March 24, 2023 • 26 mins
In this episode, we discuss the recent surgery that Lonzo Ball underwent, his third knee surgery in over a year. Dr. Grant Garcia explains cartilage transplant surgery and how it is a unique procedure that is not commonly performed on professional athletes. We also talk about the history of Lonzo Ball's knee injuries and how his meniscus tear led to the loss of cartilage in his knee. I ask Dr. Garcia if he has any Big Baller Brand gear in his wardrobe…
Dr. Garcia does about 30 to 40 of these procedures a year. The recovery process is a long one, taking about 9-12 months, but the success rates for the procedure are high. Dr. Garcia notes that success rates for professional athletes may be different. Rebless is a robotic by H Robotic that most likely will be used in Lonzo Ball’s recovery, which we’ve discussed in previous shows.
Sports Doc Talk is a podcast hosted by Will Sanchez and Dr. Grant Garcia, an orthopedic surgeon and sports medicine specialist. Check out Sports Doc Talk on all major podcast platforms and on our YouTube channel. Please reach out to us for any questions or show ideas at sportsdoctalkpodcast@gmail. You can also reach Dr. Grant Garcia at grantgarciamd.com for great orthopedic information and content.
This podcast aims to educate listeners about sports medicine and the procedures that are used to help athletes recover from injuries.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:03):
Thank you, everyone for listening to sports doc, talk.
This is great. I mean, we're super excited.
Normally, we plan our shows. This show was unplanned.
I'm will Sanchez along with dr. Grant Garcia, orthopedic surgeon
Sports Medicine specialist, check them out at Grant Garcia,
m.com before we get into our show, dr.
Garcia. Do you have any big baller brand
(00:26):
gear in your wardrobe? Not too much in my wardrobe.
No, I'm not. I'm not a huge fan of that
stuff. But, you know, more power to the
just pretty much a segue to our show, but, you know, you always
gotta check in with the dock because he will surprise us.
Just want to make sure that if he had any big bowl of brand.
(00:47):
But in all seriousness, you know, the reason we're doing
this show is because a young manjust 25 years old.
Lonzo ball is going through another procedure and just kind
of went through it again and just to remind Everybody Alonzo
ball, he's been a tremendous player.
I mean, he was the second overall pick in 2017 all-rookie
second. Team that year consensus
(01:09):
first-team going back to college, he was Pac-12 freshman
of the year. I mean this is a young man
that's been extremely successfulat the highest level at the NBA
level and it's just unfortunate that he's been having some
issues and going through what he's been going through, really.
Going back to 2022, he hasn't played a game since January
(01:33):
14th. He had surgery a short time
later, repair a torn meniscus inhis left knee.
At the time, they said that was going to set them back about six
to eight weeks. He wound up missing the rest of
the season and he he still continues to have pain
discomfort in the knee, over thesummer, he had a second surgery
this past September. And then finally, just this past
(01:54):
week, I believe it was Monday and please correct me if I'm
wrong. He underwent cartilage.
Transplant surgery on his left knee, which is third surgery on
his knee in the last year. Dr. Garcia first off.
What is cartilage? Transplant surgery.
So the the reason you picked this topic and this is very
(02:15):
unique. You know, the surge has been
around for a little while. They did say Innovative surgeon
number of the Articles and it isa sort of more cutting-edge
procedure. I kind of perform a lot of these
in patients with cartilage holes.
So what they do is in most casesAgain they're using layman terms
here. So cartilage transplant could be
taking a piece of cartilage fromhis own knee and put it in
there, but that's probably less life because that's fallen out
(02:37):
of favor. So what they probably did was
use cartilage from someone who was recently passed away, fresh
cartilage. And then you transplant, if
there's a hole in the cartilage there and the success rates are
very, very good but for an NBA player, this is the first time
this has ever been done. And so that's why this is a
really big deal. We do a lot of these in high.
(02:59):
Alas leitz and people that are very active, you know, I do a
fair number of these but we never usually do them in
professional athletes because it's just not been heard of but
you don't. It's always hard to be the first
one in something. Yeah.
And so that's why this topic is so interesting because I think
people have never heard of this procedure unless you've actually
had one of these surgeries or you know, somebody that the
performs the surgery. So it's a pretty it's a pretty
(03:21):
unique procedure and I think people want to know more about
it. So that's sort of the goal of
this is to show is to kind of talk about it.
I Think one thing people probably interested in is sort
of how did this happen, right? Like how do we get to this
section is that I'm assuming that's what we're going down.
Yeah. So you know this, it's always
hard to know. I wasn't obviously in there, I
(03:41):
wasn't seeing the inside of the knee but explain to patients are
displaying those listeners. What's what happened is, you
know, a lot of players and taking care professional
athletes and my previous experiences even working with
the bulls understand how this process goes, professional
athlete tears, their meniscus. Sometimes they can fix it.
I think he had a repair the first time and sometimes they
(04:02):
can't. And so we either had it fixed.
We've talked about these meniscus tears and sometimes
they don't heal. Eel and if they don't heal, they
go on to having a second surgerywhere it's a cleanup but the
problem you have is when you lose your meniscus, sometimes
you lose cartilage to and so thecartilage on that side of the
knee probably was also damaged but in a professional athlete
you try as much to do as little as possible.
(04:23):
You know. Really your treatment
professional athlete is very different than the treatments of
a standard athlete even though they're you know there may not
be a very large discrepancy in terms of sort of skill sets and
activities and size and everything else.
Just it's just different becauseprofessional It's you basically,
it's a sort of a death sentence for their career, if you do a
surgery that there had been donebefore on them, unless you have
(04:44):
certain levels of clout, and it certain last-minute effort, does
that make sense? So yeah, yeah.
So he the second surgery. I think they said they remove
loose bodies and what that meansis he probably had cartilage,
that was damaged and then eventually the cartilage broke
off pieces were floating around and they went in and grabbed
them out, which sounds painful. And he also probably retour is
(05:04):
meniscus and that's already a bad scenario right now you It
hit me with less less of sort ofthe soft rubbery stuff.
So like the tire Treads are goneand you also lost the padding.
So this provides a lot more problems.
