd help her up, brush her off, tell her I'm sorry. But mother don't make it to third. ~Leo Durocher
You wouldn't treat tendonitis with a Synvisc injection
Synvisc is a viscous fluid that provides a temporary substitute for cartilage.
you also would not treat tendinitis of the knee with a cortisone injection
both injections are for internal joint damage and not external tendon problems
we're from Texas
CJ says "Relax"
Cortisone IS used for tendonitis
Tendinitis is an inflammation of the tendon or tendon sheath. Cortisone is a strong anti-inflammatory. I’ve gotten Cortisone injections for tendinitis in my knee.
"What ... 92 miles per hour?" Feldman scoffed. "That's not gas. Feliz throws gas."
"If I had caught it, the force would have taken me through the fence." -- Rockies outfielder Ryan Spilborghs about a Nelson Cruz line drive.
by NorCalRangersFan on Sep 1, 2010 12:26 PM CDT up reply actions
Patella tendon, actually
but most people would call that the knee.
"What ... 92 miles per hour?" Feldman scoffed. "That's not gas. Feliz throws gas."
"If I had caught it, the force would have taken me through the fence." -- Rockies outfielder Ryan Spilborghs about a Nelson Cruz line drive.
by NorCalRangersFan on Sep 1, 2010 12:29 PM CDT up reply actions
cortisone injections into the patellar tendon or achilles can lead to rupture
which is why we don’t typically advocate that treatment. Cortisone is injected into tendinitis of the shoulder and elbow because those are musculotendinous regions with much better blood supply that do not tend to rupture from injections.
we're from Texas
CJ says "Relax"
No, cortisone is used for inflammation, sprains, and things like that.
"The Angels are like the villain in the movie that isn't dead until he's been stabbed 150 times in the bath tub, yet he still might come back up one more time." - Eric Nadel
to be more specific oral steroid/prednisone is very effective for most mild tendinitis cases
if you have a full blown case of recalcitrant tendinitis/microtears then the better treatment that has come along is injections of “PRP” or platelet rich plasma. These are essentially the cells that stimulate the body’s healing response and have been very effective treatments for tendinitis and sprains of tendons, muscles, ligaments. That treatment had been reserved for athletes such as Hines Ward, Tiger Woods, etc but now is becoming more commonly offered to the general public.
we're from Texas
CJ says "Relax"
Heh, alright you clearly know more about this than I do.
I stand corrected. :)
"The Angels are like the villain in the movie that isn't dead until he's been stabbed 150 times in the bath tub, yet he still might come back up one more time." - Eric Nadel
Thank you.
I’m not a Dr. so i was unsure what was causing him pain. I have had knee tendonitis before but never to the point of requiring any type of injection so I did not know.
What are we at the park for except to win? I'd trip my mother. I'd help her up, brush her off, tell her I'm sorry. But mother don't make it to third. ~Leo Durocher
Of the 5 brands of injectable hyaluronic acid
Synvisc has the highest rate of adverse reactions such as joint pain and inflammatory reaction post injection. Even worse than Synvisc is Synvisc-One which has had so many reactions that most orthopods have stopped using it.
we're from Texas
CJ says "Relax"
I had a bad reaction to Synvisc
Synvisc is egg based. About a week after the last injection my knee was swollen to about double normal size and about as painful as it has ever been. It took about a week for that to subside and then I did have relief with the Synvisc for at least 6 months.
the main reason for Synvisc reactions is the formadehyde preservative used in the preparation
other forms of HA such as Supartz and Orthovisc do not have the formaldehyde and do not have the incidence of reactions. If you have a chicken/egg protein allergy it could cause a massive reaction leading to respiratory problems
we're from Texas
CJ says "Relax"
Is there anything...
Josh can have done surgically during the offseason to help this? Or is it going to be a constant issue going forward?
