NBA Rumor: Kawhi Leonard Injury

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Team sources have told AllClippers that those on the team are “cautiously optimistic” about Leonard returning, as Ramona Shelburne also reported, but the Clippers are going to remain very cautious about his return. If staff doctors see any reason to shut Kawhi Leonard down, they will have no hesitancy in doing so. As of right now, those red flags don’t exist. Kawhi Leonard himself didn’t shut down any doors to returning this season, as he stated on media day, “I wanted to be able to come back if I was able to this year.”

Ballmer admits he has often thought of what could’ve been if Leonard hadn’t gotten hurt. “It was painful,” Ballmer said. “Painful for Kawhi, painful for our team, painful for me and, most importantly, painful for our fans. But yeah, we gave it a go. We gave it a good go. We managed to push past Utah, even without Kawhi. “I was proud of our guys. We were within a whisker or two of taking care of business in the Western Conference finals, even without Kawhi. We’ll see when we get him back, but we basically have most of the same team back for next year. … I remain optimistic.”

The grade twos are where you kind of get into the gray zones. There are some patients where the instability that the patients feel, depend on how ACL dependent they are. There are people who have ACL tears and don’t feel any instability. There are people who have ACL tears, and they feel very unstable. So from a clinical perspective, you have to analyze how unstable their knee is objectively and subjectively. So if a patient says that their knee is unstable, even with a partial ACL tear, then typically they need surgery to stabilize that and reconstruct the ACL. But if they’re not clinically unstable, meaning that the knee feels stable, and they don’t have any symptoms from it, there are times where people can be treated non operatively, and rehab and play sports without any issues. So it really depends on the patient.

Partial ACL tears can be categorized as tears in the anteromedial bundle, or tears in the posterolateral bundle. Those are the two main bundles that occur, that the ACL fiber has. And typically, the anteromedial bundle tears, but they can both tear. If the remaining fibers are competent, meaning that they’re stable and are strong enough to function like a normal ACL, then you could do a partial or single-bundle ACL reconstruction, where you just reconstruct or repair the bundle that’s torn. And those are different techniques that are involved in that. More often, however, the remaining bundle fibers are not competent and not functioning. So even with a partial ACL tear, the remaining fibers don’t work. And so you end up doing a full reconstruction like normal.

Now, when you say recover quicker: In a case like Kawhi, because his injury happened on June 14 and surgery on July 13, where would you realistically put a timetable on his return to play? It depends on the type of surgery that he had. If it was a full ACL reconstruction, you’re looking at the regular time period for recovery, which is typically 6-9 months. Sometimes up to a year. If it was a low-grade partial ACL tear, and they did an ACL repair or an ACL augmentation with an orthobiologic supplementation, then possibly the recovery could be quicker. Maybe even 3-6 months, as opposed to the nine months to a year timeline. But again, it depends on the type of procedure that was done, and what the original injury and severity of the original ACL tear was.

Orthopedist on Kawhi Leonard's injury: Extremely rarely are ACLs partially torn

The announcement Tuesday “does leave numerous question marks” about the nature of Leonard’s surgery and his return to the court, said T.O. Souryal, a former two-term president of the NBA’s association of team physicians and the Dallas Mavericks’ team doctor for 22 years. Souryal, now an orthopedic surgeon at and medical director of a Texas sports medicine clinic, said he had seen a “true partial ACL tear less than a handful of times.”

“Think of the ACL, which is the main stabilizer of the knee, as a rope, because it is made up of fibers made up very much like a rope is,” Souryal said. “In my experience of well over 5,000 ACL injuries, it’s either torn or it’s not. Very rarely are a few fibers torn and the remainder is intact. Extremely rare. “The big question then becomes what does one do orthopedically with the remaining ACL? Are there enough fibers left that the knee is stable, or is it perhaps a ticking time bomb and you wonder when the remaining fibers will go? On the rare occasion that there is a partial ACL tear, the treatment is typically an ACL reconstruction.”

