Timelord (Woj: To play limited minutes in Game 3)

[Hoopvortex]

when this conversation shifts to surgery, does anyone know what type?

i had arthroscopic micro fracture surgery for my meniscus seven years ago (can’t remember if i had a tear or had just worn it down from too much running), and i was back to full time running in six weeks with no issues.

is this an option for rob or is “surgery” referencing something more invasive?

I suspect it would depend on the type of tear but meniscus surgery, whether it's repair or menisectomy is usually arthroscopic. All depends on the type of tear and whether they decide to sew it or remove part of it to improve the stability of the joint. The initial arthroscopy will help them decide what they need to do because they need to see what the tear looks like, they can't really tell that from just an MRI.

I understand the basics of this, but do you have any idea of the long-term affects of repair vs. removal?  Is full removal what leads to the dreaded "bone on bone"?

Yes, people who have total menisectomies usually become candidates for osteoarthritis, because the purpose of the meniscus (as with most cartilage in the body) is to reduce the friction when the joint articulates (rotates or flexes). When it tears it causes pain and reduces knee stability and range of motion.

Menisectomy can remove part of all of the meniscus, depending on what type of tear it is and where it is. Most menisectomies would be partial where they would trim away the part of the meniscus that is torn because there is no prospect of it healing (usually for medial meniscus tears where there's no blood flow to that part of the joint). The preferred option would still be to sew it but depending on where it is it may not be easy to do so via arthroscopy and they may just decide to trim.

Total menisectomies almost always lead to osteoarthritis, because then the friction is the articular cartilage (at the bottom of the patella, that would normally rub against the meniscus) is rubbing against the top of the tibia when you flex and rotate your knee. Over years that articular cartilage wears down (like a brake pad) and when it wears out you get the is the bone-on-bone that can cause bone spurs to develop which then causes significant pain. Then you are a candidate for a knee arthroplasty (replacement). Like my dad, he has had lots of little meniscus tears in his left knee, which was never stable to begin with because he suffered a broken patella slipping on the ice in Philly 20 years ago so he may be looking at one in the next 5-10 years or so if his osteoarthritis continues to develop.

That's very unlikely for Rob - it's usually something that would be done in older patients as part of a knee arthroplasty (replacement). But even partial menisectomies increase the risk of osteoarthritis, as does suffering a tear and leaving it untreated. The risk factor is a bit lower than total though. But Rob, like a lot of basketball players that rely on explosiveness, will always be at risk of osteoarthritis when he gets older.

If it is indeed a lateral meniscus tear, the chance of having to do a menisectomy is more minimal than if it was a medial tear, because a) blood flow to the lateral part of the meniscus means it has a great chance to heal on its own; and b) it's easier for orthopods to get to the meniscus to repair it. So assuming that is indeed the case he's got a great chance at a full and quick recovery (though given his other knee issues in the past they may decide to play it safe with him and hold him out longer than needed to make sure he has max stability in his knee when he returns).

Meniscus surgery does not necessarily involve a meniscectomy. Orthopedists distinguish six types of tears, and it depends on which type of tear there is as well as how badly torn the meniscus is. In some situations it is appropriate to stitch the tissue together and let the fibrous bits bind to one another for healing, or simply form scar tissue, without needing to cut anything out.

There seems to be some confusion about anatomy and terminology in this thread.

There are two menisci in each knee, a lateral and a medial. Each meniscus is like a slice of orange. The outer parts of each meniscus have the best blood supply, in other words where the rind of the orange would be. "Outer" in this case does NOT equate to "lateral"; in fact it's mostly on the medial side of the medial meniscus where it gets the best circulation.

It is NOT the case that the lateral meniscus has a better blood supply than the medial.

[Goldstar88]

Sounds like the surgery is going to be tomorrow. Fingers crossed....

https://www.google.com/amp/s/www.bostonglobe.com/2022/03/29/sports/robert-williams-knee-injury-could-force-celtics-scramble-postseason/%3foutputType=amp

[liam]

Sounds like the surgery is going to be tomorrow. Fingers crossed....

https://www.google.com/amp/s/www.bostonglobe.com/2022/03/29/sports/robert-williams-knee-injury-could-force-celtics-scramble-postseason/%3foutputType=amp

Everything is crossed.

[ozgod]

when this conversation shifts to surgery, does anyone know what type?

i had arthroscopic micro fracture surgery for my meniscus seven years ago (can’t remember if i had a tear or had just worn it down from too much running), and i was back to full time running in six weeks with no issues.

is this an option for rob or is “surgery” referencing something more invasive?

