Prior's surgery (please translate)

by drwmsu1 on Apr 25, 2007 3:18 PM EDT Comment 24 comments

From Rotoworld:
"Dr. James Andrews performed a debridement of Mark Prior's right rotator cuff as well as repair of labral and capsular injuries in his right shoulder during seas-ending surgery Tuesday."

Okay, could DrBGiantsfan or HuskerBob, or someone who is smarter than me please tell me what is a "debridement" of the rotator cuff? And how vague is it that he repaired labral and capsular injuries?

I am smart enough to know that the words "rotator cuff surgery" and "effective comeback" have rarely if ever been spoken.

Apologies in advance to those of you about to tear me a new one because there is a previous Prior post about 20 slots down. But this guy was supposed to win 3 or 4 Cys...

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Debridement

I'm not an orthopedist or any type of surgeon, for that matter. Generally, the term debridement refers to the removal of dead, damaged, or scarred tissue. I agree with you that the terminology is vague.

Tough to make any judgements about prognosis without more information. Let's just say I'd be a bit bummed if I was a Cubs fan.

by DrBGiantsfan on Apr 25, 2007 3:23 PM EDT reply actions 0 recs

Debridement

Is just a concise/fancy term for "clean up." Loose/frayed tissue and/or bone fragments are removed. I think the "labral" part is referring to a tear in his labrum while the "capsular" part is the "sack" HuskerBob was talking about.

by slurve on Apr 25, 2007 3:23 PM EDT reply actions 0 recs

sounds to me...

like a SLAP lesion was part of this. Clean up of the labral and capsular area - that's something I had done during one of my two shoulder surgeries. I don't have the same flexibility in that shoulder anymore after that move.

At what point does Prior say enough is enough?

by UCFKnights on Apr 25, 2007 3:40 PM EDT reply actions 0 recs

As soon as

no more major league teams are willing to give him millions.

by slurve on Apr 25, 2007 3:58 PM EDT up reply actions 0 recs

Exactly what I had done in 99

IMO, what was stated says he tore the labrum in the front and rotator cuff in the back.

The labrum was repaired, likely stitched back to the bone. The rotator cuff was a fraying in the back that isn't enough to re-attach so they just "debride" or remove it. I'm going to assume they went ahead and did the thermal capsular shrinkage but that verbage is pretty vague.....typical for the Cubs. Could have been something different.

I personally don't think the rotator debridement and capsule procedure are that big of a deal (in terms of career ending) but with the labrum mentioned in there I'd say he's in trouble for the beginning of 08.

Depends on the repairs but it 6 months before I started throwing 100% again from what sounds like a similar procedure.

Lex clavatoris designati rescindenda est.

by HuskerBob on Apr 25, 2007 4:17 PM EDT reply actions 0 recs

Doesn't sound good

The stats on recovery from labrum and capsular surgeries are not good.

It's illuminating to find out just how much wear and tear that shoulder has taken. That sounds like a 35 year old shoulder from the description of the surgery. If it was one of the three (especially the rotator cuff) I could see him coming back. But all three? He'll have to work hard just to be able to raise his arm above his head.

cmathewson

by cmathewson on Apr 25, 2007 4:21 PM EDT reply actions 0 recs

shoul di drop him in my dinasty league?

or hold on to him. i mean it is such a shame to just throw him away, but if he isnt gonna be worth a damn again, i may be wasting part of salary cap on him for no reason

by rangersfan24 on Apr 25, 2007 4:36 PM EDT reply actions 0 recs

BP

Check out baseballprospectus.com for description of the surgery.

Here's my synopsis of what Wil Carrol said:

Its not neccessarily a tear. And its possible to speculate that Prior's mechancis helped shield him from more serious damage, like Wood.

Most likely comp. is Chris Carpenter, who has recovered and post a pretty good line the last few years.

That's the silver lining.

But the truth: This is a serious injury. More serious than previous MRIs indicateda. And it will keep him out for all of 2007.

by Montreal97 on Apr 25, 2007 4:36 PM EDT reply actions 0 recs

Me and Will

Don't see eye to eye on alot of pitching mechanics and performance related issues. I see now we don't agree on injury related issues either.

Will states the rotator cuff debridement was the most "significant" injury. I have to strongly disagree with this statement for a few reasons. One, I had this procedure and to have it means you have a small tear or fraying (as he alluded to), not a significant or complete tear This is the type of injury you hear about pitchers opting not to have surgery and just strengthen the muscles around it. I don't quite get Will stating this was the most significant injury then he goes to explain he obivously understands it wasn't a significant tear. Two, while Will states an MRI is imperfect (far from it) he misses the fact that an MRI will almost ALWAYS catch a rotator tear. What the MRI can't see is the labrum. It is my belief the Cubs and Prior knew about the rotator cuff tear a LONG time ago and decided to avoid surgery as long as possible, ala Pedro. What they didn't know about and couldn't see without surgery was the labrum. Three, again having had this procedure and a labrum tear, I can say without a doubt the rotator cuff tear was far less painful than the labrum. I tore the rotator cuff first and was still able to pitch. Once the labrum went I was done, completely. Extremely painful. Anyone that has had these two injuries (I know there are a few on this site) would know the labrum is the killer.

