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Old 08-14-2013   #21
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Default Re: Wade Smith had knee scoped last night

As the Texans are being nonspecific as to damage to "what" cartilage, one of the "better" scenarios (and it's still no bargain), is the cartilage involving the back side of the patella (knee cap).....patellar chondromalacia......where it is essentially crushed many times with damage to the apposing cartilage of the femur surface of the knee joint behind it. The deeper the bone bruise, the greater the probable cartilage damage to both surfaces. The more subsequent movement allowed, the greater damage is created by the two surfaces "grinding."







Adequate rest is again absolutely necessary after such a "clean up." Then intensive rehab. Depending on the extent of damage, I would still be surprised if return should take any less than a couple of months.....and with greater damage greater potentially many more. Unfortunately, that type of surgery does not correct the problem (cartilage is gone).........and the player may very likely still show progression to more severe problems with quickly decreasing levels of performance. Bone on bone and severe arthritis is commonly the final end results, with some players never coming back.
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Old 08-14-2013   #22
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Default Re: Wade Smith had knee scoped last night

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That's what the Texans do on the line: they keep young talent at the ready and move them up the chain. A potential multi-year starter from a sixth round pick? Tremendous value pick that could be the steal of the NFL Draft. Even if Quessenberry remains the top swing reserve lineman, that's still good value.
Hopefully that's what the Texans do on the line.

That's what they did in Denver. I know people talk about their RBs from that Shanahan/Kubiak era, but they had an OL factory going on down there. At least while Kubiak was there. They had the occasional first rounder playing on the line, but usually it was a 5th, 6th, or even UDFA starting on their line. Then they'd move one guy in after another & not miss a beat.

Surely our "factory" hasn't reached that level of production yet, as there are drops in production when we replace guys & it appears we use a rotation to get them up to speed.

But soon, I'm hoping we'll fill the pipeline & we can count on excellent OL play year after year, injury or no.
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Old 08-14-2013   #23
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Default Re: Wade Smith had knee scoped last night

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Originally Posted by CloakNNNdagger View Post
As the Texans are being nonspecific as to damage to "what" cartilage, one of the "better" scenarios (and it's still no bargain), is the cartilage involving the back side of the patella (knee cap).....patellar chondromalacia......where it is essentially crushed many times with damage to the apposing cartilage of the femur surface of the knee joint behind it.
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Old 08-14-2013   #24
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Default Re: Wade Smith had knee scoped last night

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Originally Posted by CloakNNNdagger View Post
As the Texans are being nonspecific as to damage to "what" cartilage, one of the "better" scenarios (and it's still no bargain), is the cartilage involving the back side of the patella (knee cap).....patellar chondromalacia......where it is essentially crushed many times with damage to the apposing cartilage of the femur surface of the knee joint behind it. The deeper the bone bruise, the greater the probable cartilage damage to both surfaces. The more subsequent movement allowed, the greater damage is created by the two surfaces "grinding."







Adequate rest is again absolutely necessary after such a "clean up." Then intensive rehab. Depending on the extent of damage, I would still be surprised if return should take any less than a couple of months.....and with greater damage greater potentially many more. Unfortunately, that type of surgery does not correct the problem (cartilage is gone).........and the player may very likely still show progression to more severe problems with quickly decreasing levels of performance. Bone on bone and severe arthritis is commonly the final end results, with some players never coming back.
CND,

Do you think it would be prudent for football players to get regular Synvisk (the lubricant made from rooster comb proteins)injections as simple prevention/maintenance? I wonder if any teams are doing that kind of thing now. From what I understand, there is no harm and likely some additional protection for the cartilage. I'd like to know your thoughts.

I'm thinking this should be considered for healthy knees, not just chronic ones...
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Old 08-14-2013   #25
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Default Re: Wade Smith had knee scoped last night

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CND,

Do you think it would be prudent for football players to get regular Synvisk (the lubricant made from rooster comb proteins)injections as simple prevention/maintenance? I wonder if any teams are doing that kind of thing now. From what I understand, there is no harm and likely some additional protection for the cartilage. I'd like to know your thoughts.