I suspect it would depend on the type of tear but meniscus surgery, whether it's repair or menisectomy is usually arthroscopic. All depends on the type of tear and whether they decide to sew it or remove part of it to improve the stability of the joint. The initial arthroscopy will help them decide what they need to do because they need to see what the tear looks like, they can't really tell that from just an MRI.

I understand the basics of this, but do you have any idea of the long-term affects of repair vs. removal?  Is full removal what leads to the dreaded "bone on bone"?

Yes, people who have total menisectomies usually become candidates for osteoarthritis, because the purpose of the meniscus (as with most cartilage in the body) is to reduce the friction when the joint articulates (rotates or flexes). When it tears it causes pain and reduces knee stability and range of motion.

Menisectomy can remove part of all of the meniscus, depending on what type of tear it is and where it is. Most menisectomies would be partial where they would trim away the part of the meniscus that is torn because there is no prospect of it healing (usually for medial meniscus tears where there's no blood flow to that part of the joint). The preferred option would still be to sew it but depending on where it is it may not be easy to do so via arthroscopy and they may just decide to trim.

Total menisectomies almost always lead to osteoarthritis, because then the friction is the articular cartilage (at the bottom of the patella, that would normally rub against the meniscus) is rubbing against the top of the tibia when you flex and rotate your knee. Over years that articular cartilage wears down (like a brake pad) and when it wears out you get the is the bone-on-bone that can cause bone spurs to develop which then causes significant pain. Then you are a candidate for a knee arthroplasty (replacement). Like my dad, he has had lots of little meniscus tears in his left knee, which was never stable to begin with because he suffered a broken patella slipping on the ice in Philly 20 years ago so he may be looking at one in the next 5-10 years or so if his osteoarthritis continues to develop.

That's very unlikely for Rob - it's usually something that would be done in older patients as part of a knee arthroplasty (replacement). But even partial menisectomies increase the risk of osteoarthritis, as does suffering a tear and leaving it untreated. The risk factor is a bit lower than total though. But Rob, like a lot of basketball players that rely on explosiveness, will always be at risk of osteoarthritis when he gets older.

If it is indeed a lateral meniscus tear, the chance of having to do a menisectomy is more minimal than if it was a medial tear, because a) blood flow to the lateral part of the meniscus means it has a great chance to heal on its own; and b) it's easier for orthopods to get to the meniscus to repair it. So assuming that is indeed the case he's got a great chance at a full and quick recovery (though given his other knee issues in the past they may decide to play it safe with him and hold him out longer than needed to make sure he has max stability in his knee when he returns).

Meniscus surgery does not necessarily involve a meniscectomy. Orthopedists distinguish six types of tears, and it depends on which type of tear there is as well as how badly torn the meniscus is. In some situations it is appropriate to stitch the tissue together and let the fibrous bits bind to one another for healing, or simply form scar tissue, without needing to cut anything out.

I did mention that in an earlier post. In the case of my tear it was appropriate to just let it heal naturally, although I was given the option to have it stitched together as well.

There seems to be some confusion about anatomy and terminology in this thread.

There are two menisci in each knee, a lateral and a medial. Each meniscus is like a slice of orange. The outer parts of each meniscus have the best blood supply, in other words where the rind of the orange would be. "Outer" in this case does NOT equate to "lateral"; in fact it's mostly on the medial side of the medial meniscus where it gets the best circulation.

It is NOT the case that the lateral meniscus has a better blood supply than the medial.

Here's where I got the information from. I took my father here for an appointment a few years ago.



https://www.thesteadmanclinic.com/patient-education/knee/meniscus-injuries

[KeepBigAl]

Going for the 1 or 2 seed should CLEARLY be out now.  We need to strategically rest players to attempt to gain a favorable first round match up.  Good news is Milwaukee will be difficult to catch and Miami has an easy schedule if they can right the ship.

Simple facts are Brooklyn will very likely be 7/8 and Rob is more important to our team than home court.

Signing a big like WCS or Thon Maker (or a miraculously healthy Baynes) seems like a no-brainer (what if Al or Theis get banged up?).  I know it's sacrilege, but still prefer Freedom as a break glass guy to Green Kornet.

[boscel33]

Going for the 1 or 2 seed should CLEARLY be out now.  We need to strategically rest players to attempt to gain a favorable first round match up.  Good news is Milwaukee will be difficult to catch and Miami has an easy schedule if they can right the ship.

Simple facts are Brooklyn will very likely be 7/8 and Rob is more important to our team than home court.

Signing a big like WCS or Thon Maker (or a miraculously healthy Baynes) seems like a no-brainer (what if Al or Theis get banged up?).  I know it's sacrilege, but still prefer Freedom as a break glass guy to Green Kornet.

