[外電] Surgery not immediate option for Pujols
來源: http://tinyurl.com/2v3usp
03/06/2008 12:17 AM ET
Surgery not immediate option for Pujols
Slugger, Cardinals planning to manage, monitor elbow
By Matthew Leach / MLB.com
JUPITER, Fla. -- Cardinals team physician Dr. George Paletta shed light on
the condition of Albert Pujols' elbow on Wednesday, confirming that the
slugger likely is best off not having any kind of surgical procedure until
the time comes when a complete reconstruction is needed.
Pujols has a "high grade" tear of the ulnar collateral ligament in his right
elbow, as well as bone spurs, inflammation and arthritis in the joint -- all
of which have likely developed as a reaction to the ligament tear. The
ligament's condition has not appreciably worsened since it was first injured,
in 2003, but the surrounding issues have become somewhat more pronounced over
that time.
According to Paletta, Pujols was presented with three feasible courses of
action over the winter. He could continue the path he had been on, which is
treating the symptoms of his injuries while he continued to play. He could
undergo arthroscopic surgery, which would address the bone spurs and the
arthritis but not the ligament tear. Or he could have arthroscopy as well as
Tommy John elbow-reconstruction surgery.
Pujols chose the non-surgical path, a decision that Paletta endorsed. The
superstar may yet require reconstruction at some point, and according to
Paletta, the intermediate option is likely no longer viable.
One concern with the arthroscopic surgery is that in many cases, bone spurs
and the like actually help stabilize an injured ligament, and removing them
can make the problem even worse. This situation occurred with Cardinals ace
Chris Carpenter last summer.
"I think now our options are really likely down to two," Paletta said. "If
his elbow condition can't be successfully managed and gives him significant
problems again, then I think the horse is out of the barn and he should
probably consider having the whole thing done."
Pujols visited with Dr. James Andrews over the winter to discuss his options.
According to Paletta, Andrews concurred with the assessment that although
three choices existed, only two were truly viable.
"In December, when he saw Andrews, a reconstruction was going to cost him all
of 2008, essentially," Paletta said. "So again, go back to trying to manage
the problem. Albert made a decision which I think personally was a wise
decision."
The Tommy John procedure requires approximately a 12-month recuperation
period for pitchers, but for offensive players, it's more like an eight-month
process. That means that had Pujols opted for reconstructive surgery over the
winter, he would have missed a large chunk of 2008.
Pujols has expressed optimism that he will be able to manage the condition
this season. He first injured his elbow in 2003 and has been dealing with the
symptoms for the past five seasons. He said in January that the discomfort
was worse in 2007 than it had been in previous years. On the other hand, he
also hopes that having a full winter off -- rather than playing deep into
October -- provided him with needed rest.
If the pain is as great in 2008 as in '07, Pujols has said, he will shut it
down rather than try to play through it again. A combination of severe
discomfort and a flagging Cardinals season would likely add up to
reconstructive surgery, with an aim toward being ready for the start of 2009.
"If he were to develop recurring elbow problems this year," Paletta said,
"and they were to be unmanageable and he said 'I can't continue to play like
this,' my recommendation would be to probably have the whole thing
reconstructed. I believe, and I don't want to speak for Andrews, but based on
the conversations Dr. Andrews and I have had, I believe that would be
Andrews' recommendation as well."
In the meantime, however, the Cardinals will attempt to treat the injury's
symptoms and keep Pujols playing frequently and effectively. That's
everyone's preference, and Paletta did not rule out the possibility that
Pujols might play his entire career without the operation.
"This is not a curable problem without a reconstruction," Paletta said. "What
we hope is that it's a manageable problem. We've been managing this problem
since 2003, when he first tore it. So we've been managing it fairly
successfully for five seasons now. But there comes a time when it's not
manageable anymore. And if it's not manageable anymore, the best answer for
Albert probably, long-term, is to consider having the reconstruction done."
Matthew Leach is a reporter for MLB.com. This story was not subject to the
approval of Major League Baseball or its clubs.
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