The hits just keep on comin’. On Thursday afternoon, the Boston Celtics announced Kyrie Irving‘s season was finished due to a bacterial infection in his left knee, which had already sidelined him since mid-March after it was determined he needed a surgical procedure to clean up a previous repair. He is expected to make a full recovery in four to five months, according to the Celtics.
So what does it all mean? Let’s go FAQ-style.
Wait, didn’t the Celtics say two weeks ago that Irving would be back soon after a “minimally invasive” surgery?
Boston Celtics @celtics
#NEBHInjuryReport Kyrie Irving underwent a minimally-invasive procedure today to remove a tension wire in his left knee. He is expected to return to basketball activities in 3-6 weeks.
🗒️: https://t.co/MqsBB95nAm https://t.co/Nq65EY6TSK
That escalated quickly.
But this is a much bigger issue. In the team’s March 24 press release announcing the procedure, the Celtics did not mention anything about a bacterial infection. The operation was intended to remove a tension wire that was holding two screws in place on the kneecap. Inserting a tension wire is a common solution for fixing a fractured patella like the one Irving suffered in the 2015 Finals.
What isn’t common is the bacterial infection part. In all likelihood, Irving was feeling soreness or pain in his left knee, and the hope was that removing the tension wire would do the trick. That, apparently, was not the case.
On Thursday, the Celtics revealed they examined bacteria from Irving’s knee and the pathology report showed a “bacterial infection at the site of the hardware.” On Saturday, Irving will have the screws removed.
Has this thing ever happened before? How bad is a bacterial infection?
In the NBA, bacterial infections pop up from time to time. Remember Blake Griffin‘s staph infection back in 2015? That was a bacterial infection in his shooting elbow that traced back to a burst bursa sac in 2012. Clippers doctors drained his elbow in early February 2015, and about a week later it was discovered he had a severe staph infection. Griffin returned after five weeks.
Bacterial infections are no joke. Consider Al Harrington‘s staph infection that developed in his knee after he had surgery for a torn meniscus in 2012. After undergoing surgery in mid-May with the Denver Nuggets, Harrington’s knee swelled up and the infection was discovered. Harrington ended up needing a PICC line in his arm (for quicker IV transmission) for eight weeks to administer the antibiotics and clear out the infection. Then rehab with his knee started. Harrington didn’t come back onto the court until late February the following season, about nine months after the initial surgery.
After suiting up with the Magic for 10 games, Harrington flew to Germany to meet with Dr. Peter Wehling for Regenokine treatment in his problematic knee, as noted by Jared Zwerling, then of B/R. (Regenokine, also known as Orthokine, is the FDA-banned procedure involving heated blood-spinning and re-injection; Kobe Bryant and Alex Rodriguez also reportedly traveled to Wehling’s office for the treatment). In 2013-14, Harrington looked rejuvenated in 34 games for the Washington Wizards and even got some playoff minutes. But at age 34, his knee wasn’t holding up like he needed it to, and he hasn’t played in the NBA since.Rob Carr/Getty Images
Then there’s Quincy Pondexter, who missed two seasons dealing with knee issues and a resulting infection. According to ESPN.com’s Chris Haynes, in early January 2017 doctors discovered Pondexter developed a bacterial infection called MRSA (methicillin-resistant Staphylococcus aureus) after multiple operations on his left knee while with the New Orleans Pelicans. One of the procedures required cartilage from a cadaver. The knee then became infected, requiring a month of hospitalization and several bags of antibiotics. Pondexter returned to regular-season action in October 2017.
Take a deep breath, Boston fans. Those are just examples to show how serious bacterial infections can be. Irving isn’t expected to be out for the next nine months—at least there’s no reason to think that at this point. That’s because even though staph infections are bacterial infections, there is no indication yet from the Celtics that this is, in fact, a staph infection. A square is a rectangle, but not all rectangles are squares.
