Taking stock of K-Mart's health, head
By DAVE KRIEGER
Scripps Howard News Service
08-MAY-06
We may not know who's in charge of the Denver Nuggets, but we know the first thing on the agenda:
What to do about Kenyon Martin.
If the Nuggets try to dump K-Mart coming off his worst professional season and a season-ending suspension, they can expect to get back somebody else's problem(s).
This is like selling a stock at its 52-week low. It's not something you want to do, but, if you think it's going lower still, it can be something you have to do. If K-Mart is going to divide the locker room, as he did last season, he needs to go.
But if he's going to show up someplace else healthy and ready to play, it could be the classic buy-high, sell-low mistake.
There are two issues here: the state of K-Mart's troublesome left knee and the state of his head.
We'll get to his knee in a minute. Dr. Steve Traina, the Nuggets' orthopedic surgeon, agreed to discuss microfracture knee surgery with me so long as it wasn't about K-Mart's (or anyone else's) specific case. It helps to know what we're talking about here.
First, his head. The number of diagnoses floating around the Pepsi Center is remarkable. I will not repeat them because medical diagnoses from laypeople are worth less than the psychobabble talk shows that spawn them. Let's just say it seems to plenty of people that K-Mart is as much a victim of his violent mood swings as his teammates or coach.
When K-Mart is rational, he's one of the more objective players I've met. At the Nuggets practice the day before his Staples Center playoff meltdown, he sat on the hardwood discussing his knee and his season with disarming frankness. Yes, he had come back too soon. But he couldn't just sit there and watch. Couldn't do it.
This is the double edge of K-Mart's sword _ the competitiveness that toughens his team or loses it. When he called out Nets teammates for playing soft, it was the former. When he called his Nuggets teammates losers at halftime in L.A., it was the latter.
By the beginning of next season, K-Mart will be almost 18 months removed from his microfracture surgery. If you're not looking for miracles, this is when recovery becomes a realistic possibility.
The popular conception, thanks to examples such as Penny Hardaway and Allan Houston, is that microfracture surgery is the last resort for a knee that is basically shot. It is not. It is a response to a specific injury, a chip in the articular cartilage that protects the ends of the bones in the knee. Microfracture surgery consists of drilling holes in the exposed bone, which releases bone marrow cells, which forms a clot that can act as cartilage.
"You've heard about stem cells?" Traina said. "That's your inherent stem cells. We all have bone marrow cells which are what we call pluripotential cells, cells that can decide to become a skin cell, a kidney cell, a blood cell, a bone cell.
"So these stem cells because of the continuous passive motion machine protecting the knee for a period of time, form this fiber cartilage, which is a plug, which is better than having an area of exposed bone.
"What's happened, because of arthroscopy and MRIs, we've seen defects in the cartilage that we didn't know existed 25 years ago because we didn't do knee scopes. So it's not the last resort. It's been around a long time.
"Now, the problem with microfractures _ you get good and bad _ depends on the size of the lesion. The bigger the lesion, the less promising the result. Also, which complicates things, it depends on the alignment of the leg.
"So what are the factors? Where the lesion is, the size of the lesion, angular alignment of the leg and what they do. Obviously, an offensive lineman can play football after a microfracture much easier than a point guard who's got to run up and down the court, jump and all that," Traina said.
On the bright side, Jason Kidd is a point guard who's got to run up and down the court, jump and all that. He leading the Nets into the second round of the playoffs, 22 months after microfracture surgery.
K-Mart is now 12 months post-surgery. The normal recovery period?
"Twelve months to two years," Traina said. "Usually about 18 months. But you can let people back at the four-month, five-month mark, and they will continue to mature with time ...''
We don't know the size or location of K-Mart's lesion, but the Nuggets do, and former GM Kiki Vandeweghe told me team doctors were optimistic following the surgery a year ago.
While they are evaluating his condition 12 months later, they should also sit down with him for a frank conversation about his psychology.
The emotional reaction following his disappointing season, postseason meltdown and suspension is to dump him. But they say you should never sell a stock based on emotion, and the same is true of a $70 million investment, which is what K-Mart has left on his contract.
The state of his knee and the state of his head should determine whether he wears a Denver uniform again. Of course, before the Nuggets can make this decision, they'll need to decide who's in charge.
