Early detection key for Napoli's hip

January, 23, 2013
1/23/13
12:56
AM ET
BOSTON -- A California orthopedist who has treated Olympic volleyball players and professional bicycle racers for the same degenerative hip condition afflicting new Red Sox first baseman Mike Napoli said Tuesday that the 31-year-old Napoli has a chance of continuing his baseball career if the condition was indeed detected in the early stages, as Napoli and his agent contend.

“He potentially could go on and heal from this and be perfectly fine,’’ said Dr. Stephen Mikulak, a hip and knee specialist with California Orthopaedic Specialists in Newport Beach, Calif., in discussing Napoli’s public admission Tuesday that he has avascular necrosis in both hips.

Avascular necrosis, known by its acronym AVN and also known as osteonecrosis (ON), is a progressive, degenerative disorder that kills bone tissue. According to AVNSupport.org, it is caused by a blockage or loss of blood flow to a joint or bone, causing the joint/bone to die. The condition caused a premature end to the career of two-sports star Bo Jackson in the 1990s.

But it all depends on what stage the disease is in, warned Mikulak, a former gymnast on the U.S. national team who grew up in Hyannis, Mass.

“There’s a 30 percent chance of being OK without doing anything,’’ he said. “[If advanced], there’s a 70 percent chance there will be a progressive death of bone tissue that will cause the ball portion of the ball and socket joint to collapse. And a square peg in a round hole doesn’t work. He could develop arthritis and have a lot of pain.

“If the ball collapses, he could wind up needing hip replacement surgery [as Jackson did], or a resurfacing of the hip joints.’’

Mikulak qualified his remarks by saying he has not seen Napoli’s X-rays nor the magnetic resonance imaging exam (MRI) that the Red Sox administered in December that revealed the condition, and thus can’t speak specifically to his case.

In hindsight, Mikulak said, he can’t help but wonder if the left quadriceps injury that was cited by the Texas Rangers as the reason that Napoli was sidelined for 36 games after a mid-July collision was actually “referred” pain radiating from the AVN in the hip down to the thigh.

“A 30-year-old guy usually doesn’t miss 36 games with a quad strain,’’ he said.

CLICK HERE for more on the Napoli signing.

Gordon Edes

Red Sox reporter, ESPNBoston.com

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