In his recovery from reconstructive knee surgery, Washington Redskins quarterback Robert Griffin III could be facing several weeks on crutches, a grueling rehabilitation of six or more months and a strong possibility of missing at least part of the Redskins’ 2013 season, according to sports orthopedists familiar with the type of surgery Griffin had Wednesday.
And when Griffin does return, there are no guarantees he will play at the elite level Redskins fans came to expect before his initial knee sprain Dec. 9.
“Can he return to the same level of agility and explosiveness?” said Benjamin S. Shaffer, head team physician for the Washington Capitals. “The answer is, I don’t know.”
But James Andrews, the orthopedic surgeon who performed the five-hour operation on Griffin’s knee, released a statement through the Redskins saying that Griffin could be back in 2013.
“We expect a full recovery and it is everybody’s hope and belief that due to Robert’s high motivation, he will be ready for the 2013 season,” Andrews said.
Andrews said he performed a “direct repair” of Griffin’s lateral collateral ligament and a “re-do” of the reconstructive surgery Griffin originally had on his anterior cruciate ligament in 2009 as a sophomore at Baylor.
The release gave no other details, so doctors who were not involved in the procedure can only speculate about Griffin’s prognosis, given the many variables that were not addressed.
According to Thomas Gill, team physician for the New England Patriots, factors that could affect Griffin’s rehabilitation time are “the status of the cartilage in the knee, whether there is also a meniscus injury, what type of graft was used for the reconstruction [from another part of Griffin’s own body, or from a cadaver], whether there is bone loss.”
Most estimates by medical experts of Griffin’s timetable for a return to the Redskins are in the range of eight to 12 months — or a few months longer than the typical return from a more simple ACL reconstruction.
Neal ElAttrache, a Los Angeles-based orthopedist who performed Tom Brady’s knee surgery in 2008, said Redskins fans shouldn’t be fooled by the relatively fast return of Minnesota Vikings running back Adrian Peterson, who had ACL reconstruction in December 2011 and did not miss a single Vikings game in 2012.
“Griffin’s injury is more significant and the surgery is more involved and significant than Adrian Peterson’s surgery,” ElAttrache said. “There’s no question about that. With this type of injury, and the position [Griffin] plays, and the way he plays the position, you have to be more conservative early on [in the recovery]. You may be looking at more like nine months than six.”
Under a nine-month timetable, Griffin would return to the Redskins in early October 2013, about five weeks into their season. Under a worst-case timetable of 12 months, he would miss the entire season.
Mark Adickes, the Houston-based orthopedist (and former Redskins lineman) who performed Griffin’s original ACL surgery in 2009, declined to comment via e-mail Wednesday, saying he was consulting with Griffin’s family and Redskins medical personnel regarding Griffin’s current treatment.
Andrews’s description of Griffin’s LCL surgery as a “repair” — which implies a reattachment of the existing ligament to the bone — as opposed to a reconstruction, which uses a graft, works in Griffin’s favor, the experts said. Still, because of the LCL’s importance in the knee’s structure, Griffin likely would require a period of three to six weeks before he can place weight on that leg.
“The vast majority of patients after an LCL are immobilized, with no weight bearing, for three to six weeks,” Shaffer said. “You would be on crutches during that time. Six weeks would be more my guess.”
As for the question of whether Griffin can return to his full, pre-surgery level of performance, Shaffer said the success rate for a full return following a single ACL reconstruction — which Griffin had in 2009 — is about 93 percent. But that figure drops when an LCL surgery is added, and drops again for a second ACL reconstruction.
Pressed for a percentage to describe Griffin’s chances of returning to his early 2012 level, Shaffer cited 80 percent.
It “remains to be seen” whether Griffin can make a complete recovery, Shaffer said. “[But] certainly the significance of the injury, structurally, captures one’s attention as a surgeon.”
Based on his own experience, ElAttrache predicted that Griffin would be better in his second year back from surgery than in his first, but said the quarterback also might be forced to adapt to a different way of playing the position.
“The silver lining is, this may ultimately be a good thing for RGIII,” ElAttrache said. “I think this is going to change the way he plays when he gets back. He’s going to evolve into the position. I hate to bet against a player, but with this type of injury I would not expect him to do the same things, the same way, in the first year back.”