Click through for a thorough, inspired look at Patella injuries throughout the NBA and other sports, courtesy of all-world commenter Norsktroll.
Want to know what Greg Oden is facing and how other athletes have dealt with similar injuries over the last 30 odd years? This is the post for you.
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Original Post by Norsktroll...
This post got mainly inspired by my hope that Greg Oden can return back to the level he had reached this season rather quickly, and this comment in Dave's What if? What Now? post:
I would like to hear some stats on broken patellas. I have never come across this in my years of playing/coaching/being a fan. How common is this? Should anything be read into this ( I mean, there wasn’t any contact, does Oden have a bone/muscle problem?), Is this an injury from which someone can make a full recovery, like a broken hand, or is it something that forever slows you down, like a ruptured calf?
And mostly, does anyone read the Umpteenth post this far down?!?!?
Yes, I did. I wrote a short reply with some examples I knew by heart and from Kevin Pelton's excellent post on the topic over at Basketball Prospectus, but wanted to look into this in much more detail so I did some research.
The available data not surprisingly is more accurate since the (mid-)90s. As you can see from some examples below this injury has always happened to players, but for much of the earlier occurrences there is no detailed information available. At least on the Internet. Even in the 80s it often just got reported that the knee in general was injured, or a "knee ligament" without stating what exactly happened. Maybe it was an ACL injury, maybe it was a patella injury. So the listings despite long are hardly exhaustive. At the end of this post I also take a look at these injuries in other pro sports (NFL, NHL, baseball, it probably is also a common injury in soccer and other sports) to get some more examples.
I am no orthopedic surgeon, so I can just look into some publicly available sources about variations of this injury to the knee of athletes and see what happened later in their career. Draw your own conclusions. Thanks to sites like CBSSports, Prosportstransactions, NBA.com, Basketball-Reference.com and its sister sites for other sports, Wikipedia, and SBN's own player profiles that all include detailed information on injuries and statistics.
Anatomy of the Knee
From Gray's Anatomy 20th edition, via Wikipedia the free encyclopedia
In Greg Oden's case, the patella (knee cap) seems to have been severely displaced and fractured. BUT, the good news amid that bad news is that the two strong tendons attaching it which control knee flexion and extension - the quadriceps tendon to the quadriceps femoris musle on the upper leg and the patellar tendon to the lower leg -reportedly were not torn. Also no other surrounding ligaments (ACL, MCL) were damaged.
(The term patellar tendon is a bit misleading, since tendons typically attach bones to muscles. It really is a ligament, attaching a bone to a bone, in this case the patella to the tibia. I will continue to use the term tendon since that is what usually got reported.)
Here is a look at different kinds of patella and patellar tendon injuries over the years.
Broken and/or dislocated patella
SF Elgin Baylor, 1965, age 30, Lakers: Fracture?
Required surgery on "injured kneecap" in April.
Next season: Appeared in 65 games, but saw his minutes and points drop massively by about 1000 each. Apparently made a full recovery returning to his previous level of production in the following seasons.
G Ronnie Lester, 1983, age 24, Bulls: Fracture
Fractured right kneecap in March, out for the remainder of the season (played 65 games).
Next season: Appeared in 43 games. Declining numbers, ended his career in 1985-86 on the Lakers after being placed on the injured list with "tendinitis in knee". He continued to work there as a scout and eventually as an assistant GM.
Trivia time: Ronnie was drafted by the Trail Blazers with the 10th pick of the first round in the 1980 NBA draft but got immediately traded along with a 1981 first round pick (#4 Al Wood) to Chicago for Kelvin Ransey and their 1981 first round pick (#15 Darnell Valentine).
C Shawn Bradley, 1994, age 22, 76ers: Dislocation and chipping
Dislocated patella and bone chip in left knee had to be surgically treated in February, out for the remainder of the season (his rookie year).
Next season: Played in all 82 games recording the most minutes of his career and improving his numbers in about all categories. Followed by a ten year career with some other sprains and muscle tears, but seemingly no ill effects from this particular injury.
SF LaPhonso Ellis, 1994, age 24, Nuggets: Stress fracture
Stress fracture of the right patella in September. Initially prognosticated to be out 8 weeks he only appears in 6 games that season.
Next season: Appeared in 45 games with lower numbers than in the season before the injury (sophomore). Then production goes up again in the following 2 seasons to the former level. After that he needed different arthroscopic surgeries on the other knee, and continued to be somewhat injury prone.
PF Bison Dele (born Brian Carson Williams), 1995, age 25, Nuggets: Stress fracture
Small stress fracture of or below left kneecap in February. Played 63 games that year.
Next season: Played 65 games for the Clippers, starting all and posting career highs up to that time.
