Carson Palmer's knee injury labeled 'potentially career-ending'

[Deattribution]

CINCINNATI -- Carson Palmer's knee injury was "devastating and potentially career-ending," involving numerous ligament tears, a shredded ligament, damaged cartilage and a dislocated kneecap, his surgeon said Thursday.



The Cincinnati Bengals quarterback tore ligaments in his left knee when he was hit by Pittsburgh's Kimo von Oelhoffen on his first pass during the Steelers' 31-17 playoff victory Sunday.

The team announced that he had torn the anterior cruciate and medial collateral ligaments. The damage was much more extensive and severe, but Dr. Lonnie Paulos said surgery went well and Palmer could be back for the start of the season.

Palmer had surgery Tuesday in Houston. Doctors used grafts from other parts of his body and donated tissue to fix the damage during an operation that lasted more than two hours. Palmer headed back to California on Thursday to do his rehabilitation.

"It's not just like it was a torn ACL," Paulos said Thursday, in a phone interview from Houston. "It's a magnitude more difficult to recover from and repair. It can and has ended careers, without a doubt.

"However, I feel very comfortable with Carson as an athlete and the heart that he's got. In the end, that's the bottom line. I can see the look in his eye already. He's ready to get going," he said.

Paulos, an orthopedic surgeon who has worked with the U.S. Ski Team since 1983, replaced the anterior cruciate ligament, which runs through the middle of the knee and provides stability. He said the medial collateral ligament, which runs along the side of the knee, was damaged "real bad."

"On a scale of one to three, it was a four," he said. "It was off the chart. It was pretty badly damaged -- shredded is the better term."

The kneecap dislocated when Palmer was hit, damaging tissue around it. There was also some cartilage damage, he said.

Paulos was able to repair the knee without removing pieces of cartilage or soft tissue, a good sign.

"The things that were torn could be repaired," he said. "They were not torn beyond repair. So he's got all his parts in there, which is good. We're optimistic, actually."

If rehabilitation goes well, Palmer could be running in a couple months and might be able to play in the first regular-season game, Paulos said. The 2006 schedule hasn't been set.

Palmer has worn a protective brace on the left knee since he sprained it near the end of the 2004 season. The knee bowed inward on von Oelhoffen's hit even though Palmer was wearing the brace.

"The brace didn't function well in this environment and should have done better than it did, frankly," Paulos said.

The plan is for Palmer to wear more substantial braces on both knees when he returns.

"No brace is perfect," Paulos said. "No brace can prevent every injury, but they do help."

Paulos saw the replay of the injury and wasn't surprised at the extent of the damage it caused. Palmer has absolved von Oelhoffen, saying he didn't think the lineman was trying to hurt him. The lineman said he was trying to sack Palmer, not injure him. He wasn't penalized for the hit.

Palmer made the Pro Bowl in only his second season as a starter, throwing an NFL-leading 32 touchdown passes. The club extended his contract through the 2014 season.

Jon Kitna, who has been Palmer's backup and mentor the last two years, can become a free agent. Palmer's injury will force the Bengals to make sure they have another reliable quarterback on board.

Kind of a conflicting story, I guess the fact is he should be back but it sounds as if he may not be the same again. Very unfortunate considering he was looking like he was going to be an outstanding QB for sure.

Throws a little more doubt into the contract extension as well, despite it being an unforeseeable injury.

Edit for linky - http://sports.espn.go.com/nfl/news/story?id=2290239

[Schmidty]

That would really, really suck. Not just for the Bengals, but for the NFL.

[st.cronin]

I would find it hard to believe that any knee injury could be career threatening in this day and age. That does sound scarily like my own knee injury, though, which occured skiing in Colorado several years ago. My knee still hurts, all the time.

[dawgfan]

Damn.

On the plus side, hopefully this kind of situation is an area where advancing technology continues to make the likelihood and severity of these injuries decrease over time, both through improving surgery techniques and improvements in equipment like knee braces.

I remember when it used to be you'd only see guys that had knee surgery wearing knee braces - now it seems like a lot more guys are wearing them as preventative measures. Improvements in braces that increase stability while decreasing in weight (and thus any impairment on playing ability) will hopefully counteract the increase in size and strength of players that contributes to these kinds of injuries.

[WSUCougar]

Originally Posted by Schmidty

That would really, really suck. Not just for the Bengals, but for the NFL.

