Carlos Beltran’s Mysterious Knee Surgery

In case you missed it, Carlos Beltran had knee surgery in Colorado on Wednesday. That’s about all we know for sure. He might have had “microfracture surgery”, which is pretty darn serious, or he may have had “arthroscopic surgery”, which is relatively routine. We’ve also been told by the Mets that he will be out for “12 weeks”, which makes sense for neither possibility.

Here is the exact quote from the official Mets press release:

He elected to undergo arthroscopic clean out of the arthritic area of his knee by Beltran’s personal physician Dr. Richard Steadman today in Colorado. He is anticipated to return to baseball activities in 12 weeks.

Considering the recent history of medical reports from Mets officials, it is hard to know what to believe.

If indeed it was microfracture surgery, the recovery time is at least 4 months, but could be as long as 8 — or a year, or a year and a half. There’s really no way to know for sure, as everyone is different.

On the other hand, athletes usually resume activities from a simple ‘scope of the knee in 6-8 weeks — sometimes sooner.

So now you can understand why the 12-week number stated by the Mets’ press release is mysterious.

Knee4As if that weren’t enough to confuse things, microfracture surgery is something that is performed via arthroscopy. Get it? So in other words, you can have arthroscopic surgery without having microfracture surgery, but you can’t have microfracture surgery without having a ‘scope. Clear as mud?

That said, if it is reported that Beltran had a ‘scope, it would be correct regardless of whether the surgery was a simple cleaning or if it included the microfracture procedure. And therein lies the mystery.

Oh, and if you re-read the above quote from the Mets’ press release, you’ll see it was Dr. Richard Steadman who performed the surgery. Steadman is the man who pioneered microfracture surgery.

The 12 weeks spit out by the Mets’ crack PR team is what makes things suspicious, because it takes the blood clot formed by microfracture surgery at least 8-15 weeks to heal — and the number 12 is right in the middle of that range. Mind you, the healing of the clot is only step one of the recovery process. From the research available on the information superhighway, if indeed he had microfracture surgery, Beltran would GET OFF CRUTCHES after 8-15 weeks — I’m not sure what kind of “baseball activities” are possible immediately thereafter. Maybe it means he can start autographing baseballs or break in a new glove.

Here is a quote from Wikipedia in regard to the sensitive nature of the recovery period:

Microfracture surgery itself is relatively minor. It is an outpatient procedure and causes only small discomfort. The harder part is the restrictions that are placed on the patient during the post-operative recovery period. This can be a major challenge for many patients. For optimal re-growth of joint surface, the patients need to be very patient and also extremely cooperative. They usually need to be on crutches for four to six weeks (sometimes longer). Sometimes a brace is needed. This all depends on the size and/or location of the joint surface defect that is being repaired or regenerated. The patients are encouraged to spend approximately 6-8 hours a day on a CPM (Continuous Passive Motion) machine that helps with optimal re-growth of joint surface. Patients usually feel pretty good and think they can avoid these critically important steps, and even start running and jumping (or playing sports) before the internal aspects of the knee, and the joint surface, are ready.

Sounds pretty dangerous, no? If a determined athlete — such as Beltran — decides to push himself to recover quickly, it could have devastating consequences. Considering that Beltran is going to make $37M over the next two years regardless of whether he sets foot on the field, and that he probably has a shot at one more big payday before he retires, you’d think that agent Scott Boras will recommend insist that Beltran go the cautious route, taking all the time he needs.

Quite a conundrum.

There are already rumors flying that the Mets were not on board with Beltran’s decision to have the surgery, and that they may sue Beltran for his salary. Per Joel Sherman:

A person familiar with the situation told the Post that the Commissioners Office and the Players Association have been alerted that “the Mets are claiming this was done without clearance and that the Mets are threatening to take some form of action. There is a potential issue out there.”

That’s a whole ‘nuther can of worms.

Here’s the bottom line: if indeed Beltran had microfracture surgery — and all signs seem to be pointing that way — there’s no way he’ll be playing before June. In fact there is a very real possibility he misses the entire 2010 campaign. This isn’t panic, it’s a statement of reality — not unlike the statement I posted here last May in regard to Jose Reyes.

Mind you, I don’t point out these possibilities because I want to be right, or so I can say “I told you so” later on. Rather, I’m evaluating the situation realistically, and understanding that the Mets will need to have a solid plan in place in preparation for the worst scenario NOW, rather than scrambling later (see: Angel Berroa, Wilson Valdez, Anderson Hernandez, et al). Maybe the Mets can survive the year and compete for a postseason spot with Angel Pagan in centerfield all year. Or, maybe they need to look for an alternative, in case Pagan doesn’t work out (Rick Ankiel? Jeremy Reed? would they be crazy enough to trade for Gary Matthews, Jr. ?).

No matter which way you scope out this situation, it is not good news for the Mets.

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About the Author

Joe Janish began MetsToday in 2005 to provide the unique perspective of a high-level player and coach -- he earned NCAA D-1 All-American honors as a catcher and coached several players who went on to play pro ball. As a result his posts often include mechanical evaluations, scout-like analysis, and opinions that go beyond the numbers. Follow Joe's baseball tips on Twitter at @onbaseball and at the On Baseball Google Plus page.

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