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February 20, 2012, 08:49 PM ET
Microfracture Again for Oden

by Kevin Pelton

Greg Oden’s NBA career took another sad turn Monday when what was supposed to be a routine procedure to remove debris from his left knee instead resulted in his third microfracture surgery in five years. Dr. Richard Steadman, who pioneered the microfracture process, found damage to the articular cartilage in Oden’s left knee that required microfracture to be performed.

Originally, Oden underwent microfracture surgery on his right knee in September 2007, keeping him out for the entirety of what would have been his rookie season. After playing 61 games in 2008-09, he began the 2009-10 campaign in dominant fashion before fracturing his left patella in an early December game against the Houston Rockets. Since then, Oden has not taken the court for an NBA game in more than two years.

As he was working back from the patella injury, cartilage damage was discovered in November 2010 that required Oden to undergo microfracture on his left knee. Oden’s recovery seemed to be on track prior to training camp, but a physical found “ligament instability” and the Portland Trail Blazers renegotiated his qualifying offer for just more than the minimum, indicating how unlikely they considered a return to the court this season.

Most recently, Oden had debris removed from his right knee in early February. Today’s procedure was to do the same thing before Oden’s cartilage damage proved worse than expected.

At this point, we’re into unprecedented territory. I’ve done extensive research into the history of NBA players undergoing microfracture surgery and also studied microfracture in the NFL several years ago. There are a handful of players who have had microfracture on both knees (most notably Kenyon Martin) and a handful that have had it twice on the same knee (including Matt Harpring), but I am not aware of any player having three total microfracture procedures. At some point, there’s a cumulative effect. When combined with all of Oden’s other knee injuries, it suggests he may never return to the floor.

I can’t imagine a best-case scenario where Oden is able to play before the end of the 2012-13 season, which would mean aiming for training camp in the fall of 2013. By that point, Oden would be nearly four years removed from his last NBA game, and such long absences due to injury are extremely uncommon. The closest comparison might be ’80s All-Star center Jeff Ruland, who sat out five years due to knee problems before attempting a comeback at 32. Ruland managed 24 games over two seasons before retiring for good.

The cumulative toll on Oden’s psyche might be as great as his knees. From that standpoint, we may find better guides in college hoops, where players of both genders often struggle with repeated ACL tears. UConn legend Shea Ralph is reported to have injured her ACL five times; at least three or four of those were torn ligaments. Three ACL tears delayed the start of touted USC guard Jacki Gemelos‘ career by three and a half years, and just as she was establishing herself as a WNBA prospect this season, she tore her ACL again in December. Gemelos hasn’t given up and is working to return and play in the pros. Also in the Pac-12 on the men’s side, Stanford’s Andy Brown is finally seeing action after three ACL tears cost him two and a half seasons.

If Oden decides he cannot keep trying to rehab, that would be completely understandable at this point. If he does give it another shot, we can only wish him better health in the future.

You can contact Kevin at kpelton@basketballprospectus.com. Follow him on Twitter at @kpelton.

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