Agreed

[biological warrior]

http://www.msnbc.msn.com/id/10826927/

[Daimyo]

I bet he'll be back... a RB might never recover from something like that, but its not like he was known for his mobility before the injury.

[Swaggs]

Am I the only one who reads this and thinks that Dr. Paulos is just very proud of his work?

[gottimd]

http://www.retrojunk.com/details_theme/319/

Steve Austin= Carson Palmer
Astronaut=Quarterback

[Dutch]

As long as Vinny Testeverde and Bryan Leftwich can play standing still, Carson Palmer has a chance.

Seriously, I hope he can play again, but more importantly, I hope he can play again as a top-flight quarterback.

[Coffee Warlord]

Originally Posted by st.cronin

I would find it hard to believe that any knee injury could be career threatening in this day and age. That does sound scarily like my own knee injury, though, which occured skiing in Colorado several years ago. My knee still hurts, all the time.

Ditto, from identical conditions (skiing in CO). Absolutely destroyed cartiledge in my knee. Doctor told me he'd never seen damage like that on anyone close to my age (I was about 19-20 at the time).

Hurts on and off, I even tried skiing on it a couple years later...nuh uh. An hour on the slopes and I was hurting bad.

[Eaglesfan27]

Originally Posted by Swaggs

Am I the only one who reads this and thinks that Dr. Paulos is just very proud of his work?

Nope. He talks about how horrible the injury is, and how it is "potentially career ending" but also says that he thinks Carson could be back by the beginning of next year. I think that he maybe trying to make his work sound even more impressive than it is and win him future clients.

[Dutch]

Originally Posted by Eaglesfan27

Nope. He talks about how horrible the injury is, and how it is "potentially career ending" but also says that he thinks Carson could be back by the beginning of next year. I think that he maybe trying to make his work sound even more impressive than it is and win him future clients.

It's better than the soup-line behind the mall in Southeast DC in February.

[st.cronin]

Originally Posted by Coffee Warlord

Ditto, from identical conditions (skiing in CO). Absolutely destroyed cartiledge in my knee. Doctor told me he'd never seen damage like that on anyone close to my age (I was about 19-20 at the time).

Hurts on and off, I even tried skiing on it a couple years later...nuh uh. An hour on the slopes and I was hurting bad.

Yeah, I can't even really run for more than about 5 steps without feeling like my leg is about to fall apart.

[Coffee Warlord]

Originally Posted by st.cronin

Yeah, I can't even really run for more than about 5 steps without feeling like my leg is about to fall apart.

Heh, you got it worse than I did then.

[hoosiergoody]

If he comes back, we can call him Carson Marino. Was a huge Marino fan- he had zero mobility, yet had a great career. Don't think Carson has the arm strength that Marino had...

[Senator]

So, can he just retire and collect his 9 year contract or whatever it was?

[biological warrior]

Im thankful that I have not had any of these type of injuries and can still ''run'' 3-5 miles. I hope he comes back. His career was just blossoming too.

[JPhillips]

A rather different take including clarification from Paulos at Bengals.com.

Doc optimistic Palmer can start season
By GEOFF HOBSON
January 12, 2006

6 p.m.

Although his patient suffered what he called “severe ligament damage,” Carson Palmer’s surgeon is optimistic that the Bengals quarterback can return in time for the start of the regular season.

Dr. Lonnie Paulos also said Thursday that much hinges on the next few months of rehab and how it heals, “things that are really out of my control and Carson’s control. We need to give it a few months. But he’s got an excellent chance to be back playing as well as he did before.”

Paulos says the normal time frame for recovery for reconstructive knee surgery is nine to 12 months, but he thinks Palmer will be back “long before that,” even though he called it an atypical tear of the anterior cruciate ligament.

“The knee cap slipped off to the side and caused some damage,” Paulos said. “It’s not the usual ACL tear, but we don’t believe this is going to be a career-ending injury. Really, it comes down to rehab and determination, and knowing Carson, he’s going to do what he has to do.”

Palmer left for home Thursday to begin rehab in California after Paulos operated Tuesday at the Houston Medical Center.

Paulos, 59, who is establishing the Baylor University Sports Medicine Clinic in Waco, Tex., surfaced as the surgeon once Palmer and his people told the Bengals they preferred an independent doctor rather than a team doctor to do the operation. The landscape in pro sports has changed since Paulos was literally on the cutting edge of sports medicine in Cincinnati a generation ago.

