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Wade Smith had knee scoped last night

Wish we could have some consistency on oline but it does allow others to get work. Hope to see Q get some additional work on left.
 
We've been pretty healthy at O-Line for a couple of years now compared to most teams. I'm just glad it happened at this point in the season. Get it cleaned up and get ready to roll a month or so from now.
 
eriadoc said:
I'm shocked.

:yawn:
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We were already specifically told that Wade had a "knee bone bruise," which in of itself is bad enough. Now he has undergone a scope, for whatever reason, which signifies that there was definitely additional damage present. The fact that bone bruises are commonly associated with damage to other adjacent knee structures is why I posted what I did on his injury originally.........none of these associated injuries plays well to a more favorable prognosis or quicker recovery.

Today, Dougherty reports that the Texans described Smith as having a "deep bone bruise."

The deeper the bone bruise signifies greater damage to the involved bone and greater likelihood of significant associated injuries.


[Original post over 1 week ago]

CloakNNNdagger said:
This is what I was concerned about with Brooks direct knee impact injury. A patella (knee cap) bone bruise can becoming a nagging injury leaving the player unable to participate due to lack of range of motion and often very intense pain. Furthermore, it is not unusual to be associated with damage to the adjacent bursae, fat, patellar ligament or the posterior cartilage surface of the patella. An accompanying small chip fracture or stress fracture of the patella is also not uncommon. Especially, even if a tiny stress fracture is present, if not addressed with an 8-10 week healing rehab period, there is long term concern that another blow to the knee could break the knee cap in two because of the quadriceps muscle pulling from above while the patella tendon pulling from below during flexion of the knee. This would require major surgery with at least a 3-4 month period prior to returning to play.

anatomy%20of%20knee.GIF


An MRI will have been already performed to diagnose the bone bruise. The Texans would know at this point if and how much collateral damage may exist. Patella bone bruises alone are bad enough in that depending on how severe, it could take months (up to a year in some cases) to completely heal, barring further trauma to the area. Rest and rehab of several weeks would not be out of order for even a modest bone bruise. However, as it stands now, if that is the case, I would guess that the Texans would push Wade to the limits of his pain threshold in order to get him back on the field as soon as possible. In doing so, it would not be surprising to see a significant performance drop off and/or setback.

In that the reports only say bone bruise of the "knee," this could also apply to bone bruise to the lower femur bone or upper tibia bone which are considered part of the knee. When bone bruises occur in load-bearing bones such as the tibia and femur, avoidance of weight-bearing for significant periods (depending on severity of the bruise) is extremely important to reduce the extension of the damage and significant prolongation of recovery.
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Wade Smith ✔ @Smitty74allday

My surgery went well. I appreciate everyone's calls, texts, thoughts, prayers, & well wishes 4 a speedy recovery. Be back before you know it
12:15 PM - 13 Aug 2013

From Battle Red Blog
 
We've dodged injuries so far, but it was inevitable that we would eventually have to deal with a few. This sounds worse than they initially led us to believe.
 
As bad as it may sound, I'd rather see Wade down than many other players. The Texans can survive this and still be dominant.
 
CloakNNNdagger said:
We were already specifically told that Wade had a "knee bone bruise," which in of itself is bad enough. Now he has undergone a scope, for whatever reason, which signifies that there was definitely additional damage present. The fact that bone bruises are commonly associated with damage to other adjacent knee structures is why I posted what I did on his injury originally.........none of these associated injuries plays well to a more favorable prognosis or quicker recovery.

Today, Dougherty reports that the Texans described Smith as having a "deep bone bruise."

The deeper the bone bruise signifies greater damage to the involved bone and greater likelihood of significant associated injuries.


[Original post over 1 week ago]
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CnD,

I read the events and reports that they likely went into the knee to clean up torn cartilage and discovery to see what they fear: significant cartilage loss leading to something close to bone on bone, requiring the dreaded microfacture surgery... or constant pain and further deterioration... or retirement.

Correct me where I may be misguided.
 