I'm thinking this should be considered for healthy knees, not just chronic ones...
Synvisc has been around since the mid 90s. Studies have revealed very mixed results. Several have shown absolutely no differences from placebo saline injections (which resorb quickly). The ones that tended to show some pain relief were relatively small studies in numbers, short spans of follow-up (6 months or less) and representing more of the regular Joe population with very lightly sprinkled elite athlete representation. The idea is that it acts as a lubricant and shock absorber. Neither effect has been truly proven to be significant. Some patients, after the usual 5 injection series exhibit 6 month pain decrease (usually not relief) anecdotally. But regular Joe is not looking to crunch against 300 pound players that are trying to kill them.....they are mostly looking for some improvement in simply getting around.......i.e., walking.............trying to temporize total knee replacement for a couple of years. You could just as well be pouring motor oil into the joint.




As far as injecting the knee "prophylactically," if teams are doing this, it is far from benign. Each time you poke a perfectly normal knee, you run the risk of infection. Even one infection of the knee during a multiple injection series can cause wide devastating scarification and destruction of the knee joint structures. BTW, depending on which studies you read, the rate of infection following each Synvisc injection is anywhere from ~5% to 10%......certainly no small number........especially for knee that started out normal.
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Old 08-15-2013   #26
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Default Re: Wade Smith had knee scoped last night

It appears that Smith had another knee scope around the beginning of this past February that wasn't revealed. We don't know if if it was on the same knee or the other knee. If it were the same knee especially, the bone bruise episode certainly didn't make it better.
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Old 08-15-2013   #27
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So it would seem he is return is TBD with no foreseeable return in the immediate future?
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Old 08-15-2013   #28
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Default Re: Wade Smith had knee scoped last night

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So it would seem he is return is TBD with no foreseeable return in the immediate future?
Que Q & Ben Jones. Could be an upgrade. Wade was a little shaky last season.
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Old 08-15-2013   #29
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Que Q & Ben Jones. Could be an upgrade. Wade was a little shaky last season.
Just like I said in the QB2 v PSQB thread; let the best man win. :tipshat:
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Old 08-15-2013   #30
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Default Re: Wade Smith had knee scoped last night

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Originally Posted by CloakNNNdagger View Post
It appears that Smith had another knee scope around the beginning of this past February that wasn't revealed. We don't know if if it was on the same knee or the other knee. If it were the same knee especially, the bone bruise episode certainly didn't make it better.
I know they've been doing work on his knees from time to time last year; I just don't what it was they were doing.

Do you any info on those occasions?

My gut feeling in the off-season was that he's not going to make it through another year healthy or in decent playing shape with those knees.
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Old 08-15-2013   #31
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Default Re: Wade Smith had knee scoped last night

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I know they've been doing work on his knees from time to time last year; I just don't what it was they were doing.

Do you any info on those occasions?

My gut feeling in the off-season was that he's not going to make it through another year healthy or in decent playing shape with those knees.
Beginning with the Jets game (week 5) last year, Smith essentially made the Injury Report every week for a "knee." This is an independent reason I have for being concerned with the history of "deep bone bruise" AND a recent history of 2 scopes. The combination of history of last year, with these 3 recent "events," makes his future look that much more questionable......not optimistic.



Let's look back to just a short while ago:

Quote:
Posted: 6:05 p.m. Monday, Aug. 12, 2013
BREAKING NEWS: With Questions Surrounding Wade Smith's Knee, Texans Make Trade With Eagles

Earlier today, Gary Kubiak revealed that Pro Bowl left guard Wade Smith, thought to have suffered a relatively minor knee injury, is getting a second opinion after the knee failed to respond to treatment as well as the team hoped:

"Obviously, he banged knees, had his knee swell up on him, had a big bone bruise," head coach Gary Kubiak said Monday morning. "Hasn’t responded the last few days the way we wanted it. We’re re-evaluating him, having some other people look at it today."


"We were expecting him back in a few days, but it just didn’t happen,"
Kubiak said. I’m okay until I hear what’s next, but obviously there’s another step for us to take. Got to find out what’s going on here."
link
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Old 08-15-2013   #32
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Default Re: Wade Smith had knee scoped last night

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Originally Posted by CloakNNNdagger View Post
Beginning with the Jets game (week 5) last year, Smith essentially made the Injury Report every week for a "knee." This is an independent reason I have for being concerned with the history of "deep bone bruise" AND a recent history of 2 scopes. The combination of history of last year, with these 3 recent "events," makes his future look that much more questionable......not optimistic.