"The only good is knowledge and the only evil is ignorance."-Socrates
to answer that we would have to know exactly what the problem is, and it would require an MRI
could be a torn meniscus, could be divots in the cartilage of his knee. Both conditions can be treated with arthroscopic knee surgery, but the latter does not bode well for the long term.
we're from Texas
CJ says "Relax"
he could have a torn meniscus scoped
and be playing full speed again in two weeks.
by I am Neftali Feliz on Sep 1, 2010 12:06 PM CDT up reply actions
no. Recovery from a knee scope requires more like 4-6 weeks before running activity
we're from Texas
CJ says "Relax"
unless your a heisman trophy winning RB from alabama
then its only 1-2 weeks
by RQ on Sep 1, 2010 6:24 PM CDT up reply actions
that is an unusual case and not the typical recovery seen
to be frank I have had patients go out and run 5 miles 2 days after arthroscopic partial menisectomy, but it would be unprofessional to give that kind of expectation to your patients
we're from Texas
CJ says "Relax"
Yes I know that is not usual
That is why I was making fun of Alabama parading to their fans that he would be back so soon so they wont worry so much. Recovery depends on the overall condition before surgery (very good for Hambone or Ingram not so much for your average joe), the extent of the injury and the precision of the surgeon.
Also, running 5 miles in a straight line is very different than sprinting, cutting, sprinting back to top speed all at the same time. Plus he must trust his knee to do that without hesitation. No chance he is back by week 2.
by RQ on Sep 2, 2010 9:38 PM CDT up reply actions
just out of curiousity
you seem to have some medical insight, what is your source?
by RQ on Sep 1, 2010 6:25 PM CDT up reply actions
I'm assuming...
that will certainly be something the Rangers look at after the season then.
"The only good is knowledge and the only evil is ignorance."-Socrates
I'm sure the Rangers staff is already highly considering it
They probably know exactly what’s wrong, but when you’re the MVP of the year playing on a contending team, you can’t just get surgery in the middle of the season.
By 2028, Mark Teixeira will be in the HOF.
"I am one of the biggest Texas Ranger fans out there but I'm also one of the smartest. Deal with it."
-The Outlaw
He's not the MVP, he sucks
/linedrive222
"I support you, Wash; I’ve always supported you," Young said
"Back on the scene, with a gangsta lean" RW
I'm worried he could have osteoarthritis
which would require an arthoplasty or at least UKA.
Troy McClure: "Don’t kid yourself, Jimmy! If a cow ever got the chance, he’d eat you and everyone you care about!"
by stupidsexyflanders on Sep 1, 2010 1:49 PM CDT up reply actions
it is very unlikely he would ever get arthroplasty such as a replacement in the near future
for one it is very unlikely his arthritis would be that advanced unless he had a chronic ACL rupture, and his age would deter most any sane orthopod from advocating even a UKA such as an Oxford prosthesis. More likely he has a focal osteochondral defect which can be treated by microfracture or “OATS” mosaicplasty.
we're from Texas
CJ says "Relax"
Sorry
I left out “down the road”. If he does undergo mosaicplasty, then that’s no prob. Three months of rehab and he’ll be good as new.
Troy McClure: "Don’t kid yourself, Jimmy! If a cow ever got the chance, he’d eat you and everyone you care about!"
by stupidsexyflanders on Sep 1, 2010 7:32 PM CDT up reply actions
Ever since he got the second cortisone injection I've been thinking knee surgery is probably in the plans for him this offseason.
"The Angels are like the villain in the movie that isn't dead until he's been stabbed 150 times in the bath tub, yet he still might come back up one more time." - Eric Nadel
This reminds me of that scene in Varsity Blues...
Where that RB is about to take a shot in the knee while Moxson (sp?) looks on urges him not to listen to the coach…heh.
"Fuck Tom Hicks. There is no aspect of my baseball universe that man hasn't shit on."
"and to Adam J. Morris and the Lone Star Ball regulars; go fuck yourself."- cmkelly29
by TooLegitToQuit on Sep 1, 2010 1:51 PM CDT via mobile reply actions
I downt wownt
yo life.
Purgatory's kind of like the in-betweeny one. You weren't really shit, but you weren't all that great either. Like Tottenham.
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