DocBar said:
As bad as it may sound, I'd rather see Wade down than many other players. The Texans can survive this and still be dominant.
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I wanted to replace him anyway. Feel bad for him, I really do, but it is what it is.

I'd like to see Brooks next to the big guy... er, bigger guy & Ben Jones in Brisiel's spot.


But, I am intrigued by putting the Q next to Duane. More than likely it's going to be a rotation there with Ben & Quessenberry(sp).
 
CloakNNNdagger said:
We were already specifically told that Wade had a "knee bone bruise," which in of itself is bad enough.
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I've just adopted a rule of thumb when considering what the Texans medical staff reports. I just multiply the severity by 10. They're kind of like the Black Knight reporting a flesh wound.
 
I have been pushing Q for OG and here is a link you might like to read:

http://www.battleredblog.com/2013/5...-rookie-ot-david-quessenberry-scouting-report

Quessenberry has long arms, left tackle length arms, and knows how to use them. You'll also notice, if you've an eye for it, a wider-than-normal stance, which helps him establish a stable, strong base to help with his leverage. Powerful Brandon Williams? Down. Athletic freak Margus Hunt? Blocked. Violent, physical Datone Jones? Shut down. Watch the practices for that blue helmet on the line and you see him keep at it.

2014 is where Quessenberry should begin to make his impact. If Houston feels he's progressing nicely, I can see them letting 32-year-old Pro Bowl guard Wade Smith's contract expire and penciling in Quessenberry as a starting guard with, presumably, Brandon Brooks. 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.
 
dalemurphy said:
CnD,

I read the events and reports that they likely went into the knee to clean up torn cartilage and discovery to see what they fear: significant cartilage loss leading to something close to bone on bone, requiring the dreaded microfacture surgery... or constant pain and further deterioration... or retirement.

Correct me where I may be misguided.
Click to expand...

With a DEEP bone bruise, cartilage destruction is common, as are other tissue injuries. Virtually by definition, these players are destined to severe arthritis. But if the bones of the knee joint are involved as the bones of "deep bruise," acute damage to the cartilage may require removal of large fragments of cartilage, essentially denuding significant surface areas of apposing bones, in this case distal end of the femur to the proximal end of the tibia.............known as bone on bone. Separated cartilage fragments like these do not heal if attempts are made to "transplant" or "re-graft" them. So they are "cleaned up," i.e., removed. And, as much as has been made of micro-fracture surgery, it seldom solves any problems unless the denuded area is extremely small.........and then only temporarily. If he undergoes micro-fracture surgery for a limited area and it is considered successful, your would still not expect return to play for at least 6 months..........if ever.

I hope this answers your question.
 
CloakNNNdagger said:
It all depends on what the extent of damage and type of damage he has sustained....and what procedure(s) they truthfully performed during the scope.
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Scary stuff

The word truthfully should never be used in the same sentence with the Texans medical staff.
 
eriadoc said:
Strictly based off draft reports, training camp reports, and one preseason game, I like the guy a lot. I think he can be the second best lineman at some point down the road.
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I am hoping for 2014
Brown, Q , Ben Jones, Brooks and Newton backed by Williams will be the future. of course there will always be others either low draft picks or FA like Harris to fill in as back ups.
 
Brisco_County said:
When will we get to the point where we can just 3D print some cartilage and shove it in there?
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Computer manufactured 3D implants exist for many bony parts of of the body (I've used them for facial/skull and chest reconstruction). However, pieces of isolated joint cartilage are not replaceable.......when it gets to that point, both apposing surfaces must be replaced in substitution of bone and cartilage in the form of joint replacement.
 
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."

patel_ch.jpg


pic1.jpg


1836W.jpg


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.
 
badboy said:
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.
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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.
 
CloakNNNdagger said:
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.
Click to expand...

Ever so often, some of your freely given information is directly applicable to me. I know I've thanked you before, but allow me once again. Your knowledge and ability to share that knowledge is a huge contribution to this community. Thank you. Rep when I can.
 
CloakNNNdagger said:
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."

patel_ch.jpg


pic1.jpg


1836W.jpg


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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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...
 
dalemurphy said:
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...
Click to expand...