SF Mario Bennett, 1995, age 22, Suns: Severe bruise, chipping?
Surgery on left knee to repair what was reported as "roughening under kneecap" (chondromalacia) at the end of October. Comparable to a bone chip a la what Greg had last year? Missed 4 months before he was reactivated.
Next season: No team in 1996-97. Appeared in 45 games in 1997-98 for the Lakers, the most of his short NBA career.
C Priest Lauderdale, 1996, age 23, Atlanta: Partial dislocation
Happened in mid-November. No surgery, played in 35 games that season.
Next season: Played in 39 games, posting better numbers in most categories. His short NBA career then ended (28th pick). He continued his career in US minor leagues and internationally in Cyprus, Bulgaria (citizenship after 3 years in the league), Saudi Arabia, China, and Iran where he is still active.
PF/C Dino Radja, 1997, age 29, Celtics: Patella fracture
Required surgery on left patella in January, missed the rest of the season.
Next season: Six months later he failed a physical voiding a trade that would have sent him to the 76ers for Clarence Weatherspoon. Never played in NBA again but successfully continued career in Europe (somewhat easier schedules), winning 2 Greek championships with Panathinaikos, a league MVP title, a Croatian championship, and playing until 2003 at age 36.
SG/SF Greg Buckner, 2001, age 24, Mavericks: Dislocation
Dislocated left kneecap in April. Missed the remainder of the season.
Next season: Appeared in 44 games for the Mavericks on about the same level of the previous season (when he played 37 games). Then in 75 games for the Suns, posting career highs or close to that in many categories.
PF Antonio McDyess: See below for injuries to both the patella and the tendon
PG Shaun Livingston, 2004, age 19, Clippers: Dislocation
Dislocated right patella end of November during his rookie season. Appeared in 30 games.
Next season: Appeared in 61 games, the most of his career so far. Then obviously hurt the other knee much more severely in 2007 dislocating not just the kneecap but tearing multiple ligaments in a well-covered gruesome moment. Successful comeback at the end of the 2008-09 season.
SF Jarvis Hayes, 2005 and 2006, age 24, Wizards: Two patella fractures
On March 2nd 2005 he was put on the injured list with 'right knee tendinitis'. Two days later he was diagnosed with a fractured patella, and missed the remainder of the season. It appears that he didn't have surgery.
Next season: After a preseason game, swelling returned to the knee and he missed the rest of the preseason but was named a starter. On December 15, he had to leave a game vs. the Lakers, and was diagnosed 3 days later with another fracture to the right kneecap. He again tried to let it heal without surgery, but in mid-February 2006 ultimately needed to have screws inserted and missed the rest of the season. For the 2006-07 season he returned and appeared in all but 1 regular season games. In the 2007-08 season he played all 82 games. His total stats dropped slightly due to a decrease in minutes per game, though he eventually became a more efficient shooter and played similar minutes again. It's debatable how much better his career would have become without the injury (e.g. clear starter instead of just rotation player).
SG/PG Randy Foye, 2007, age 24, Timberwolves: Stress reaction/fracture
Stress reaction in November 2007 in left patella. Missed 43 games.
Next season: Appeared in 70 games posting career-highs in minutes, points, assists.
C Andrew Bynum, 2008, age 20, Lakers: Dislocated patella
On January 14th, Bynum dislocated his left kneecap and suffered a bone bruise in a game against the Grizzlies. He was initially expected to be out 8 weeks. After slow healing progress, he required an additional arthroscopic surgery to remove loose bone debris from the knee and thus missed the rest of the season/playoffs.
Next season: Returned to full form, until in February 2009 an unrelated torn MCL in the other knee caused him to miss two months.
PF Blake Griffin, 2009, age 20, Clippers: Patella stress fracture (not dislocated)
This year's #1 draft pick is out with a fractured left patella since end of October, and not expected back until Christmas. He opted to have no surgery (rather a crack than a complete break).
C Greg Oden, 2009, age 22, Blazers: Patella fracture (dislocated)
Injury on the left knee on December 5th, projected to be out for remainder of the season. Had already suffered what was reported as a 'bone chip' on the same knee after a collision missing 15 games in the previous season. The two injuries were reported as not related to each other by the surgeon examining Oden.
A much milder form with no (severe) breaks. Some examples from a longer list:
PF/C Harvey Catchings, 1982, age 31, Bucks
Put on IL with bruised kneecap for November. Still appeared in 74 games with no discernible drop in production.
PF Shawn Kemp, 1995, age 25, Sonics
Had to leave a game with a bruise, but played in 79 games that season at the peak of his production.
C Bryant Reeves, 1998, age 24, Van. Grizzlies
Missed most of April.
SG/SF Quentin Richardson, 2003, age 22, Clippers
Missed about the last 2 weeks of the season, played 62 games in total.