“Now it’s a more involved process with the family, the agents, the team,” Paulos said. “I know the sports medicine community very well in Cincinnati and he’ll be well taken care of by the team with the Bengals. He’s in excellent hands.”

The Bengals know Paulos well enough that they referred him to Palmer and Palmer decided to go with the recommendation. In 1978, Paulos and Dr. Frank Noyes formed Cincinnati’s first sports medicine clinic at One Lytle Place, where Paulos worked on some Bengals and Reds. It is Noyes, Paulos says, that did much of the definitive research on the ACL.

“Frank showed that it was the athlete’s ligament,” Paulos said. “It’s the one that’s used for running and jumping and pivoting. He demonstrated that without it, you can’t do it. Before Frank did that work, people didn’t think the ACL was very important.”

During the three–hour procedure to repair the ACL as well as the medial collateral ligament, Paulos grafted Palmer’s own tissue as well as tissue from organ donors to reconstitute and augment the damaged anatomy in the region between the tibia and femur.

Palmer wore a brace on his knee since he sprained his MCL in the same knee back in December of 2004, and Paulos said he and the team could end up opting to wear a brace that provides more protection.

Like everyone else, Paulos, who is a partner in the group that administers to the Texans and University of Houston, came away impressed with Palmer.

“He’s bright, he’s committed, you can see it in his eyes,” he said.

Yes, Paulos did look at the play before surgery, and watched Steelers defensive end Kimo von Oelhoffen’s hit on Palmer’s knee a few times.

“Sometimes the speed of the play, the angle, can give you a better idea of what you’re going to find,” Paulos said. “But no matter how much you see it, you really don’t know until he’s asleep on the table and you go into the knee with the microscope.”

And here’s a second opinion from the good doctor:

“A clean hit,” Paulos said. “It was an accident. No athlete would ever do something to another athlete like that on purpose.”

Late Thursday night after conducting a series of media interviews, Paulos, through the Bengals public relations department, released the following clarification:

“I believe and regret that media reports, based on interviews with me, have misinterpreted my view of Carson Palmer’s knee injury. Though the injury was serious, the essential facts remain his ACL and MCL have been repaired. I would consider this a typical MCL-ACL football injury. My comments attributed to me that the knee injury was, “devastating and potentially career ending,” were meant to describe such injuries in general, not Carson’s particular case.

“I was accurately quoted by the Associated Press that my bottom line is optimism regarding Carson’s prognosis. With a successful rehabilitation program, he has an excellent chance of being medically cleared for play at the beginning of the 2006 NFL regular season.”

[Young Drachma]

Originally Posted by Senator

So, can he just retire and collect his 9 year contract or whatever it was?

I was wondering this, too.

[SackAttack]

Originally Posted by Senator

So, can he just retire and collect his 9 year contract or whatever it was?

The guaranteed bonuses, yes.

The non-guaranteed stuff like roster bonuses, and the base salaries, no.

But I don't think Carson's the kinda guy to screw a franchise over that way.

[Senator]

Originally Posted by SackAttack

The guaranteed bonuses, yes.

The non-guaranteed stuff like roster bonuses, and the base salaries, no.

But I don't think Carson's the kinda guy to screw a franchise over that way.

He might not have a choice.

[WrongWay]

Which leg is it? Is it his front or back leg when he throws?

If it is his back leg, the one he plants and pushes off of, then I don't think he'll ever be back.

[M GO BLUE!!!]

Believe it or not, I think that Cincinatti would be a good place for Joey Harrington. I'm not saying this just to want rid of him, but I honestly believe that Joey might still have a good career if he were to leave Detroit. In Detroit, even if he improves and has many good games every mistake he makes will be highly scrutinized. If he were to be the backup in Cincinnati however, he would be in an offense that more closely suits his abilities and he would be able to take the role of starter until Palmer is recovered. There would be a clear role for him, and he could use a season of work where his role is clearly defined. If he looks good before Palmer is ready then he could use that as a springboard to be a hot free agent next season (assuming a 1 year deal.) If Palmer is clearly affected by his knee and Joey has looked good, maybe he may even find a home. It would be a good, pressureless environment where little would be expected of him. It would be like having a temp QB.

[sovereignstar]

Originally Posted by WrongWay

Which leg is it? Is it his front or back leg when he throws?

If it is his back leg, the one he plants and pushes off of, then I don't think he'll ever be back.

