Friday, April 18, 2014
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Bynum: Is it over?

Andrew Bynum's season officially ended on Tuesday. Will we ever see him in a Sixers uniform? A local knee expert offers some thoughts.

Bynum: Is it over?

Sixers center Andrew Bynum. (AP Photo/Matt Rourke)
Sixers center Andrew Bynum. (AP Photo/Matt Rourke)

After months of speculation littered with countless doctor’s visits, setbacks (and hairstyles), the Sixers confirmed this week what we’ve all suspected—Andrew Bynum’s 2012-13 season is over before it even started.

How could this have happened? How could the franchise invest so many resources into a player with one year on his contract, only to have him never step on the court? Dr. Arthur Barotlozzi, MD says that with cartilage injuries, you just never know.

“Cartilage is the holy grail of sports medicine,” he summarizes. “Once we figure it out, we'll be able to solve everything.”

Dr. Bartolozzi is the director of sports medicine at Aria 3B Orthopaedic Institute in Langhorne and formerly worked with the Eagles and Flyers. He says that no matter how thorough the physical examinations before acquiring a player, some things are a matter of chance. Players have failed physicals and gone onto thrive in the professional ranks, while others pass with flying colors and suffer through injury-plagued careers.

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“I examined a player once who had a terrible knee,” he says. “I told the coach not to take him under any circumstances—the coach told me he didn’t want to hear it, because he knew the guy would play his heart out.”

That player went onto become an All-Star. Over the past 20-30 years, immeasurable strides have been made in the area of ACL repair in the sports medicine community. As Dr. Bartolozzi says, the great question now is knee cartilage.

“You can sit there as a coach or a GM and say ‘I only want players with perfect knees, no cartilage injuries.’ That’s not too easy, but there are a fair number of players in the league with cartilage damage who are playing just fine. Some people can play with the damage, some players can’t.”

Differentiating between the two groups isn’t just a question of a MRI. There’s also the physical exam, but the most important factor that outweighs all others is also the simplest—can this particular athlete play in his condition?

“That’s the hard part—some people can play with it, some can’t,” says Dr. Bartolozzi. “Some people have terrible damage and play tennis with no pain at all. Others have minimal damage and can’t walk. It really is a great unknown.”

Dr. Bartolozzi scoffs at the idea of any professional athlete who ‘doesn’t care’ or ‘doesn’t want to play.’ “Skin heals in seven days. If you break a bone, that’s eight weeks. If you injure cartilage, sometimes the healing can be up to 18 months,” says Dr. Bartolozzi. “You don’t get to that level in any profession if you don’t want to be there, if you’re not willing to work,” he says. “There’s a component of the healing process that does take time—that’s the part we don’t like.”

In Bynum’s case, he flew to Germany before the season for Orthokine treatments but saw no improvement. He aggravated one knee in a freak bowling mishap, the first of many seemingly small setbacks that culminated in Tuesday’s announcement.

But Bynum doesn’t even turn 26 until the start of the 2013-14 season, and has repeatedly stated his commitment to coming back healthy. On the other hand, he’s now missed almost half of the total number of games for the Lakers and Sixers the past half-dozen years. Is it worth the risk of bringing him back—even at a potentially reduced price?

“Obviously, any decision would be made after a great deal of assessment of performance,” Dr. Bartolozzi clarifies. “I examined a wide receiver one time in a similar situation—a talented player coming off of a surgery that brought his asking price down. I told the coach that the outcome for that surgery was unknown, and that it was high-risk. There was a chance of serious or catastrophic injury.

“Any player with a cartilage injury, there’s always going to be a question of whether he can play. The team willing to accept the risk will have to weigh all those factors and make their decision.”

Read more Sports Doc for Sports Medicine and Fitness.

Robert Senior Sports Doc blog Editor
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Whether you are a weekend warrior, an aging baby boomer, a student athlete or just someone who wants to stay active, this blog is for you. Read about our growing list of expert contributors here.

Robert Senior Sports Doc blog Editor
Alfred Atanda, Jr., M.D. Nemours/Alfred I. duPont Hospital for Children.
Robert Cabry, M.D. Drexel Sports Medicine, Team physician - U.S. Figure Skating, Assoc. Team Physician - Drexel
Brian Cammarota, MEd, ATC, CSCS, CES Symetrix Sports Performance, athletic trainer at OAA Orthopaedics
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Rothman Institute, Head Team Physician for the Phillies & St. Joe's
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Rothman Institute, Head Team Physician - Eagles, Head Orthopedic Surgeon - Flyers
Joel H. Fish, Ph.D. Director - The Center For Sport Psychology, Sports Psychology Consultant - 76ers & Flyers
R. Robert Franks, D.O. Rothman Institute, Team Physician - USA Wrestling, Consultant - Philadelphia Phillies
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer at The Sporting Club at The Bellevue
Cassie Haynes, JD, MPH Co-Founder, Trap Door Athletics, CrossFit LI Certified
Eugene Hong, MD, CAQSM, FAAFP Team Physician - Drexel, Philadelphia University, Saint Joe’s, & U.S. National Women’s Lacrosse
Jim McCrossin, ATC Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales, Pa.
David Rubenstein, M.D. Main Line Health Lankenau Medical Center, Team Orthopedist - Philadelphia 76ers
Justin Shaginaw, MPT, ATC Aria 3B Orthopaedic Institute, Athletic Trainer - US Soccer Federation
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