Next season: Played 79 games, stats on same level (some up to career highs, some down)
SF Caron Butler, 2009, age 29, Wizards
Bruised left patella end of October. Missed 1 game.
Injuries to the patellar tendon
Milder forms usually stated as "strained patellar tendon" and "patellar tendinitis" (inflammation) on injury reports. Many, many occurrences of this injury. Here is a quick rundown of some:
Danny Manning, 1990, Clippers
James Worthy, 1994, Lakers
Ben Wallace, 1997, Bullets
Bruce Bowen, 1997, Heat
Dominique Wilkins, 1997, Spurs. Missed 8 games.
Otis Thorpe, 1997, Vancouver Grizzlies. Missed 4 games.
Donyell Marshall, 1999, Warriors. Again in 2000.
Fred Hoiberg, 1999-2000, Bulls. He managed to strain the quadriceps tendon in both legs, the counterpart to the patellar tendon that gets injured less often. Missed much of the season playing only 31 games.
Stephon Marbury, 2000, Nets. Again in 2006.
J.R. Reid, 2000, Cavaliers. Both knees, eventually ending his career that season after appearing in just 6 games.
Brian Cardinal, 2001, Pistons. Again in 2002. In both knees.
Antonio Harvey, 2001, Sonics
Jonathan Bender, 2002, Pacers. In his case it was the first sign in a series of more serious knee problems over 3 years (usually just described as a "sore knee" in the injury reports), ultimately leading to his retirement.
Brent Barry, 2003, Sonics
Mike Sweetney, 2003, Knicks
Joel Przybilla, 2004, Hawks. 'Left knee patella tendinitis', placed on IL for close to 4 months after initial diagnosis of 4-6 weeks. Might have been more than just tendinitis, or just a strategic move to free a spot.
Anderson Varejao, 2004, Cavs
Mario Kasun, 2004, Magic. Again in 2005.
Tim Thomas, 2005, Knicks
Kenyon Martin, 2005, Nuggets
Mike Miller, 2007, Grizzlies. Missed 1 month.
And dozens more players. It was and is a common cause for missing a few games especially while the injured lists still existed, usually returning after anything from 1 game to 2 weeks.
Torn or partially torn patellar tendon: A much more severe injury.
SF Cedric Ceballos, 1996-97, age 27, Lakers/Suns
Partial tear of the right patellar tendon in November 1996, expected to be out 2 months. He got reactivated in January, but it continued to bother him throughout the season missing several more games with a strained patella in March after a trade to the Suns. He continued to have s ome problems with his right knee (meniscus) and especially his wrists over the following years. Some drop in production, though he did have another strong season with the Mavericks in 1999-00.
PF Antonio McDyess, 2001-2003, age 27-29, Nuggets: Several fractures and tears
Subluxated left patella in March 2001 (partial/incomplete dislocation). Missed remainder of the season.
Initially there was no surgery, then in October 2001 he required surgery to repair what was then diagnosed as a partially torn patellar tendon. In addition he needed arthroscopic surgery on the right knee to clean out some loose debris and was expected to be out 3-4 months. In March 2002 he briefly got activated, but was deactivated quickly again when both knees got inflamed.
Next season: Joining the Knicks that offseason, he was immediately placed on the injured list with a "left knee inflammation", and then in October required another surgery to repair a fracture to the left patella. In April 2003 he needed yet another surgery on the left knee patella missing the entire 2002-03 season.
When finally returning to action, he played in 42 games in 2003-04 season. Then continued to play several seasons completely or close to. His statistics dropped significantly across the board before going up slightly again but never back to previous state. However as of now he is still active as a rotation player.
SF Glen Rice, 2001-02, age 34, Rockets
Partial tear in December required surgery on right knee a month later, out for the remainder of the season.
Next season: Appeared in 62 games, but he continued to have some problems with the right knee (strain, hyperextension, bruise). His stats dropped slightly, and at age 36 he was reaching his career end the following season where he appeared in his last 18 games.
PG Damon Stoudemire, 2005-06, age 32, Grizzlies
Surgery on torn right patellar tendon in January 2006 after injuring it just before the end of the year, out for remainder of the season.
He already had suffered from what was deemed 'left knee tendinitis' a decade earlier when on the Raptors missing the end of the 1995-96 season without going into detail which tendon. While with the Blazers he missed much of November with 2001 right knee tendinitis.
Next season: Played in 62 games. Stats dropped to level from a few years earlier while about maintaining efficiency. Career end after 2007-08 season where he played in another 60 games.
C Alonzo Mourning, 2007, age 37, Heat
Surgery on right knee to repair torn patellar tendon after 25 games, out for remainder of the season.