Dr. Van Nostrum, ladies and gentlemen.

[Deattribution]

I think if he never plays again, Palmer collects something like 30 million from here on regardless.

[Emiliano]

Damn, very bad news. I really hope the guy comes back 100% healthy, but I highly doubt that. I'm not a doctor but with a damage like that the biggest problem is the high chanche of getting re-injured, and that would be really devastating. Let's hope for the best.

[WrongWay]

Originally Posted by sovereignstar

Dr. Van Nostrum, ladies and gentlemen.

Yeah, yeah, yeah, can you please just answer the question?


I have been reading article, after article about how this will change his mobility, but no one is talking about his throwing ability. I am hoping this means it is his front leg, and not his back one then.

QB's that have lost the ability to scamble can still be very good in this league, a braced John Elway, QB's that have lost the ability to push off with their back leg are finished.

[Butter]

It was his left leg, so it would be his front leg during the throwing motion.

[Julio Riddols]

Carson will be just fine. There is way too much gloom going on here for someone who most assuredly WILL return from this injury and be just as good as he was before.. He may lack a small amount of escapability, but his mind and his arm (The one that put the ball 60 yards in the air to Henry on that fateful pass) will be just fine, and I happen to believe his mind will only get better as the years go on.. Even moreso after this, which everyone seems to think could be the death of him.

Carson, if he hasn't proven it already, is committed to being the best QB Cinci has ever had, and in his mind probably, he wants to be one of the best ever. His progression over the course of 1 year is evidence of that. I mean, last year, Cincinnati didn't no huddle until they needed to.. This year, it was a staple of the offense, more and moreso toward the end of the season. Carson is not far behind Manning in the regard that he can call his own plays quite efficiently and pick apart a defense.

I will tell everyone right now, he will be back, and he will be just fine. If this ends his career, I will never watch football again, because I simply won't know how to have faith anymore.

[rkmsuf]

I don't get why the doctor would say this in the first place.

[PackerFanatic]

Julio put it well, Carson is a fighter and will do whatever the hell he has to to get back out on that field and lead the Bungles. He is a great QB and will be great next year just as he was this year.

[Eaglesfan27]

Originally Posted by PackerFanatic

Julio put it well, Carson is a fighter and will do whatever the hell he has to to get back out on that field and lead the Bungles. He is a great QB and will be great next year just as he was this year.

Personally, I think Carson is a great fighter who will be back, but like others have said, I think it will be 2 years until he is really back to himself. Next year, I suspect will be an off year for him IF he makes it back in time for the season.

[PackerFanatic]

Then the Kane look-alike can take over the reigns again.

I was shocked when I saw how much Kitna looked like Kane, it was wierd, lol.

[Swaggs]

I think he will be back at some point next season. He will likely be less mobile, but the other problems he will probably have are fear of being hit again (which is reasonable when you have to put in 6-12 months of rehab between playing) and injuring other areas of his body in compensating for his physical changes.

I suspect it will be a season or two before he looks similar to what he did this year.

[terpkristin]

Originally Posted by Eaglesfan27

Nope. He talks about how horrible the injury is, and how it is "potentially career ending" but also says that he thinks Carson could be back by the beginning of next year. I think that he maybe trying to make his work sound even more impressive than it is and win him future clients.

I gotta agree with EF here. Maybe I've just know too many orthopaedic surgeon's and (by association) their egos. I also have to say that for an ACL tear with collateral damage (damage to other aspects of the knee, I'm not just referring to the MCL here), 2 hours to explore and make sure you get it all right is right about average for length of surgery. Actually, most orthopaedic surgeries are done in 1-2 hours.

Glad Carson's surgery went well, I never like to see people get injured, even if they're on Duke (I know he's not, just saying, even if they're on a team I really love to hate).

Maybe I've just had too many bad experiences with ligament and tendon injuries...


/tk

[korme]

THis might be the worst week of my life.

[sovereignstar]

Originally Posted by Shorty3281

THis might be the worst week of my life.

???

[pennywisesb]

I really hope Palmer can come back from this. I was a huge fan of his at SC and I've followed the Bengels since they drafted him.

[Eaglesfan27]

Originally Posted by pennywisesb

I really hope Palmer can come back from this. I was a huge fan of his at SC and I've followed the Bengels since they drafted him.

Ditto. I'm becoming a Bengals fan primarily because of Carson. I hope he makes it back at his high level of play.