Why he couldn't get back. I'd probably swelling, pain,
Etc, and the, and once you develop a big hole in your
cartilage for small ones, they can do other small things for
(05:25):
these sort of professional athletes that we would normally
just do it. Go straight to a transplant for
but with hand, they ran out of options and it was either do a
transplant or he's going to, youknow, eventually go on to a knee
replacement. And so this is a good option.
For him in life and also a good option for him to potentially go
back. Okay, so, so real quick.
I'm just going to backtrack a little bit.
(05:46):
So initially, they said when he tore his meniscus, that he would
be sick out, six to eight weeks.How do we go from that?
Diagnosis to the point where, you know, where they think that
he was going to go back, but he continuously had pain and
discomfort in his knee, right? Because I think that's what
(06:09):
they're saying. They like, you know, from what
I've read. They couldn't understand why and
they were like, whoa, you know, certain things are in place.
We kind of, we think you're ready to go but he's like, I'm
still having pain, I'm still having pain.
So how do we go from that six toeight week?
Timetable to the point where we're at now?
(06:29):
What changes and as a doctor youknow what is something that it's
something that triggered for yousay, hey I thought this was
happening but then this is the result in this is where we're
at. So, this is something where you
got to see the worst case scenario everything happening.
So when you get a part of your meniscus, remove do most people
do very well, but occasionally, there's pieces that go on to
(06:53):
either spontaneous osteonecrosis.
So we're their knee doesn't likethat new environment.
And they start developing bone problems and things like that in
their knee. Or and there's people that when
they have part of the meniscus removed, they can't compensate
very well and they lose we call the hoop stress so that means
the bones are now colliding. More frequently when that
happens, your bone reacts, and it starts to it starts to die or
(07:16):
starts to change. Now, a lot of times if you catch
this on time some you can stop it and I'm not saying that
that's what he had exactly here.Yeah.
But if that happens, you know, your take them off, you shut
them down because he probably had a mastectomy because six to
eight weeks in standard recovery, but you members Ian
Williamson, he took forever to come back to, he's in your right
situation. Yeah, so that's exactly.
(07:37):
We talked about how know a whileago, so now he gets
decompensated his knees, not Well, they can't figure out
what's going on because it's MRIprobably looks good.
He's having pain. This is called meniscal
deficiency or and eventually cango up this sort of thing called
spontaneous osteonecrosis. He starts sloughing.
Cartilage off has a loose body removal and all of a sudden.
Now, you have this very bad situation that happened very
(07:57):
quickly. It's no fault of anybody's but
it just won't a very bad complication.
A very bad reaction to having this sort of surgery.
And again, it's very infrequent.I do tons of surgeries like this
and I almost never see this happen, but high-level athlete,
he probably pushed through levels of things that we
normally wouldn't people would normally not do Do you think
(08:18):
that I'm see I'm I'm going to wear this here.
Do you think this injury was exasperated by something prior?
Right? And I know he's had some
injuries before he had you know,he had the knee injury before in
fact that the opposite leg he's had in the right knee.
Obviously, now he's having issues with the left knee.
He's had issue with his adductor.
(08:39):
He had an experience that hip injury twice.
I'm not sure of anything is related to anything.
But is, is there something there?
On the line. So I can say, hey this added to
the injury or it's just something and that has to do
with kind of. This is your body type and this
is how you recover in. This is kind of like the hand
that you're dealt with and it's just as simple as that.
(09:02):
You know, it's not as simple as that.
I think you were better off the first comment you made.
You know, in terms of how these connected you know this happens.
You can happen all the time withpatients, we see standard
patients. Not, you know, regular
recreational athletes that, I take care of as well.
Yeah, you know they come in something gets hurt.
It's just a bad Cascade. Then the next thing.
It certainly seen those Pro players.
You know, DeMarcus Cousins I think remember had one injury
(09:24):
the next year. Another injury next year.
Another injury, you know those are coincidence, right?
Your body to start shutting downand you use your hips
differently. That can cause more knee
problems. He may have certain levels of
laxity in his body that allowed to do certain abnormal athletic
things. But then against it also puts
you at a higher risk of an injury.
And when you get a meniscus injury or a knee injury, like
(09:45):
this, a lot of times it goes great, but the situation.
If you had these other injuries,he was weaker in certain sides.
But he's also a super physical highly.
You know, why way above any of our skill level player?
We talked to us before athletes,that are crazy, good and have
incredibly good at Athletics, can overpower Our their bodies,
you know, you and I can't go outthere for injured and play.
Well, yeah, but you probably could.
(10:06):
Yeah. You know, why did we get to this
option here? We've talked about before with,
whether it's plate, rich, platelet-rich plasma stem cells,
bone marrow. We've heard different things.
We know that Kobe Bryant has gone over to Germany.
(10:27):
We, you know, like, why did we get to this point?
And why are maybe some of the other options weren't explored
or they were explored but determined that we were going to
go with this. Cartilage, transplant surgery.
Well, I can tell you right now, I know the team doctors for the
Bulls and I know they use all ofthese options to try to stop
(10:47):
this from happening. That's just so, you know, PRP,
you know, dr. Brian calls ahead team doctor
for the Chicago Bulls. He's probably one of the best
cartilage surgeons in the country, if not the best, and
that's the person who taught me,everything I know.
So, you know, he's this is an incredible surgeon and
diagnostician as well as the rest of the team positions at
the Chicago Bulls actually, knowing these people first hand
(11:08):
at work with this play. Are ya PRP was definitely used.
I'm sure they use bone marrow aspirate and they may be
considered stem cell therapy forthem.
But unfortunately, as you, he'llhear about, in many of my talks
about Central therapies, they don't correct.
Cartilage problems, they helped calm down the inflammation.
So nothing's going to give him new cartilage back, you know,
despite we see on the internet or these stem cell clinics all
(11:28):
around which we talked about before.
So they probably tried that in the early stages and try to get
his need to calm down with PRP or try to get his me to calm
down with bone marrow aspirate. And And it just it didn't get
enough that he could stop it. And then eventually you have
these this structural issue, which is the lack of meniscus
and eventually send to stabilization of his cartilage
that they just couldn't stop it at that point, because it
(11:50):
becomes a mechanical problem. And that's why you can't just
treat these problems with, with those biological options, you
mentioned, I mean, once you get a hole in the cartilage, there's
no going back to that. What?