Update: He had already sustained a partial tear in the left knee in 1997 pausing for ca. 3 months (initial diagnosis was 8 to 12 weeks), and missed a few games in December 2004 with 'right knee tendinitis'.
Next season: Ended career
SG Kelenna Azubuike, 2009, age 26, Warriors
Torn patellar tendon in left knee after having appeared in 9 games, out for the season. In the video of the injury it looked like someone had beaten him out of mid-air with a bat when he tried to go up on a drive to the basket.
Other sports: NFL
DT/NT Joe Klecko, 1982, age 29, Jets
Torn patellar tendon in left knee in September, out for season
Next season: 16 games. Played successfully until age 35 reaching 3 more Pro Bowls and 1 first-team all-pro selection.
RB/Ret Byron Hanspard, 1998, age 22, Falcons
Torn patellar tendon and torn ACL in August, out for season.
Next season: 12 games, his last.
DE Joseph T. Johnson, 1999, age 27, Saints
Torn patellar tendon in August, out for season
Next season: 16 games, AP Comeback Player of the Year, Pro Bowl selection
RB Correll Buckhalter, 2004 + 2005, age 26, Eagles
Torn patellar tendon in right knee August 2004, out for season
Next season: August 2005 torn patellar tendon in right knee requiring surgery again, out for another season. Continued career in 2006 appearing in 16 games. Then played 3 more years upping his production again after a drop.
LB Antwan Peek, 2008, age 29, Browns
Torn patellar tendon in right knee in September, out for season. Ended NFL career.
Other sports: Baseball
It doesn't seem to be a very common problem there. The only events that I could find were:
Milton Bradley (Dodgers) in 2005 with a torn patella tendon as well as ACL injury in the left knee requiring surgery.
Manny Ramirez (Red Sox) in 2006 with tendinitis.
Aramis Ramirez (Cubs) in 2007 with tendinitis.
Jeff Keppinger (Reds) in 2008 with a 'kneecap injury' (fracture).
Other sports: NHL
D Borje Salming, 1984, age 32, Maple Leafs
"Cracked kneecap" in March, out for the rest of the season.
Next season: Appeared in 73 games, among the most of his career. Played until age 38.
D Glen Cochrane, 1984, age 26, Flyers
"Multiple fractures" of the right patella in March, out for the season.
Next season: Appeared in 18 games, down from 67. Continued his career with the Vancouver Canucks, playing in 49 games the following season and eventually in 73. Ended career at age 31.
D Doug Halward, 1987, age 31, Red Wings
Dislocated kneecap and damaged ligament in January. Only 11 games that season.
Next season: Played in 70 games, the third-most of his career. Played one more season after that before retiring.
D Michael Thelven, 1988, age 28, Bruins
Tendinitis and inflammation under right patella in December. Played in 40 games.
Next season: Played in only 6 more games before ending his career.
D Shawn Chambers, 1990, age 24, North Stars
Fractured left kneecap in October, surgery in December. Played in 29 games that season after a career-high 78.
Next season: Changed teams and played in only 2 games for the Washington Capitals. But then had a successful career with the Tampa Bay Lightning, New Jersey Devils and Dallas Stars until age 33 winning 2 Stanley Cups.
Trivia: "Chambers holds the record as the athlete with the lowest rating in video game history. In EA's NHL 93, then a member of the Tampa Bay Lightning, he had an overall rating of 1." (Wikipedia)
C Bob 'Bobby' Carpenter, 1990, age 27, Bruins
Surgery on fractured left kneecap in December, out for the season after playing in 29 games.
Next season: Played in 60 games, and continued his career for 7 more seasons mainly with the New Jersey Devils (along with Chambers) helping them win their first Stanley Cup. He stayed as an assistant coach winning two more.
D Shea Weber, 2007, age 22, Predators
Dislocated kneecap in October, out several weeks. Played in 54 games.
Next season: Played in 81 games posting career-highs. Is still with the same team.
C/RW Dainius Zubrus, 2009, age 31, Devils
Fractured right patella in November after 20 games, out indefinitely. In NHL since age 18.
So all in all injuries to this part of the body are not uncommon. A number of NBA players were able to recover very well from it, others not so much. Injuries involving a rupture of the tendon tended to have a lot more severe consequences, so that definitely is a plus for Oden's recovery.
Age doesn't seem to have a lot to do with it. Athletes are injuring themselves there from their early 20s to their mid-30s.
One thing I found interesting where I'm not sure if that means something or not: Severe injuries to the patella and patellar tendon very often seem to happen early in the season (November, December, January). Are supporting muscles and ligaments really "tired" for the first time then? Imbalances in the body? I don't know.
I hope this rundown of players gives you some hope that Greg Oden can recover well from this serious injury, and continue to have a successful and long career.