Let's look back to just a short while ago:

link
How does this bode for Foster? We're all used to sketchy reports from the team, but they've been less forthcoming with Foster, who is immeasurably more vital to the team than Wade Smith.
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Old 08-15-2013   #33
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Default Re: Wade Smith had knee scoped last night

Oh well, we'll just have $3M in salary cap open up if Smith is cut then.
That's not all bad, given that his play has gone down last year due to the problems with the knees.
Having him play hurt again isn't going to help anybody.

Last edited by 76Texan; 08-16-2013 at 07:05 AM.
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Old 08-16-2013   #34
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Default Re: Wade Smith had knee scoped last night

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How does this bode for Foster? We're all used to sketchy reports from the team, but they've been less forthcoming with Foster, who is immeasurably more vital to the team than Wade Smith.
The Texans are insistent that Foster's calf is completely well and no problem. And his back has just for some reason "tightened up on him." It would be remiss to discount that the likely reason for a tight back would be as a back strain compensatory to his calf injury.......something that would be changed by his postural dynamics (core instability) either secondary to adjusting to some residual soreness of his calf, and/or fear of re-injury. Remember, calf strain/tear is associated with a high incidence of later strain of the same calf (re-injury to the same calf can lead to long-term chronic calf problems) or contralateral calf, a combined risk reported as high as 50% .
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Old 08-16-2013   #35
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Default Re: Wade Smith had knee scoped last night

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Oh well, we'll just have $3M in salary cap open up if Smith is cut then.
That's not all bad, given that his play has gone down last year due to the problems with the knees.
Having him play hurt again isn't going to help anybody.
76, that all depends on how his contract was structured if cutting him would free up $3 million, a portion of that, or if an injury cut would turn it all into dead money anyways.

I actually was trying to see if there were any mentions of being "guaranteed for injury" but could never find the info. With him not being a star by any means and not even a for sure starter when he was signed 4 years ago, the Texans could have avoided guarantees of any type on the final year.

Still, it is pretty common for bigger name vets to get at least a partial guarantee placed against injury until there are pre-existing injuries the teams wants to protect against (in the case of Manning's contract with the Broncos). So if Wade Smith has a great agent, he could have gotten something put in. Also not sure what the union does in these cases. Most cuts for injury I've seen in the past without any major payout were of rookies drafted in the 2nd or later rounds.
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Old 08-16-2013   #36
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Default Re: Wade Smith had knee scoped last night

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76, that all depends on how his contract was structured if cutting him would free up $3 million, a portion of that, or if an injury cut would turn it all into dead money anyways.

I actually was trying to see if there were any mentions of being "guaranteed for injury" but could never find the info. With him not being a star by any means and not even a for sure starter when he was signed 4 years ago, the Texans could have avoided guarantees of any type on the final year.

Still, it is pretty common for bigger name vets to get at least a partial guarantee placed against injury until there are pre-existing injuries the teams wants to protect against (in the case of Manning's contract with the Broncos). So if Wade Smith has a great agent, he could have gotten something put in. Also not sure what the union does in these cases. Most cuts for injury I've seen in the past without any major payout were of rookies drafted in the 2nd or later rounds.
I reckon you're partially right.
I've been reading up on it.
It's still clear as mud, but it looks like the team and the player just reach an injury settlement, which should be the amount that counts toward the salary cap.
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Old 08-16-2013   #37
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Default Re: Wade Smith had knee scoped last night

So we're possibly looking at Wade Smith's career being done, with his history of knee issues?
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Old 08-16-2013   #38
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Default Re: Wade Smith had knee scoped last night

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So we're possibly looking at Wade Smith's career being done, with his history of knee issues?
That's got to be considered a possibility. I'm hoping we've already got a couple of upgrades at that position, though.
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Old 08-16-2013   #39
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Default Re: Wade Smith had knee scoped last night

http://bleacherreport.com/tb/db2S2?u...houston-texans

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Old 08-16-2013   #40
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Default Re: Wade Smith had knee scoped last night

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Looks like we got the answer.........the arthroscope was on the same knee as the "bone bruise." Goes along with what I have posted about commonly associated injuries to adjacent structures, especially with "deep" bone bruises which occur with more severe impact to the bone.

Quote:
Smith had a bone bruise on his knee that eventually required an arthroscopic surgery this week. While hes out, Ben Jones will start the preseason game on Saturday but rookie sixth-round pick David Quessenberry is battling for time too.
It would now be interesting to know if this knee was the same one he had scoped back in the beginning of February.
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