There are few words NBA players and teams fear more than "microfracture." The term, describing a type of surgery used to stimulate the growth of cartilage in damaged joints, has foretold the demise of many a player's career. For others, the lucky ones like Jason Kidd and Grant Hill, microfracture surgery has prolonged their NBA careers.
For all the jokes about looking 40 years old when he was a freshman in college, Greg Oden has the knees of a 20-year NBA veteran. So with the news that Oden, another Sam Bowie for the Portland Trail Blazers, is considering a comeback for the 2012-13 season, we are left to wonder if his thrice microfractured knees will deliver on his first overall pick promise.
For Oden the trouble started before his NBA career began. After being hailed as the savior of the Portland Trail Blazers franchise as the 2007 NBA Draft first overall pick, Oden underwent season-ending microfracture surgery several months before his first NBA game. Despite the fact that his pre-draft MRI's were said to be "pristine," Oden developed an area of knee cartilage loss that caused his knee to swell and hurt during pre-season workouts.
Oden subsequently missed the entire 2007-8 season. He returned the following year and showed glimpses of the dominant ability that he displayed in college. Unfortunately after two injury-riddled seasons, he underwent a microfracture procedure on his left knee, again causing him to miss the 2010-11 season.
The knee's articular cartilage, like that of the other joints, serves as a cushion and shock absorber against the forces of running, jumping and cutting. Damage to this cartilage diminishes the ability of the knee to withstand the stress of athletics with pain and swelling the usual result. Injuries to other shock-absorbing structures in the knee such as the meniscus can accelerate this process and lead to the degeneration of the knee's cartilage. When the cushion-like cartilage has worn away to the bone, the knee is extremely vulnerable to any impact.
As the body is unable to regenerate this cartilage layer, surgery is often required in an attempt to restore the function of the knee. Unfortunately, as these procedures are unable to fully restore the natural ability of the cartilage, the success rate is variable at best. Microfracture surgery, a procedure in which the surgeon drills small holes in the exposed area of bone to stimulate a layer of scar-like cartilage, involves a lengthy recovery process.
In a research study examining those players that were able to return to the NBA after microfracture surgery, less than two-thirds had post-microfracture careers lasting longer than two seasons. Not surprisingly, the research study, which looked at microfracture surgery and rate of return to the NBA, found that younger players were more likely to return to professional basketball.
Because of this, Oden will face an uphill battle in his return to the NBA. If he is able to return to full strength, like Amar'e Stoudemire and Jason Kidd, he provides a high rate of return for the team that assumes the risk of signing such a chronically injured player.