Both Souryal and Alan Beyer, the executive medical director at Orange County’s Hoag Orthopedic Institute, called a full reconstruction, in which the damaged ACL is replaced with a tendon from usually the patella, quadriceps or hamstring, the “gold standard” of ACL repair and easily the most common route. A return time is typically between nine and 12 months, though some athletes have returned sooner. Beyer, who also is an orthopedic surgeon, said that newer possibilities for repairing partially torn ACLs had emerged in recent years, such as inserting a type of bridge with the hope the torn tendon could be stabilized and regrow. But he added that any such operations have little data supporting their outcomes, making it difficult to project their efficacy on an elite athlete.

“You don’t do this operation to get him back quicker, you do this operation because you think it’s going to be less long-term morbidity, in that you’re not sacrificing another one of his tissues to function as an ACL,” said Beyer, who, like Souryal, had not consulted with either the Clippers or Leonard about the surgery. “We don’t have a large number of long-term success stories that we can say ah-ha, this works, when this is the presenting picture. It is a little bit of a risk that it’s not going to work as well as if you’d just bitten the bullet and done a conventional ACL reconstruction.”

Kawhi Leonard still expected to opt out despite injury

One executive I spoke to following the announcement that Kawhi had surgery to repair the partially torn ACL said he thinks no matter what, Kawhi would opt out, especially given the fact that Kevin Durant got the max after he suffered a ruptured Achilles. That executive also noted that Kawhi’s going to hit the 10-year mark for his years of service, which plays a role in upping his max contract as well.

Kawhi Leonard on right knee: 'I'm good'

While the Clippers won their second straight game in blowout fashion to give them all the momentum, Tyronn Lue’s team heads to Utah with some concern over Leonard’s health. The Clippers’ franchise player came up gimpy after driving to the basket while being fouled by Joe Ingles with 5:25 left in the game. Leonard leaned over before briefly grabbing his right knee. Leonard left the contest with 4:35 remaining and did not return. “I’m good,” Leonard would only say when asked about his knee. “Next question.” Lue believes Leonard will be fine for Wednesday’s pivotal Game 5 in Salt Lake City. “Yeah, I think so,” Lue said. “We’ll know more after the game, but yeah, I think everybody is pretty good.”

Kawhi Leonard playing through foot injury

In his first game back after missing the previous five games due to right foot soreness, Leonard had 16 points, six assists and five rebounds in 30 minutes in the LA Clippers’ 110-104 loss to the Denver Nuggets at Staples Center. “I’m feeling good,” Leonard said in his first comments since April 9. “We took the proper steps to get me right, to make sure nothing significant is wrong with me … so hopefully we can just keep moving up from here.”

A bloodied Kawhi Leonard was forced from the LA Clippers’ game at the Denver Nuggets in the fourth quarter Friday night after a collision with a teammate left him needing eight stitches to treat a mouth laceration. Serge Ibaka was going up for a defensive rebound when his elbow collided with Leonard’s face, immediately sending the All-Star forward to the floor. Leonard bled profusely from his mouth as he was treated on the court, before being helped back to the locker room with 6:07 left in the game.

For the second straight media availability, head coach Doc Rivers was non-committal when asked about Leonard’s health status and the team’s plan with his injury management. “I don’t know that yet,” Rivers said of Leonard’s limitations with minutes and back-to-backs. “But no limits. Kawhi is healthy, for the most part. That still doesn’t mean that we don’t want to maintain him and get him through the first eight games and get ready for the playoffs. We want to be smart about this. Not just for Kawhi. It’s with everybody. “But having everybody healthy was more about training camp. I mean, we really did not have a great training camp because we didn’t have enough bodies and enough of our key guys practicing. We have a virtually new team so we needed our new guys to be on the floor, and we didn’t have that ability to do that. This time, for the most part, we’ll have everybody in.”
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