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.


viscosupplementation.jpg


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.
 
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.
 
CloakNNNdagger said:
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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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.
 
76Texan said:
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.
Click to expand...

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:

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."
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link
 
CloakNNNdagger said:
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
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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.
 
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.
 
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DocBar said:
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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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% .
 
76Texan said:
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.
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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.
 
MidtownMikey said:
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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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.
 
badboy said:
http://bleacherreport.com/tb/db2S2?...medium=newsletter&utm_campaign=houston-texans

Left Guard
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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.

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



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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For some reason I am thinking it was the other leg. This is one reason I have been working to replace Wade on my roster. I like Ben Jones but Q just seems better suited to LG after watch him at LT last year. I think many are going to look back on this season and realize what we saw with our Oline of the future.
 
badboy said:
For some reason I am thinking it was the other leg. This is one reason I have been working to replace Wade on my roster. I like Ben Jones but Q just seems better suited to LG after watch him at LT last year. I think many are going to look back on this season and realize what we saw with our Oline of the future.
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???? I'm not really sure if I know what you mean.
 
I've been touting Ben Jones @ RG & Brooks at LG.... makes more sense to me, than Ben Jones at LG.

I've been wanting to replace Wade Smith since before he was a pro bowler.


But... I do like Brooks @ RG & Q at LG
 
Lucky said:
Could you explain why?
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I've thought Wade Smith's play has been below par for some time now. I also liked what I saw from Ben Jones last year. I know he doesn't have the power & strength of Brooks, but I think he's more athletic & better at getting to the second level. He reminds me of Myers.

Brooks is a big strong guy. He's not built like Wade, but he plays the same. Put that hulk next to Brown & just mow'em down. Then pull Ben Jones around and surprise that LB or Safety coming around the edge.

I thought all along the plan was to move Brooks to RG when the season starts & let Ben Jones get a couple of reps at Center through camp. But when Wade got hurt & they left Brooks @ RG I figured that's where they want him.

Sent from my SCH-I535 using Tapatalk 2
 
thunderkyss said:
Brooks is a big strong guy. He's not built like Wade, but he plays the same. Put that hulk next to Brown & just mow'em down. Then pull Ben Jones around and surprise that LB or Safety coming around the edge.
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OK, so you believe the Texans have more of a left sided running attack, and Brooks would be better at the point of attack and Jones better at cutting off the back side.

I see your point.
 
The thing is that the Texans change things up all the time.
One year, they would favor running to the left side more; another year, they would run right more.
One year, they ran more inside zone; another year, outside zone.
One year, they ran pure ZB; another, they added the gap-scheme runs and counters, and pulling linemen.

So if they decide to put a guy at certain position for now, I imagine they have an idea what they want to do this year.
 
76Texan said:
So if they decide to put a guy at certain position for now, I imagine they have an idea what they want to do this year.
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I'm sure they do. I'm just trying to figure out where there thinking is. Our best OL was with Winston, Brisiel, & a pretty good Wade Smith. Jones looks like a better Brisiel & Brooks a younger Wade.

Problem, in my mind now, is Newton is nothing like Winston in the run game.

Right now it looks to me that Kubiak & Dennison doesn't have any rathers & build there line & attack according to there strengths.

Sent from my SCH-I535 using Tapatalk 2
 
thunderkyss said:
I'm sure they do. I'm just trying to figure out where there thinking is. Our best OL was with Winston, Brisiel, & a pretty good Wade Smith. Jones looks like a better Brisiel & Brooks a younger Wade.

Problem, in my mind now, is Newton is nothing like Winston in the run game.
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Jones has not reached the level of competence that Brisiel had. I agree with you on Newton. Brooks is TBD.
 
Lucky said:
Jones has not reached the level of competence that Brisiel had. I agree with you on Newton. Brooks is TBD.
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TBD for sure on both Brooks & Jones.

I'm thinking in time, Jones will surpass Brisiel & Brooks will be as good as Wade in Wade's best season here. I think Wade was a monster his first season here.
 
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