What? What do you, what would you deem
success? This is a tricky question, and
(12:11):
that's why I hesitated to ask it, right?
He just had this procedure this past Monday as a doctor.
I guess. Maybe the better question is to
ask, what are the stages of success, right?
Because the simplest stage for someone like myself or someone
that's not an athlete that's listening to this program is to
(12:32):
have quality of life. Right to be able to walk to be
able to have some, a lack of discomfort to kind of have some
normality where I'm not in in pain for the last three years.
But for high-level athlete, it'svery very different.
Especially a 25 year old athletethat signed a huge contract with
(12:53):
the Chicago Bulls and has a lot of expectations going back to
his high school and everything that has to do with the ball
family, right? This was the guy that was going
to pay. The way for this family.
So if you had to break down the steps for an athlete like that
and more importantly, as a doctor, what are the steps?
(13:15):
Where you go? We cleared this whole this
hurdle. What's the next one?
Etc? Etc.
So, the one thing patients to know and our listeners should
know, is that, you know, you probably saw my post yesterday.
This is one of the most quality of life improving procedures
that I do. Because it's generally patients,
like lingerie ball, who are not that level Athletics, but those
(13:36):
patients ages, they have hole intheir cartilage, and they can't
do things. They want to do, can't play
basketball. They can't do Sports, and they
have pain and swelling all the time, which is really not
acceptable in a young patient. So this ability to replace the
cartilage is a is a really amazing sir.
Surgery and works very very well, especially if done by the
right people and I'm sure he hadamazing surgeons.
Do it? The steps you are.
(13:58):
As you start off in terms of therecovery to, you know, the
problem is you can't put weight on this for almost six weeks.
So that's the rough part about this.
Welfare ready. Put it up there a on it.
That's, that's, that's a long time frame.
I did not expect that. Because normally and we've
discussed this before and I apologize for interrupting that
we've talked about having a procedure done and really kind
of trying to get the patient to move or rehabilitated.
(14:21):
Soon as possible as soon as theycan.
So it could promote health and kind of get on that path toward
recovery. So that surprising hearing that
go ahead. So he can start physical therapy
right away, he's probably doing crazy therapy already since his
own chemistry surgery only a fewdays ago.
Yeah, but you just can't put anyweight on it because you need
this to start an ingrate becausemember it's bone from somebody
(14:43):
else that's growing into his bone now.
And if you were to step on this or walk on it and put pressure
on that area, inadvertently, youcan cause cause the bone to not
heal properly. So, the first sort of four weeks
really delicate about weight, and then progress to start
walking normally by six weeks. And I know the guys that are
probably giving him the recovery, I use the same
protocol that they use, and thenreally, it's sort of a Time
(15:05):
Testament, and it's a really long process.
I mean, people do not understandthat if they think that they can
get their car, those taken care of like this and your back to
everything you want to do in three months.
This is a nine month to a year recovery because you want to
make sure the environment is right for the cartilage.
It does. Very well but, you know, you're
not doing any real high impact tool for five months and, you
(15:26):
know, he can start doing liftingand those things, but nothing
high, no squats, no, major activities like that.
But really, you know, probably starting basketball at nine
months probably an entire seasonwith the hopes that a year.
Now again, I actually think he might make it back because as
long as his team's willing to let it have an opportunity, you
know, if he was getting traded or something else, they probably
(15:47):
never let him play because it because of the fact that it's
such an unknown procedure, right?
Yeah. Because it's just additional
Point. Yeah, I'm sorry the team
physician. Yeah no.
It's okay. The team positions are very
finicky about these procedures, right?
Because you don't want to be thefirst person.
I mean, we all want to be the first on something, but you
don't wanna be the first, you know, player person to sign
somebody with his contract with a cartilage transplant.
(16:09):
Even though I do probably 30 or 40 to use a year, and I see many
of my patients, go back to extremely high levels of
activity. You know, when I heard he got
this, I was just it was just impressive.
I want to make sure people knew about This procedure because
people don't know about it. When I tell them, they need this
surgery, they're very shocked, right?
But now you can see, there's there's players that get this
(16:29):
and so I want to make sure people are informed, but the
surgery is very good. And if done for the right
reasons which I'm sure his was, you know, there's a high chance
as a good quality of life. The problem is it's just can it
take the impact of the professional level and will it
wear out faster? Right.
There's no data to show that it will with the certain impact
that he does but these know these don't be so don't live
forever. These cartilage transplants
(16:51):
because They're separate units. Like if you go back in and look
at them you could still see where the plug was on the
cartilage. It just lives by itself.
Does that make sense? It's on an island, and you just
transmit the whole thing you just lives there forever.
It never really comes and get together.
Exactly. But it, you know, it's flush and
perfect along with everything else.
But you know, about 85% of theseare still there at about 10
years. So it's a pretty good number.
(17:13):
Now again, that's not professional athletes.
Yeah, that's my patients that are in their sort of early 20s
to the mid 50's, but success rates are high.
Hi. You know, I would say that my
page he asked an average patient.
It's about 90 to 95% patients. Say they're much happier than
they were before again. Is it going to be different
professional athlete? And I want to make sure if he
starts running his, no swelling,right whatsoever.
(17:36):
And then you're going to start working things and he's probably
gonna get an MRI, you know, at six months, nine months, one
year, make sure this thing is integrated.
So those are really important. I'm going to say the dirty word
that nobody wants to talk about but I'm going to bring it up.
What's the concern? When it comes to arthritis for a
procedure like this, or just maybe the condition of his knee
(17:58):
at this point of because of all the treatments and injuries that
he sustained over the last threeyears.
So I'm not worried about arthritis from the cartilage
standpoint. I mean, that's the reason we do
this surgery to prevent arthritis.
Okay, but I worry that in him that wasn't a hundred percent of
the reason. So, You know, if he's missing
some, his meniscus now and he's out of needed, a cartilage
(18:20):
Retreat, like our lives transplant.
Does he already have deficiency?And is this, this cartilage
could translate gonna wear out faster than make sense?
You know, the people that do thebest with these procedures other
ones that have perfect-looking these except for a hole?
Hmm, we already know, is he's not perfect?
No. So could this could be a higher
you could be at a higher risk because because of why he needed
(18:41):
it and because of what his proceeding surgeries were, you
know, as soon as I do Surgery onthis with somebody with a
meniscus issue. Etc, I worry about it.