He is young, although I was thinking about it today and I was 24 first injured my shoulder and 27 when I had this procedure done. I'm not sure age helps a whole lot here. To speculate that he will be arthritic by 30 would not be out of bounds.

Lex clavatoris designati rescindenda est.

by HuskerBob on Apr 25, 2007 10:45 PM EDT up reply actions 0 recs

question for you

Why don't clubs do exploratory surgery more often and earlier?

Obviously we can say hindsight is 20/20. But there was no reason why they wouldn't or shouldn't have gone in to take a look once they knew there were problems with his arm.

by pedrophile on Apr 26, 2007 12:44 AM EDT up reply actions 0 recs

I Would Say....

that surgery should be avoided if at all possible, with the possible exception of TJ. Surgery can fix injuries, but it never completely restores to normal and leaves behind scar tissue that can come back to haunt you. You just don't want to do it unless there is extremely remote chance the body may heal itself.

TJ is the only surgery I know of that may leave you better than new. The more we see of it though, the more we find out that TJ is no sure thing either.

by DrBGiantsfan on Apr 26, 2007 2:12 AM EDT up reply actions 0 recs

but

I'm talking about exploratory surgery which I thought rarely left behind much scar tissue or did much damage.

by pedrophile on Apr 26, 2007 7:56 AM EDT up reply actions 0 recs

Exploratory

Well, each case and each surgery is different, but sometimes explortory surgery does more damage because there is not specific target, so you have to look at everything. That's why the medical profession/industry has worked so hard to develop better diagnostic techniques to eliminate the need for exploratory surgery.

by DrBGiantsfan on Apr 26, 2007 8:37 AM EDT up reply actions 0 recs

Its still extremely invasive

You'd still have to open the guy up.

And if you don't find anything he's probably still on the shelf for several weeks to a few months just so the incision can heal.

by Montreal97 on Apr 26, 2007 9:14 AM EDT up reply actions 0 recs

Just to follow up

It sounds like these were partial tears.

And not full tears or labral tears.

Still, very signifigant but not as bad as it could have been or as bad as Wood's surgery was.

by Montreal97 on Apr 25, 2007 4:40 PM EDT reply actions 0 recs

Wouldn't be shocked if Cards picked him up

I think he would be a great low risk high reward for the Cardinals like when they signed Carpenter. I think if he could comeback, he could be a 15 game winner. Look at Suppon, he was nothing special and Duncan turned him into a very good 3rd starter.

by Bravesin07 on Apr 25, 2007 5:02 PM EDT reply actions 0 recs

how can you even begin to speculate that?

Its april in the third or fourth year in a row he has had injuries derail his season.

It seems like it would be a stroke of luck if the guy ever came back to do anything at all.

by wildthang on Apr 25, 2007 5:30 PM EDT up reply actions 0 recs

That May Be

Yet, it's the first operation on his arm and shoulder. He's still young enough to come back from this. There's ZERO chance the Cubs will let him go to sign with their arch-enemies the Cardinals though. They've actually done what Bravesin07 suggests themselves, aka Ryan Dempster and Wade Miller. My personal belief is that Prior will sign a deal much like Kerry Wood's and come back. Mahalo

Matt

I don't suffer from insanity, I enjoy every minute of it.

by WayneCampbell05 on Apr 25, 2007 9:51 PM EDT up reply actions 0 recs

repair of labral and capsular injuries

This is what i currently have. I have a torn labium and my options was to get this surgery. I chose not to. Its a minor procedure where they heat up the capsule and tighten the ligament. If thats the surgery he gets the Rehab will suck and he will lose some flexibility with his shoulder for sure.

by Metty5 on Apr 25, 2007 5:27 PM EDT reply actions 0 recs

The rehab

DID suck and you do lose some flexibility, not alot and probably less for a professional athlete that can rehab 8 hours a day but you do lose some.

He'll probably be a sling for 10 days because of the rotator cuff but they will want to get it moving as soon as possible after that.

My guess, depending on the severity of the labrum is he will start throwing on flat ground in 4 months.

Lex clavatoris designati rescindenda est.

by HuskerBob on Apr 25, 2007 10:49 PM EDT up reply actions 0 recs

Translation

DONE

by Team Moneyball on Apr 25, 2007 6:01 PM EDT reply actions 0 recs

good news, from another angle

As someone who lives in Chicago, I'd say the news on the surgery is actually good. Most of the city thinks Prior's problems are all in his head. As Marrioti wrote, "Wood's the guy who drives his car into the ground; Prior takes it into the shop the second he hears a rattle." (or thereabouts) A lot of people think that after the last few starcrossed years, he's deteriorated into a complete head case. These results say otherwise.

By the same token, though, to the extend there's any "spin" going on in reporting the results, it could well be they're erring on the side of saying more is wrong, for Mark's sake.

Either way, here's wishing him the best.

by Rogers Reilly on Apr 25, 2007 6:30 PM EDT reply actions 0 recs

OK

Like was said below, Mariotti is in fact a tool. A complete windbag hack excuse for a reporter.
When have the cubs EVER exaggerated the report of an injury? Are you talking about the mirror universe cubs or something, where everything is the opposite of real life? (and Mark Pawalek has a kick ass goatee...) They are the major league leaders in lying to the press and fans about the (lack of) severity of player injuries.

by AucklandGM on Apr 25, 2007 7:34 PM EDT up reply actions 0 recs