Jared Dudley has platelet-rich-plasma injection in knee

USA TODAY Sports

Jared Dudley has platelet-rich-plasma injection in knee

This really isn't a big deal but with all the talk about Derrick Rose's most recent knee injury and with the mystery surrounding Kobe Bryant's medical trips to Germany I thought it was interesting to see that Jared Dudley had platelet-rich-plasma injected into his sore knee. (As a disclaimer, I'm not a doctor, not an orthopedist, everything I know is from stuff readily available on the web.)

The source is Brad Turner at the LA Times. Platelet rich plasma therapy is pretty simple. The orthopedist removes some blood from the subject, puts it in a centrifuge and separates the platelet-rich material from the rest of the blood and injects those into and around the suffering portions of the body (in this case, the knee). Platelets are produced by the bone marrow are full of oxygen and are critical to the healing process... or so modern medicine believes. The treatment seems to work, although how much, how well, or how quickly is debatable.

If you're thinking this is similar to Kobe Bryant's German knee treatments you'd be correct although there's a little more voodoo in the German "Regenokine" treatment in that the blood is heated before it's centrifuged. Why? The German doctors who invented it say it's to give the blood a "fever". Why that works or doesn't work is the voodoo part. (Kobe Bryant says it works, so does Alex Rodriguez. You can take it from there.) But the heating part is also why the treatment isn't approved in the US.

There are other similar "biologic" treatments using stem cells though these are considered both more cutting edge and are also not USDA approved.

Finally, I thought it was interesting that Mike Smith did a decent if not perfect job explaining Derrick Rose's most recent injury. Rose tore the mediall meniscus in his right knee (not the knee in which he suffered an ACL injury, the other one). There are two menisci in each knee, lateral and medial. And yes, they are shock absorbers between the big bones of the upper and lower legs. And you can tear them and an orthopedist will go in and figure out whether or not to remove the meniscus or sew it back together. In Rose's case they opted to repair the meniscus and re-attach it, which requires a longer rehab than simply removing the meniscus. But then Mike Smith made a curious statement and omission. He stated that meniscus removal was what Brandon Roy had done and it created a "bone on bone" situation and hastened the demise of Roy's career. That's both correct and incorrect. Brandon Roy had something like six knee surgeries from high school through his pro career. Some of them were done well and some of them weren't. He had ALL the meniscus cartilage removed from his knees over those six or eight years (only he and his doctors know for sure). All those procedures hastened an advanced arthritis condition on his knees. The meniscus doesn't regrow but it's a mistake to say that the condition is "bone on bone". That's too simple. There's a lot of other material, muscle, ligaments, other cartilage that can hold the bones apart without the meniscus. In Roy's case, the knees were too deteriorated, too chronic to save.

But Smith curiously left out a pair of Clippers players who've had all or pieces of meniscus removed from their knees. Two summers ago Blake Griffin had a partial (at least I think it was partial) meniscectomy on one of his knees. In 2010 Chris Paul had ALL of the medial meniscus removed from his right knee. Both Griffin and Paul were out weeks (Griffin's surgery was in the off-season) not months. Was either surgery somehow inferior to the surgery Derrick Rose suffered? Was removal of Paul's meniscus an inferior treatment to Rose's? No, on all counts. All the surgeries were performed by leading orthopedists. Decisions were made during the surgeries and the results are the results. Chris Paul wore a knee brace for a while and while he might be a little slower and less athletic than when he came in the league it might be because he's eight years older as much as because of his knee injury. And Blake Griffin still regularly gets his head above the rim.

Will Derrick Rose, Blake Griffin, Jared Dudley, and Chris Paul suffer later in life because of these knee surgeries? Probably. The pounding pro basketball players big joints take put them all at risk of arthritis, tendinitis, etc. later in life. But how many people do you know who don't suffer some joint deterioration? How many people eventually wind up with an artificial hip or knee? A really really lot. It's going to happen to those guys too... despite the fact that they're superior athletes, not because of it.

I didn't mean it to, but this has become a sort of follow up to this old article. There's more, better information in there if you're interested.

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