The meniscus. Is there enough meniscus left to
support this now? Patients, still do really well.
But we don't know what the rest of his cartilage look like.
So they could be doing somethinglike a Hail Mary, where he has
some arthritis, but it's very early on because grade 1 grade 2
(19:02):
arthritis, and his age should dothese procedures and his age and
his and his status, you know, ifhe has pain that to do
something. So it's, it was probably a
pretty good-sized hold for them to make this decision.
But also, it's sort of time for this procedure to get tested in
the pros because it's been around a while it does.
So well, it's a really a Workhorse for many of us
(19:23):
cartilage surgeons. And I'm really, I'm happy.
They went after it to get this, this young, man, a chance to get
back. And I really hope he does.
And I, you know, you're going tohear me, put it here.
I think he might do it again. That's knowing that's assuming
that his meniscus is still pretty good.
And that's assuming that, you know, the doctors had looked all
that stuff and made sure everything else checked out,
which, I'm sure they did. If everything checks out like
(19:45):
it. Disclose to there's a high
chance. I think you'll make it back, but
was like, I hope so. I mean, you know, you never want
to see young athlete kind of go through something like that.
I know what kind of long we're like, we're going to wrap this
up in 10 minutes, is right before we started.
And obviously, we're just chatting away.
Now we do and I apologize because I'm gonna ask another
question. Here does something like
(20:06):
regulus, help with this recovery.
That's absolutely perfect question.
So yeah, this is what are you ina winner, chicken dinner, baby.
I mean, I, I know that you're not a doctor, but you mustn't
say to the Holiday Inn. I did.
The, so this is so the rebels machine, which we can talk about
(20:27):
our, we talked about before, we don't want to go into too much
detail, but basically it's a machine that allows for sort of
a range of motion but also strengthening.
So it gets my patients back. I can't put weight on it, it
does sort of extra physical therapy for them.
So yes, that is This is one of the procedures that I use the
wrap the red list or on Carla's transplant, patients or patients
with cardiac transplants and other stuff.
They can't cook. Wait.
(20:47):
And so they have this machine. That's not only going to get
their emotion back because I used to use an old motion
machine and now I use this new machine.
The regulus that can be programmed digitally, it does
range emotion but it also does strength and resistance, when
you can see, the recent posts had put up one of my friends
trying it out and you can see that you know, at 45 weeks you
know, Alonso ball could start doing other exercises.
Now again it's probably not a Athlete machine, because he's
(21:10):
going to have people, literally.Moving your leg for him.
Yeah. Right.
He could has unlimited resources.
But for you and I that are like normal people, you know, this
having this machine at your house that you can use every day
rather than a PT that can only help you for one or two hours a
week. It's a game changer.
So I think it'll give me. I think the king would give a
kiss Temptations, a huge leg up.And I've already noticed in my
patients, can add cartilage transplants on both sides.
(21:31):
The ones that had the rebels machine already feel better, and
they're starting to feel Stronger Faster, which is great.
And we're looking forward to showing that data at some point,
and funny one. Out there.
That's like what the hell's Rebel is.
We touched upon it right now. I believe it's HR robotics or
something that we talked about before, and I was just curious
to see if that would be something that they would
utilize, let's wrap it up because I figure we could kind
(21:53):
of keep going with this because it's just kind of cool stuff,
you know, and apologies to the ball family.
If they're listening, obviously,we're not, you know, getting
excited about it injury, but talking about the procedure and
talking about really kind of thewhole point of what we do.
Who is to give information to people out there and patient and
(22:14):
really, it's for me, it's a platform just to ask questions,
right? If you have a doctor out there
and you want to ask questions because you've heard something
or you looking into something and dr.
Garcia is always great with saying, hey, get a second
opinion, get more information, you know, at learn what you're
going to do, let's wrap it up in.
I didn't tell you this because Idon't tell you these things.
(22:35):
I have trivia for you. I need music.
I didn't like trivia music. Eric we have trouble.
Okay, buddy. Here we go.
All right, since 1975. There have been three players
from the University of Washington to win Pac-12 player
of the year. The reason I bring it up is
because Lonzo ball. One PAC, 12 player of the year
(22:57):
for UCLA when he played. Can you name one of the three
players from the University of Washington because we're in the
state of Washington? That's why bring it up that one
player of the year. I don't think I named one and
unfortunately, you're hurting meor something.
I take care of a lot of you Deb players, Etc.
(23:19):
And I can't name a single one, so this isn't good.
All right, so you have to know by now that usually I tried to
tie in My Trivia to what we're doing.
So in 2018, Jalen, no l was Player of the Year, Christian
welp in 1985 with an assignee 586.
Season. And in 2005 and 2006 season,
(23:43):
Brandon Roy from the University of Washington was named Claire,
the year Pac-12 player of the year and I bring that up because
we know the difficulties that hehad with his knee injuries and
if he was playing in 2023 and inthe same condition, who knows
his career might have been longer.
So I wanted to bring up that trivia just because of the
(24:06):
Brandon Roy reference with the knee injuries.
Well, you got me again, thank you.
It does not feel like a thank you, but we do want to thank our
listeners. Thank you so much for listening
with us and joining us for will Sanchez dr.
Grant Garcia, please check them out.
(24:26):
Grand Garcia, m.com, he has so much information.
I mean, great videos. I when I say information, his
websites ridiculous, there's lots of information.
There's videos, you could ask Ask questions, you name it.
He's our orthopedic surgeon Sports Medicine specialist for
reason. Dr. Garcia.
(24:47):
Thank you for taking some time. I know this show came out of the
blue. We were like, we heard this
information. You say, hey, we got to do this
and I'm glad we did. So thank you for really
partaking and sharing great information for our listeners.
Thanks for having me and again you know, the website, which you
referred to, we can you can learn about the cartilage
(25:09):
transplant and see exactly how we do it.
I have talks on there, so that'll be even more informative
as well as patients are interested.
All free information, you guys can take away and look at and
really learn sort of its first hand that sort of level
peer-reviewed information and secondly a big shout-out, which
will forgot to say of our brand new website,
www.stock-market-strategy.com facades and all of our video.
