Commentary

Occupational Hazard: Stoudemire, Arenas knee issues

Updated: November 12, 2007, 11:10 AM ET
By Guy Lake | Special to ESPN.com

Two players taken in the first round in most leagues are struggling with knee issues post surgery. Gilbert Arenas has not performed anywhere close to expectations, and Amare Stoudemire has missed three games with right knee soreness. I have enlisted the expertise of ESPN's resident injury guru, Stephania Bell, to help us understand what might be going on with each player.

Guy: Let's start with Amare. Last year he came back from microfracture surgery on his left knee and played all 82 games plus the playoffs. Now his right knee is bothering him after his October 2 surgery to clean up cartilage. What can we make of this?

Stephania: My concern is what causes some of these guys (like Stoudemire) to end up with such severe cartilage damage in the first place (especially if trauma is not involved). One thought could be (although there is no firm evidence to support it) that their cartilage is a bit more "fragile" than the next person's. The cartilage breaks down a little easier, perhaps a result of combining the extreme stresses placed on players' knees with their genetics as far as the health and durability of their cartilage.

Guy: Given that the left knee seems trouble-free, what can we expect from the right knee?

Stephania: Interestingly, Stoudemire had surgery this October for a non-traumatic injury to that knee. He began to have pain during camp, and they went in to remove loose cartilage. Once a fleck of cartilage has come loose and been removed, the joint surfaces are no longer pristine; there will be a rough spot along one aspect of the knee where the cartilage damage was. This can be benign for a while, but the spot can progress in terms of size and in terms of the symptoms that it creates for the athlete. Knowing that a piece of cartilage has been removed, it leads one to wonder whether this is the beginning of further joint problems now in the right knee for Stoudemire; the track record of cartilage problems in his knees is not good.

Guy: So, should Amare owners be worried looking ahead?

Stephania: Yes, it's worrisome. Can he overcome it and go on to have a good season? Yes. It just raises a flag that this could be a persistent problem for him; and we should not be surprised if that's the case.

Guy: OK. Now let's turn to Gilbert Arenas. He underwent surgery to repair the torn lateral meniscus in his left knee. He was initially injured when Gerald Wallace careened into him, causing the knee to buckle. Arenas had surgery on April 5 and now, five months later, he has had his knee drained twice and has been far from the Agent Zero fantasy owners have come to love. Is this another case, as with Stoudemire, where his owners are going to be fretting all season long?

Stephania: First, some definitions. The meniscus is a band of cartilage that serves as a cushion within the knee joint, absorbing the pounding basketball players put on their knees. Once a portion of the meniscus is damaged, you increase the shear forces throughout that meniscus. The lateral meniscus is the band of cartilage on the outside of the knee, where the medial meniscus wraps around the inner part. Lateral meniscus tears always are harder to rehab than medial meniscus tears. They just don't respond as well post surgery as medial tears/surgeries do.

The fact that Arenas is having persistent swelling, enough to get the knee drained twice, is cause for concern. This means that something is continuing to cause irritation inside the joint, which in turn causes swelling. Again, Arenas may return to play and play well, but the setback here raises the question of whether he will continue to have problems intermittently throughout the season.

Guy: Thanks for schooling us on the ins and outs of cartilage and the specific issues facing Stoudemire and Arenas. I think what we can take away from this is that both players are clearly at greater risk for knee injuries this season than your typical player. However, risk does not equal injury. Arenas came out gunning Thursday night and had his best night of the season: 22 points, two 3-pointers and six assists. He's not "back," but it was a good sign. After all, it took Kobe a little while to turn it on last season after returning from his arthroscopic knee surgery, and in the end he had a great year. Meanwhile, the Arizona Republic reports that Amare Stoudemire is likely to return in tonight's game. We will see how the knee responds.

Triage Unit

Nene, PF/C, Nuggets: According to the Denver Post, Nene tore a ligament in his thumb on Wednesday and will miss six weeks. The Nuggets aren't likely to boost Kenyon Martin's minutes (he's still not playing in back-to-back games) just yet, so look for Eduardo Najera to step into the breach.

Ike Diogu, PF, Pacers: Diogu is going to miss the next 4-6 weeks with a torn left calf muscle, according to the Indianapolis Star. His minutes will be absorbed by Troy Murphy and Shawne Williams, though Murphy may be a week or so away from regular 30-plus minute nights as he recovers from a sore Achilles.

Cuttino Mobley, SG, Clippers: Cat has been a great value this season, but his high-scoring ways will be put on hold for a week or so as he recovers from a groin strain suffered on Wednesday.

Raymond Felton, PG, Bobcats: This one looked scary when it happened but it appears that Felton should be back soon. The Charlotte Observer reported that there were no indications of soft tissue damage and Felton should be fine. The Bobcats are desperate to get him back, as they really struggled with Jeff McInnis starting at the point.

Rashad McCants, SG, Timberwolves: The Timberwolves' second-leading scorer is listed as day-to-day with a sprained left ankle. The Wolves are scheduled to play Friday in Los Angeles against the Lakers and Saturday in Sacramento. I expect McCants to miss both games, though a Saturday return is possible. Corey Brewer will see more minutes until McCants is back.

Pau Gasol, F/C, Grizzlies: The back is clearly bothering him, but Gasol is soldiering on. His numbers are down (17.0 points, 7.7 boards, 0.7 blocks) but there isn't much you can do at this point other than wait it out and hope that Gasol returns to form during his four games next week.

Ben Wallace, C, Bulls: While many of us expected a decline, Wallace just isn't this bad. The left ankle is robbing him of his lift, and his numbers are horrible. If he is dropped or available on the dirt-cheap, make a play. I grabbed him off the wire in one of my leagues and will wait out the injury.

Welcome Back

Dwyane Wade, G, Heat: No date is set yet, but my guess is we will see Wade this Sunday. Wade will probably shoot fewer free throws as he comes back as he has told the Miami Herald that he will look to use his midrange game more as he returns from knee and shoulder surgeries.

Lamar Odom, F, Lakers: The L.A. Times reports that Odom will return tonight but that Ronny Turiaf will be the starter at power forward. Odom should be starting by next week and should be in your active rosters.

Zaza Pachulia, F/C: Hawks: Expect Zaza to make his limited return tonight against the Celtics. He practiced this week and will soon be sharing minutes with Al Horford.

Guy Lake is a fantasy basketball analyst for ESPN.com.