Don't believe they can sign Freedom.  I thought of Stein, another poster mentioned Zeller, as two legit bigs.  There's also Parker who has been with us and can play some PF.  That said, had a WojBomb this morning:  "Boston Celtics C Robert Williams is expected to return within 4-to-6 weeks" (partial quote)


https://twitter.com/wojespn/status/1509144540543913984

[Roy H.]

After undergoing surgery for a torn meniscus in his left knee Wednesday morning, Boston Celtics center Robert Williams III is expected to return within four to six weeks -- a timetable that could land him back in the lineup as soon as the second round of the Eastern Conference playoffs, sources told ESPN.

Williams suffered the tear Sunday night, but the extent of the injury allowed for a procedure that won't require him to be sidelined for several months, sources said.

After the procedure on Wednesday, there was some initial optimism of a return on the shorter end of the timeline, sources told ESPN. The Eastern Conference semifinals are expected to start around May 1.

https://www.espn.com/nba/story/_/id/33629299/boston-celtics-center-robert-williams-iii-expected-miss-4-6-weeks-surgery-repair-meniscus-sources-say

[Celtics2021]

After undergoing surgery for a torn meniscus in his left knee on Wednesday morning, Boston Celtics center Robert Williams III is expected to return within four-to-six weeks -- a timetable that could land him back in the lineup as soon as the second round of the Eastern Conference playoffs, sources told ESPN.

https://www.espn.com/nba/story/_/id/33629299/boston-celtics-center-robert-williams-iii-expected-miss-4-6-weeks-surgery-repair-meniscus-sources-say

That seems like near the best case scenario.  Here’s hoping the rehab heals him fully.

[CelticSooner]

In my mind an able-bodied Timelord is the difference in making the Finals or not. Enough basketball gods!

[Donoghus]

All things considered, that's about the best news you could get.

[PaxtonDarcy]

Will this be our Willis Reed moment? Round 1 game 7 vs the nets, Timelord comes running out of the tunnel.

[jpotter33]

Sounds like best case scenario. Love it.

Now we just need to do what we can to avoid Brooklyn in round one to give us the best shot possible of lasting long enough to have a fully healthy team for the playoffs. Still think we can beat Brooklyn without Timelord, though.

[Birdman]

Doubt he can come back that quick with conditioning and all..that’s why a backup good center is important

[Erik]

Doubt he can come back that quick with conditioning and all..that’s why a backup good center is important

Doesn’t the 4-6 week timeline include conditioning usually ? I can’t imagine he won’t start PT until week 6 for example. Should be once the swelling goes down..?

[slamtheking]

Going for the 1 or 2 seed should CLEARLY be out now.  We need to strategically rest players to attempt to gain a favorable first round match up.  Good news is Milwaukee will be difficult to catch and Miami has an easy schedule if they can right the ship.

Simple facts are Brooklyn will very likely be 7/8 and Rob is more important to our team than home court.

Signing a big like WCS or Thon Maker (or a miraculously healthy Baynes) seems like a no-brainer (what if Al or Theis get banged up?).  I know it's sacrilege, but still prefer Freedom as a break glass guy to Green Kornet.

great news with Timelord if he's back to playing in that 4-6 week window.

with the seeding, anywhere in the top 4 is pretty much a lock but #1 is looking like the best slot for avoiding Brooklyn for those concerned about that matchup. 
- Brooklyn has gotten to #8 in the standings and is very unlikely to slide back to #9 beneath either Charlotte or Atlanta.
- At the #8 seed in the play in round, they play the #7 which is looking like Cleveland.  While not impossible for Cleveland to win that matchup, it's highly unlikely so that puts Brooklyn in as the #7 seed -- takes on whoever is at #2.
- Next round, winner of Brooklyn and the #2 seed gets to take on the winner of the 3-6 matchup.  that would be any of Miami, Mil, Phil against Toronto.  figure odds are that Toronto loses. 
- C's as #1 would be up against the Cavs in all likelihood unless Atlanta or Charlotte upset them in that matchup for the #8 seed.  C's should be any of those teams without Timelord. 
- Second round, C's get the winner of the 4/5 which would likely be Miami, Mil or Phil against Chi.  Chi most likely loses that series so second round C's face Miami, Mil or Phil where Timelord would really be needed.  Miami possibly less so than against Mil or Phil but we stand a much better chance with all hands on deck (obviously).

That's the likely situation for those concerned with avoiding Brooklyn as long as possible (or completely if the hopes are for someone else to knock them off).