(25:34):
We're going to do a big announcement of the next week,
but I found at least we'd still the beans today and get paid get
ever, get our listeners excited that there's any more
information, you can learn aboutboth will and I on there and you
can see all of our episodes. And it's pretty easy, subscribe.
So thank you guys all for listening.
Great job. That's Garcia.
You have a great night and once again thank you very much
(25:54):
YouTube. Thanks, bye.
We're going to do a big announcement of the next week,
but I found at least we'd still the beans today and get paid get
ever, get our listeners excited that there's any more
information, you can learn aboutboth will and I on there and you
can see all of our episodes. And it's pretty easy, subscribe.
So thank you guys all for listening.
Great job. That's Garcia.
You have a great night and once again thank you very much
YouTube. Thanks, bye.
Thank you, everyone for listening to sports doc, talk.
This is great. I mean, we're super excited.
Normally, we plan our shows. This show was unplanned.
I'm will Sanchez along with dr. Grant Garcia, orthopedic surgeon
Sports Medicine specialist, check them out at Grant Garcia,
m.com before we get into our show, dr.
Garcia. Do you have any big baller brand
(00:26):
gear in your wardrobe? Not too much in my wardrobe.
No, I'm not. I'm not a huge fan of that
stuff. But, you know, more power to the
just pretty much a segue to our show, but, you know, you always
gotta check in with the dock because he will surprise us.
Just want to make sure that if he had any big bowl of brand.
(00:47):
But in all seriousness, you know, the reason we're doing
this show is because a young manjust 25 years old.
Lonzo ball is going through another procedure and just kind
of went through it again and just to remind Everybody Alonzo
ball, he's been a tremendous player.
I mean, he was the second overall pick in 2017 all-rookie
second. Team that year consensus
(01:09):
first-team going back to college, he was Pac-12 freshman
of the year. I mean this is a young man
that's been extremely successfulat the highest level at the NBA
level and it's just unfortunate that he's been having some
issues and going through what he's been going through, really.
Going back to 2022, he hasn't played a game since January
(01:33):
14th. He had surgery a short time
later, repair a torn meniscus inhis left knee.
At the time, they said that was going to set them back about six
to eight weeks. He wound up missing the rest of
the season and he he still continues to have pain
discomfort in the knee, over thesummer, he had a second surgery
this past September. And then finally, just this past
(01:54):
week, I believe it was Monday and please correct me if I'm
wrong. He underwent cartilage.
Transplant surgery on his left knee, which is third surgery on
his knee in the last year. Dr. Garcia first off.
What is cartilage? Transplant surgery.
So the the reason you picked this topic and this is very
(02:15):
unique. You know, the surge has been
around for a little while. They did say Innovative surgeon
number of the Articles and it isa sort of more cutting-edge
procedure. I kind of perform a lot of these
in patients with cartilage holes.
So what they do is in most casesAgain they're using layman terms
here. So cartilage transplant could be
taking a piece of cartilage fromhis own knee and put it in
there, but that's probably less life because that's fallen out
(02:37):
of favor. So what they probably did was
use cartilage from someone who was recently passed away, fresh
cartilage. And then you transplant, if
there's a hole in the cartilage there and the success rates are
very, very good but for an NBA player, this is the first time
this has ever been done. And so that's why this is a
really big deal. We do a lot of these in high.
(02:59):
Alas leitz and people that are very active, you know, I do a
fair number of these but we never usually do them in
professional athletes because it's just not been heard of but
you don't. It's always hard to be the first
one in something. Yeah.
And so that's why this topic is so interesting because I think
people have never heard of this procedure unless you've actually
had one of these surgeries or you know, somebody that the
performs the surgery. So it's a pretty it's a pretty
(03:21):
unique procedure and I think people want to know more about
it. So that's sort of the goal of
this is to show is to kind of talk about it.
I Think one thing people probably interested in is sort
of how did this happen, right? Like how do we get to this
section is that I'm assuming that's what we're going down.
Yeah. So you know this, it's always
hard to know. I wasn't obviously in there, I
(03:41):
wasn't seeing the inside of the knee but explain to patients are
displaying those listeners. What's what happened is, you
know, a lot of players and taking care professional
athletes and my previous experiences even working with
the bulls understand how this process goes, professional
athlete tears, their meniscus. Sometimes they can fix it.
I think he had a repair the first time and sometimes they
(04:02):
can't. And so we either had it fixed.
We've talked about these meniscus tears and sometimes
they don't heal. Eel and if they don't heal, they
go on to having a second surgerywhere it's a cleanup but the
problem you have is when you lose your meniscus, sometimes
you lose cartilage to and so thecartilage on that side of the
knee probably was also damaged but in a professional athlete
you try as much to do as little as possible.
(04:23):
You know. Really your treatment
professional athlete is very different than the treatments of
a standard athlete even though they're you know there may not
be a very large discrepancy in terms of sort of skill sets and
activities and size and everything else.
Just it's just different becauseprofessional It's you basically,
it's a sort of a death sentence for their career, if you do a
surgery that there had been donebefore on them, unless you have
(04:44):
certain levels of clout, and it certain last-minute effort, does
that make sense? So yeah, yeah.
So he the second surgery. I think they said they remove
loose bodies and what that meansis he probably had cartilage,
that was damaged and then eventually the cartilage broke
off pieces were floating around and they went in and grabbed
them out, which sounds painful. And he also probably retour is
(05:04):
meniscus and that's already a bad scenario right now you It
hit me with less less of sort ofthe soft rubbery stuff.
So like the tire Treads are goneand you also lost the padding.
So this provides a lot more problems.
Why he couldn't get back. I'd probably swelling, pain,
Etc, and the, and once you develop a big hole in your
cartilage for small ones, they can do other small things for
(05:25):
these sort of professional athletes that we would normally
just do it. Go straight to a transplant for
but with hand, they ran out of options and it was either do a
transplant or he's going to, youknow, eventually go on to a knee
replacement. And so this is a good option.
For him in life and also a good option for him to potentially go
back. Okay, so, so real quick.
I'm just going to backtrack a little bit.
(05:46):
So initially, they said when he tore his meniscus, that he would
be sick out, six to eight weeks.How do we go from that?
Diagnosis to the point where, you know, where they think that
he was going to go back, but he continuously had pain and
discomfort in his knee, right? Because I think that's what
(06:09):
they're saying. They like, you know, from what
I've read. They couldn't understand why and
they were like, whoa, you know, certain things are in place.
