Derrick Rose injury: surgery details emerge, can he be trusted to come back?

Bulls GM Gar Forman was on AM1000 on Tuesday afternoon (audio link). He was twiced asked fairly directly by hosts Waddle & Silvy whether he and the Bulls can expect Derrick Rose to not only come back, but be a top-option superstar again.

Gar was very steadfast in his responses, which I transcribed (with some paraphrasing) below.

I don't think he'll have to change his style. There was no question in our minds that physically he was back 100%, to where he was pre-injury as far as the explosiveness, speed and quickness. It took a while for him to get his rhythm back, but I was on the trip and against Denver and Portland and you started to see the rhythm coming back, I think he was getting back to where he was going to turn that corner.

And that's coming off an ACL tear. This injury [the meniscus], though it's serious and he'll miss the year, is not as severe an injury. And the fact that Dr. Cole were able to go in and 98% of the tissue was still there and in great shape and they were able to repair it...they're projecting 100% recovery and no ill-effects once he's back and healthy.

...

In our minds there's no reason he won't come back and be the Derrick that we've seen. We project he'll be 100% from this injury. Talking to our doctors, this injury was an absolute fluke, that can happen to any player at any time. We talked extensively about this. It wasn't due to overcompensation [due to the ACL tear], or fatigue, or minutes...it just happened. And it was flukey that it happened.

I think you'll see natural changes [to Rose's game] like how any player gets older and more experienced. But from an athletic standpoint we project he'll be back, and I think he's always be an aggressive player who's going to attack the basket.

I'd guess that will be the most we get when it comes to details on Rose's surgery. My primary concern with the repair vs. removal surgical option was that they were not even considering removal as some unreasonable dedication to 'long term patience' and that was influenced by non-medical personnel. But it appears that the damage was relatively minor to where repairing was a more clear option. So that's a bit reassuring, I think.

For those in the Ric Bucher fan club (::raises hand::) his people (i.e. Rose's team) said that they actually preserved 100% of the meniscus. I can only hope that everyone was lying to eachother, because it's funnier to me that way.

But is Gar lying to us when it comes to his (and the team's) rationale for Rose's second consecutive season-ending knee injury, the chances at recovery, and the mindset going forward?

Was Derrick Rose 'back' athletically and just needing to get back his rhythm?

Tough to tell. I think there were a lot of facets shown of Rose's game this year that indicated the knee was fully recuperated. A lot of the first step, coast-to-coast moves were there. But he did look to be doing his damage exclusively when people were out of the way, and we did not see him elevate as often or to the same degree as he did pre-injury, despite Rose's proclamations of an increased vertical.

It wouldn't be unusual for Rose to take time to gain rhythm, or even suffer setbacks, despite last season's decision to take more time than most require to return. In the preseason Rose rested with knee soreness, suffered a strained neck (remember that fun day of necktape-talk?), and a few days before this meniscus tear suffered a strained right hamstring in the same leg.

Was this meniscus injury a fluke?

...not this again. In the wake of the left ACL tear, there was an immediate reaction questioning the overuse of Rose (especially since he'd been battling injuries that whole year especially heading into that playoff opener), and then a nearly-as-fast rush to the defense of Thibs. To which I responded, essentially saying: even if you can't prove a single cause of the injury, that doesn't mean you just write it up to a fluke and 'move forward'.

The Bulls appeared to indeed take some reflection as to how they handle injury management and made moves to try and help that aspect of their organization. Though with Jimmy Butler's injury this season, we've seen some repeated issues.

Rose's most recent knee injury does seem to indicate 'no Bulls fault' more than even that last one. Outside of perhaps questioning whether Rose returned too soon from that hamstring strain there aren't many contributing factors to this meniscus tear. But to immediately say there's no way it was due to overcompensation just seems a weird return to what we saw in 2012.

Should we expect Rose to be fully recovered from this right meniscus tear?

Sean Deveney of the Sporting News interviewed a orthopedic surgeon regarding meniscus injuries that, while not speaking specifically about Rose's surgery, did provide an expert opinion on the general topic. The doctor did say that "an ACL tear in one knee, and a meniscus tear in the other, that is not necessarily connected", but went further into the general risks of current NBA players:

Part of it is, athletes are bigger, faster, more explosive, but that puts more pressure on the knee because of the way they play—their movement, their cutting, their change of direction. It predisposes you to meniscus tears or ACL tears. It’s like you’re cramming the engine of a Ferrari into a Yugo. It might make the Yugo go faster, but you are still going to have structural problems.

He goes on to say this is 'luck' when it comes to Rose's knee injuries, though I'm not sure how he's not instead implying that a style of play can contribute to such luck.

And though Gar Forman is expecting 100% recovery, the doctor went on to say there is a risk in meniscus repair:

It might not heal...the success rate for meniscal tears is not close to 100 percent, but the younger somebody is, being an athlete, a non-smoker—those things help so there is less of a chance of it not healing. If you follow the protocol...it is still about an 80 percent chance it heals, maybe 85 percent. If it doesn’t, he has to either do a re-repair or take out the torn part.

As I said, this surgeon didn't know the condition of Rose's meniscus, and from what Forman is saying Rose should be predisposed to a high chance of recovery. Deveney also published recent cases of meniscus tears, some more severe than Rose's, some after meniscus removal, each with varying degrees of recovery. They're all unique, so while Rose has some things in his favor it's no guarantee.

But even if he does look to be back, totally 100%...

Is Derrick Rose too injury-prone to be relied upon?

Well, in a sense: of course he's injury-prone. Two non-contact severe knee injuries separated by merely a dozen regular season games. Several minor injuries this season, and myriad ones over the course of 2011-12 leading up to (but don't say 'causing'. DON'T YOU EVER) the ACL tear of the left knee. And heck, maybe he did physiologically require that extra time to return from the ACL tear, which would further indicate something unique to his body. In the question of who to blame, maybe Derrick Rose himself is just not cut out for NBA basketball, at least his MVP version of it.

So while in terms of definitive causality these prior injuries may not have anything to do with the likelihood of a future one, should Gar be planning the Bulls future that way like he seems to say in this interview?

1) Gar could be just lying to us, here.

2) The Bulls have the general mindset that regardless of Rose's status they simply want to get more talented overall, more flexibility and freedom and country and all that.

3) It could be argued that due to Rose's very high salary for the next 3 years after this one, the Bulls really have little choice but to merely hope he's a superstar again.

And indeed, future Rose injuries are not an easy thing to prepare for or mitigate against. Simply getting better players should always be a goal, but there's something to be said for the type of players they should look to acquire in the future.

The Bulls have long had almost a zealous desire to make sure nobody besides Rose would ever need the ball, let alone create a shot attempt with it. This isn't referencing the concept of having guys like Nate Robinson for when Rose is out, as you're kind of screwed regardless if Rose keeps having significant injuries. But what I mean more is that the Bulls should be thinking they perhaps need more shot-creators, ballhandling, and athleticism (or top-end talent as opposed to accumulating a lot of very-good talent) for when Rose is playing. Because even if he comes back, can the Bulls really prepare under the assumption he'll be the same player anymore?