A blog dedicated to the New York Mets with some other baseball thrown in.

Friday, December 03, 2004

A Look at Magglio

Here is some info on the ailments that Magglio had dealt with last season and is still dealing with. Obviously all of the news on his health is speculation and nobody knows what is really going on but Magglio, Boras, and the doctor who worked on Magglio. But with the meetings coming up and decisions to be made, I figured I'd take a closer look on his injury situation so everyone has a full understanding of what is going on with his knee.

A big thanks to Doug for getting this info together for me and doing the research so I could put this together.

Magglio collided with Willie Harris on May 19th in Cleveland and that started all of his problems. On June 5th when he received surgery to repair torn cartilage in his left knee and Magglio had a second knee surgery in October of 2004 in Vienna, Austria, to reportedly correct a posterior meniscal tear. Magglio was diagnosed with bone marrow edema after the first surgery was unsuccessful and the problem persisted.

Now, let's get into bone marrow edema quickly.

Your bone is comprised two types of bone, cortical and cancellous. Cortical is the hard shell and the cancellous is the bone marrow section. This area is almost like a lattice like area that has a lot of gaps in between. In short, it's not solid. When interstitial (cell) fluid leaks into these areas it is called bone marrow edema. There are a few different kinds but we will focus only on trauma.

If you strike (or are struck) a bone in your body, in Magglio's case the knee, then it is a contusion (bumps and bruises). A strike directly on the bone that is extra painful is usually called a bone bruise. Only when the outer bone is disrupted is it called a fracture. It is basically a nice shot to your bone that you were lucky enough not to break. Injury to the trabeculae results in the leakage of this interstitial fluid into the empty marrow spaces. This is the most common cause of bone marrow edema (BME).

BME is usually diagnosed on MRI and is often an additional finding in addition to arthritis/meniscal problems. You can suspect it in any non-fracture contusion but will usually only prove it on imaging like MRI. There is really nothing to do for BME on it's own. It is usually swelling that will eventually go down on it's own unless there is a cause other than trauma (tumor, bone/cell disease, etc which Magglio presumably does not have).

The BME is no long-term concern but the meniscus could be. The edema is definitely reversible if the trauma is not constant and I’d assume he will not make it a common practice to slam into Willie Harris. Surgery should not be necessary for BME, just time to recuperate and maybe physical therapy if it is persistent and bothersome.

He had the second surgery on his meniscus to either complete a job that wasn't done right the first time or to clean up an area that was injured in an unrelated incident. Why exactly he had the second surgery would be impossible to tell without the operative pictures. The long term concern would not be the BME, but the big concern would be how much meniscus he has left. Meniscus is the shock absorbers that help cushion the blows between his two main leg bones (femur/tibia). The less meniscus Magglio has the quicker the progression of osteoarthritis. There is no way to help him increase his ability to absorb shocks if he has little meniscus left.

The Doctor’s Advice:
The bottom line, if the Mets choose to sign him, they better do their due diligence. A new MRI would help but they are not 100% accurate. I would get one done, but I would also examine all of his medical records. Specifically the photos they took of the inside of his knee when the surgeon scoped him. This would really give everyone a better picture on the progression of osteoarthritis a in his knee. That would be the best determining factor to go along with a recent MRI as well as Ordonez showcasing the knee.

BME should resolve, you can't grow any more meniscus. When it runs out, it is out. You can't reverse the course of osteoarthritis. Whatever he has will not get any better, it may not get much worse over a short period but it won't improve. Osteoarthritis is the real concern, Mets fans need to look no further than Mo Vaughn for a first hand experience of what happens in that situation.

Thanks again to Doug for rounding out that information. I know you have to be cautious about pursuing any player coming off a injury, knee injuries especially, but what I take away from all of this is that a reasonable diagnosis can be made. Anyone in the medical profession would shy away from making any definitive claims about a patient they have not seen and do not have any medical records for, which is why everything about him is very vague. The fact that he went to Austria was perhaps to see a specialist in the field as some people do, no one really knows. If the Mets or whoever signs him can get a hold of those records (which presumably would be made available to a team dishing out millions for hiim), see him showcase the knee, and take a new MRI can make an assessment on his health. Let us not forget, no one will be talking about a five year deal that he was looking for before the injury. I leave this to professionals, but with all the information at hand I do not see why his health and subsequent risk cannot be accurately gauged.

From 1999 to 2003, the year before his injury, Magglio averaged 157 games, 600 ABs, 102 runs, 40 doubles, 32 homers, 118 RBIs, 70 K's, a .309 AVG, a .370 OBP, and a .543 SLG for a .913 OPS. He has no injury history and no previous knee ailments. He is listed at 6-0 and 215 pounds. The fact that his meniscus is his biggest problem, tells me he may just be OK since he wasn't wearing it down like some other players who end up OA. Guys like Mo Vaughn who were 6-1 and 275 pounds (that seems a bit generous) have much more wear and tear on his knee's shock absorbers. Being that we are only talking about Magglio for a three year contract at maximum for about $9 to $10 million per year, the guy could be a bargain. One of the best bargains of the off season in fact. He would be the consummate hitter that the Mets need to plug in at #3 and give you .300/25/95 at Shea. The fact he has never made more than five errors in a season sure does not hurt either. People can point to him playing U.S. Cellular helped his average, but he still hit .308 away from home over the past three years and I think he can hit .300 at Shea. People preach line drive gap hitters at Shea, and that is what Magglio is. They guy can flat out hit. If not for his knee surgery he’d be one of the most sought after people on the market.

In case you missed my first Magglio post and you have nothing better to do, here it is.

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  • The Mets are the only team thought would deal Stanton for one of the worst pitchers and send money to cover the difference. Unreal.


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