We kind of, we think you're ready to go but he's like, I'm
still having pain, I'm still having pain.
So how do we go from that six toeight week?
Timetable to the point where we're at now?
(06:29):
What changes and as a doctor youknow what is something that it's
something that triggered for yousay, hey I thought this was
happening but then this is the result in this is where we're
at. So, this is something where you
got to see the worst case scenario everything happening.
So when you get a part of your meniscus, remove do most people
do very well, but occasionally, there's pieces that go on to
(06:53):
either spontaneous osteonecrosis.
So we're their knee doesn't likethat new environment.
And they start developing bone problems and things like that in
their knee. Or and there's people that when
they have part of the meniscus removed, they can't compensate
very well and they lose we call the hoop stress so that means
the bones are now colliding. More frequently when that
happens, your bone reacts, and it starts to it starts to die or
(07:16):
starts to change. Now, a lot of times if you catch
this on time some you can stop it and I'm not saying that
that's what he had exactly here.Yeah.
But if that happens, you know, your take them off, you shut
them down because he probably had a mastectomy because six to
eight weeks in standard recovery, but you members Ian
Williamson, he took forever to come back to, he's in your right
situation. Yeah, so that's exactly.
(07:37):
We talked about how know a whileago, so now he gets
decompensated his knees, not Well, they can't figure out
what's going on because it's MRIprobably looks good.
He's having pain. This is called meniscal
deficiency or and eventually cango up this sort of thing called
spontaneous osteonecrosis. He starts sloughing.
Cartilage off has a loose body removal and all of a sudden.
Now, you have this very bad situation that happened very
(07:57):
quickly. It's no fault of anybody's but
it just won't a very bad complication.
A very bad reaction to having this sort of surgery.
And again, it's very infrequent.I do tons of surgeries like this
and I almost never see this happen, but high-level athlete,
he probably pushed through levels of things that we
normally wouldn't people would normally not do Do you think
(08:18):
that I'm see I'm I'm going to wear this here.
Do you think this injury was exasperated by something prior?
Right? And I know he's had some
injuries before he had you know,he had the knee injury before in
fact that the opposite leg he's had in the right knee.
Obviously, now he's having issues with the left knee.
He's had issue with his adductor.
(08:39):
He had an experience that hip injury twice.
I'm not sure of anything is related to anything.
But is, is there something there?
On the line. So I can say, hey this added to
the injury or it's just something and that has to do
with kind of. This is your body type and this
is how you recover in. This is kind of like the hand
that you're dealt with and it's just as simple as that.
(09:02):
You know, it's not as simple as that.
I think you were better off the first comment you made.
You know, in terms of how these connected you know this happens.
You can happen all the time withpatients, we see standard
patients. Not, you know, regular
recreational athletes that, I take care of as well.
Yeah, you know they come in something gets hurt.
It's just a bad Cascade. Then the next thing.
It certainly seen those Pro players.
You know, DeMarcus Cousins I think remember had one injury
(09:24):
the next year. Another injury next year.
Another injury, you know those are coincidence, right?
Your body to start shutting downand you use your hips
differently. That can cause more knee
problems. He may have certain levels of
laxity in his body that allowed to do certain abnormal athletic
things. But then against it also puts
you at a higher risk of an injury.
And when you get a meniscus injury or a knee injury, like
(09:45):
this, a lot of times it goes great, but the situation.
If you had these other injuries,he was weaker in certain sides.
But he's also a super physical highly.
You know, why way above any of our skill level player?
We talked to us before athletes,that are crazy, good and have
incredibly good at Athletics, can overpower Our their bodies,
you know, you and I can't go outthere for injured and play.
Well, yeah, but you probably could.
(10:06):
Yeah. You know, why did we get to this
option here? We've talked about before with,
whether it's plate, rich, platelet-rich plasma stem cells,
bone marrow. We've heard different things.
We know that Kobe Bryant has gone over to Germany.
(10:27):
We, you know, like, why did we get to this point?
And why are maybe some of the other options weren't explored
or they were explored but determined that we were going to
go with this. Cartilage, transplant surgery.
Well, I can tell you right now, I know the team doctors for the
Bulls and I know they use all ofthese options to try to stop
(10:47):
this from happening. That's just so, you know, PRP,
you know, dr. Brian calls ahead team doctor
for the Chicago Bulls. He's probably one of the best
cartilage surgeons in the country, if not the best, and
that's the person who taught me,everything I know.
So, you know, he's this is an incredible surgeon and
diagnostician as well as the rest of the team positions at
the Chicago Bulls actually, knowing these people first hand
(11:08):
at work with this play. Are ya PRP was definitely used.
I'm sure they use bone marrow aspirate and they may be
considered stem cell therapy forthem.
But unfortunately, as you, he'llhear about, in many of my talks
about Central therapies, they don't correct.
Cartilage problems, they helped calm down the inflammation.
So nothing's going to give him new cartilage back, you know,
despite we see on the internet or these stem cell clinics all
(11:28):
around which we talked about before.
So they probably tried that in the early stages and try to get
his need to calm down with PRP or try to get his me to calm
down with bone marrow aspirate. And And it just it didn't get
enough that he could stop it. And then eventually you have
these this structural issue, which is the lack of meniscus
and eventually send to stabilization of his cartilage
that they just couldn't stop it at that point, because it
(11:50):
becomes a mechanical problem. And that's why you can't just
treat these problems with, with those biological options, you
mentioned, I mean, once you get a hole in the cartilage, there's
no going back to that. What?
What? What do you, what would you deem
success? This is a tricky question, and
(12:11):
that's why I hesitated to ask it, right?
He just had this procedure this past Monday as a doctor.
I guess. Maybe the better question is to
ask, what are the stages of success, right?
Because the simplest stage for someone like myself or someone
that's not an athlete that's listening to this program is to
(12:32):
have quality of life. Right to be able to walk to be
able to have some, a lack of discomfort to kind of have some
normality where I'm not in in pain for the last three years.
But for high-level athlete, it'svery very different.
Especially a 25 year old athletethat signed a huge contract with
(12:53):
the Chicago Bulls and has a lot of expectations going back to
his high school and everything that has to do with the ball
family, right? This was the guy that was going
to pay. The way for this family.
So if you had to break down the steps for an athlete like that
and more importantly, as a doctor, what are the steps?
(13:15):
Where you go? We cleared this whole this
hurdle. What's the next one?
Etc? Etc.
So, the one thing patients to know and our listeners should
know, is that, you know, you probably saw my post yesterday.
This is one of the most quality of life improving procedures
that I do. Because it's generally patients,
like lingerie ball, who are not that level Athletics, but those
(13:36):
patients ages, they have hole intheir cartilage, and they can't
do things. They want to do, can't play
basketball. They can't do Sports, and they
have pain and swelling all the time, which is really not
acceptable in a young patient. So this ability to replace the
cartilage is a is a really amazing sir.
Surgery and works very very well, especially if done by the
right people and I'm sure he hadamazing surgeons.
Do it? The steps you are.
(13:58):
As you start off in terms of therecovery to, you know, the
problem is you can't put weight on this for almost six weeks.
So that's the rough part about this.
Welfare ready. Put it up there a on it.
That's, that's, that's a long time frame.
I did not expect that. Because normally and we've
discussed this before and I apologize for interrupting that
we've talked about having a procedure done and really kind
of trying to get the patient to move or rehabilitated.
(14:21):
Soon as possible as soon as theycan.
So it could promote health and kind of get on that path toward
recovery. So that surprising hearing that
go ahead. So he can start physical therapy
right away, he's probably doing crazy therapy already since his
own chemistry surgery only a fewdays ago.
Yeah, but you just can't put anyweight on it because you need
this to start an ingrate becausemember it's bone from somebody
(14:43):
else that's growing into his bone now.
And if you were to step on this or walk on it and put pressure
on that area, inadvertently, youcan cause cause the bone to not
heal properly. So, the first sort of four weeks
really delicate about weight, and then progress to start
walking normally by six weeks. And I know the guys that are
probably giving him the recovery, I use the same
protocol that they use, and thenreally, it's sort of a Time
(15:05):
Testament, and it's a really long process.
I mean, people do not understandthat if they think that they can
get their car, those taken care of like this and your back to
everything you want to do in three months.
This is a nine month to a year recovery because you want to
make sure the environment is right for the cartilage.
It does. Very well but, you know, you're
not doing any real high impact tool for five months and, you
(15:26):
know, he can start doing liftingand those things, but nothing
high, no squats, no, major activities like that.
But really, you know, probably starting basketball at nine
months probably an entire seasonwith the hopes that a year.
Now again, I actually think he might make it back because as
long as his team's willing to let it have an opportunity, you
know, if he was getting traded or something else, they probably
(15:47):
never let him play because it because of the fact that it's
such an unknown procedure, right?
Yeah. Because it's just additional
Point. Yeah, I'm sorry the team
physician. Yeah no.
It's okay. The team positions are very
finicky about these procedures, right?
Because you don't want to be thefirst person.
I mean, we all want to be the first on something, but you
don't wanna be the first, you know, player person to sign
somebody with his contract with a cartilage transplant.
(16:09):
Even though I do probably 30 or 40 to use a year, and I see many
of my patients, go back to extremely high levels of
activity. You know, when I heard he got
this, I was just it was just impressive.
I want to make sure people knew about This procedure because
people don't know about it. When I tell them, they need this
surgery, they're very shocked, right?
But now you can see, there's there's players that get this
(16:29):
and so I want to make sure people are informed, but the
surgery is very good. And if done for the right
reasons which I'm sure his was, you know, there's a high chance
as a good quality of life. The problem is it's just can it
take the impact of the professional level and will it
wear out faster? Right.
There's no data to show that it will with the certain impact
that he does but these know these don't be so don't live
forever. These cartilage transplants
(16:51):
because They're separate units. Like if you go back in and look
at them you could still see where the plug was on the
cartilage. It just lives by itself.
Does that make sense? It's on an island, and you just
transmit the whole thing you just lives there forever.
It never really comes and get together.
Exactly. But it, you know, it's flush and
perfect along with everything else.
But you know, about 85% of theseare still there at about 10
years. So it's a pretty good number.
(17:13):
Now again, that's not professional athletes.
Yeah, that's my patients that are in their sort of early 20s
to the mid 50's, but success rates are high.
Hi. You know, I would say that my
page he asked an average patient.
It's about 90 to 95% patients. Say they're much happier than
they were before again. Is it going to be different
professional athlete? And I want to make sure if he
starts running his, no swelling,right whatsoever.
(17:36):
And then you're going to start working things and he's probably
gonna get an MRI, you know, at six months, nine months, one
year, make sure this thing is integrated.
So those are really important. I'm going to say the dirty word
that nobody wants to talk about but I'm going to bring it up.
What's the concern? When it comes to arthritis for a
procedure like this, or just maybe the condition of his knee
(17:58):
at this point of because of all the treatments and injuries that
he sustained over the last threeyears.
So I'm not worried about arthritis from the cartilage
standpoint. I mean, that's the reason we do
this surgery to prevent arthritis.
Okay, but I worry that in him that wasn't a hundred percent of
the reason. So, You know, if he's missing
some, his meniscus now and he's out of needed, a cartilage
(18:20):
Retreat, like our lives transplant.
Does he already have deficiency?And is this, this cartilage
could translate gonna wear out faster than make sense?
You know, the people that do thebest with these procedures other
ones that have perfect-looking these except for a hole?
Hmm, we already know, is he's not perfect?
No. So could this could be a higher
you could be at a higher risk because because of why he needed
(18:41):
it and because of what his proceeding surgeries were, you
know, as soon as I do Surgery onthis with somebody with a
meniscus issue. Etc, I worry about it.
The meniscus. Is there enough meniscus left to
support this now? Patients, still do really well.
But we don't know what the rest of his cartilage look like.
So they could be doing somethinglike a Hail Mary, where he has
some arthritis, but it's very early on because grade 1 grade 2
(19:02):
arthritis, and his age should dothese procedures and his age and
his and his status, you know, ifhe has pain that to do
something. So it's, it was probably a
pretty good-sized hold for them to make this decision.
But also, it's sort of time for this procedure to get tested in
the pros because it's been around a while it does.
So well, it's a really a Workhorse for many of us
(19:23):
cartilage surgeons. And I'm really, I'm happy.
They went after it to get this, this young, man, a chance to get
back. And I really hope he does.
And I, you know, you're going tohear me, put it here.
I think he might do it again. That's knowing that's assuming
that his meniscus is still pretty good.
And that's assuming that, you know, the doctors had looked all
that stuff and made sure everything else checked out,
which, I'm sure they did. If everything checks out like
(19:45):
it. Disclose to there's a high
chance. I think you'll make it back, but
was like, I hope so. I mean, you know, you never want
to see young athlete kind of go through something like that.
I know what kind of long we're like, we're going to wrap this
up in 10 minutes, is right before we started.
And obviously, we're just chatting away.
Now we do and I apologize because I'm gonna ask another
question. Here does something like
(20:06):
regulus, help with this recovery.
That's absolutely perfect question.
So yeah, this is what are you ina winner, chicken dinner, baby.
I mean, I, I know that you're not a doctor, but you mustn't
say to the Holiday Inn. I did.
The, so this is so the rebels machine, which we can talk about
(20:27):
our, we talked about before, we don't want to go into too much
detail, but basically it's a machine that allows for sort of
a range of motion but also strengthening.
So it gets my patients back. I can't put weight on it, it
does sort of extra physical therapy for them.
So yes, that is This is one of the procedures that I use the
wrap the red list or on Carla's transplant, patients or patients
with cardiac transplants and other stuff.
They can't cook. Wait.
(20:47):
And so they have this machine. That's not only going to get
their emotion back because I used to use an old motion
machine and now I use this new machine.
The regulus that can be programmed digitally, it does
range emotion but it also does strength and resistance, when
you can see, the recent posts had put up one of my friends
trying it out and you can see that you know, at 45 weeks you
know, Alonso ball could start doing other exercises.
Now again it's probably not a Athlete machine, because he's
(21:10):
going to have people, literally.Moving your leg for him.
Yeah. Right.
He could has unlimited resources.
But for you and I that are like normal people, you know, this
having this machine at your house that you can use every day
rather than a PT that can only help you for one or two hours a
week. It's a game changer.
So I think it'll give me. I think the king would give a
kiss Temptations, a huge leg up.And I've already noticed in my
patients, can add cartilage transplants on both sides.
(21:31):
The ones that had the rebels machine already feel better, and
they're starting to feel Stronger Faster, which is great.
And we're looking forward to showing that data at some point,
and funny one. Out there.
That's like what the hell's Rebel is.
We touched upon it right now. I believe it's HR robotics or
something that we talked about before, and I was just curious
to see if that would be something that they would
utilize, let's wrap it up because I figure we could kind
(21:53):
of keep going with this because it's just kind of cool stuff,
you know, and apologies to the ball family.
If they're listening, obviously,we're not, you know, getting
excited about it injury, but talking about the procedure and
talking about really kind of thewhole point of what we do.
Who is to give information to people out there and patient and
(22:14):
really, it's for me, it's a platform just to ask questions,
right? If you have a doctor out there
and you want to ask questions because you've heard something
or you looking into something and dr.
Garcia is always great with saying, hey, get a second
opinion, get more information, you know, at learn what you're
going to do, let's wrap it up in.
I didn't tell you this because Idon't tell you these things.
(22:35):
I have trivia for you. I need music.
I didn't like trivia music. Eric we have trouble.
Okay, buddy. Here we go.
All right, since 1975. There have been three players
from the University of Washington to win Pac-12 player
of the year. The reason I bring it up is
because Lonzo ball. One PAC, 12 player of the year
(22:57):
for UCLA when he played. Can you name one of the three
players from the University of Washington because we're in the
state of Washington? That's why bring it up that one
player of the year. I don't think I named one and
unfortunately, you're hurting meor something.
I take care of a lot of you Deb players, Etc.
(23:19):
And I can't name a single one, so this isn't good.
All right, so you have to know by now that usually I tried to
tie in My Trivia to what we're doing.
So in 2018, Jalen, no l was Player of the Year, Christian
welp in 1985 with an assignee 586.
Season. And in 2005 and 2006 season,
(23:43):
Brandon Roy from the University of Washington was named Claire,
the year Pac-12 player of the year and I bring that up because
we know the difficulties that hehad with his knee injuries and
if he was playing in 2023 and inthe same condition, who knows
his career might have been longer.
So I wanted to bring up that trivia just because of the
(24:06):
Brandon Roy reference with the knee injuries.
Well, you got me again, thank you.
It does not feel like a thank you, but we do want to thank our
listeners. Thank you so much for listening
with us and joining us for will Sanchez dr.
Grant Garcia, please check them out.
(24:26):
Grand Garcia, m.com, he has so much information.
I mean, great videos. I when I say information, his
websites ridiculous, there's lots of information.
There's videos, you could ask Ask questions, you name it.
He's our orthopedic surgeon Sports Medicine specialist for
reason. Dr. Garcia.
(24:47):
Thank you for taking some time. I know this show came out of the
blue. We were like, we heard this
information. You say, hey, we got to do this
and I'm glad we did. So thank you for really
partaking and sharing great information for our listeners.
Thanks for having me and again you know, the website, which you
referred to, we can you can learn about the cartilage
(25:09):
transplant and see exactly how we do it.
I have talks on there, so that'll be even more informative
as well as patients are interested.
All free information, you guys can take away and look at and
really learn sort of its first hand that sort of level
peer-reviewed information and secondly a big shout-out, which
will forgot to say of our brand new website,
www.stock-market-strategy.com facades and all of our video.
(25:34):
We're going to do a big announcement of the next week,
but I found at least we'd still the beans today and get paid get
ever, get our listeners excited that there's any more
information, you can learn aboutboth will and I on there and you
can see all of our episodes. And it's pretty easy, subscribe.
So thank you guys all for listening.
Great job. That's Garcia.
You have a great night and once again thank you very much
(25:54):
YouTube. Thanks, bye.
We're going to do a big announcement of the next week,
but I found at least we'd still the beans today and get paid get
ever, get our listeners excited that there's any more
information, you can learn aboutboth will and I on there and you
can see all of our episodes. And it's pretty easy, subscribe.
So thank you guys all for listening.
Great job. That's Garcia.
You have a great night and once again thank you very much
YouTube. Thanks, bye.
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