We’ll have to wait until Celtics doctors go in and remove the screws to fully understand what kind of infection Irving’s dealing with and how deep the infection is in the knee. The four- to five-month timetable indicates this is a two-part recovery with a planned rehab from the infection followed by rehab from the removal of the hardware. If the infection has reached the bone, that’s not a good sign and could delay the recovery with the need for more extensive antibiotics and treatment.
Over the long term, it’s too early to say how this might affect Irving’s contract when he is a free agent in July 2019, assuming he declines his player option for the following year. The current timeline means he should be ready for training camp and fine for next season. More concerning is Irving has missed 117 games in his seven years in the league. His injuries have been piling up.
Speaking of injuries piling up, what’s going on in this league this season?
Injuries are indeed way up. We talked about it after DeMarcus Cousins ruptured his Achilles on January 26. And we revisited it when Kristaps Porzingis tore his ACL on February 6. The latest news on Irving comes on the heels of surgeries ending the seasons of Dirk Nowitzki and Denzel Valentine.
According to injury tracking by InStreetClothes.com’s Jeff Stotts, the frequency of injuries is up roughly 10 percent compared to last season, amounting to 100 more injuries than the entire 2016-17 season. And we still have about a week left.Gerald Herbert/Associated Press/Associated Press/Associated Press
Irving’s news doesn’t affect those numbers further. He was already out with the initial knee issue. It was already possible (if not likely) Irving would miss the rest of the regular season. It’s just another long recovery to add to the list of those already taken down.
Gordon Hayward, Kawhi Leonard, John Wall, Cousins, Porzingis, Jimmy Butler, Isaiah Thomas and Stephen Curry all have missed large chunks of the season due to injury. Leaguewide, contests lost to injury have exceeded the 5,000-game threshold, the first time that has happened since Stotts began tracking in 2004-05. That’s not good.
So why is this happening?
There may be a few things going on this season. For one, the game is faster than ever. (Pace—possessions per 48 minutes—has reached levels unseen since the 1990-91 season, per Basketball Reference tracking.) And second, the league shortened the preseason and started training camp earlier, which may have backfired with players not being in shape for the season, thereby creating a domino effect of injury risk.
There is another possibility. With the rise of sports science and armies of injury-prevention staffers in place, teams may be increasingly more risk-averse when it comes to bringing guys back from injury.
With more information than ever thanks to wearable tracking (outside of games) and fancy sports-science departments, it seems teams are being more careful than ever. Some in the league think that’s the good, safe approach. But others believe the DNP-rest movement has gone too far, erring too much on the side of caution rather than understanding that playing basketball will always present reasonable risk. One executive called it “paralysis by analysis.”
Injuries are up by 10 percent, but time missed due to injury is up by about 25 percent, per Stotts’ analysis. So, yes, players are out longer. Perhaps it’s a fluke season with a random string of major injuries. And it’s true that not all injuries have been of the wear-and-tear variety. Joel Embiid’s collision with Markelle Fultz’s head isn’t an overuse injury. Jaylen Brown’s scary fall wasn’t because he was playing too much. But maybe something else is going on, and conversations with players, trainers and execs have left mystery far from solved.
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Good luck with that. Have you seen the Celtics lately? The team is 12-6 without Irving this season. In the last month, the Irving-less Celtics have beaten the Blazers, Jazz, Raptors and Thunder. The Jazz win came on the road without Al Horford (and, of course, Hayward). This team won’t go down lightly. Despite all the injuries, the Celtics are set to exceed last season’s win total (53) that netted them the top seed.
It’s why Brad Stevens would get my nod for Coach of the Year (although I have no vote this season). The Celtics have fielded the league’s fourth-youngest roster once you weight it by minutes played, per Basketball Reference; only the basement-dwelling Suns, Lakers and Bulls have been greener in that department.
Despite relying on such a young squad, the Celtics have the league’s best defense, allowing the fewest points per 100 possessions, per NBA.com. Without Irving, that will have to be their identity, just as the Cavs adapted in the 2015 playoffs when Matthew Dellavedova took Irving’s place in the lineup. The Celtics have allowed just 99.2 points per 100 possessions this season with Irving off the floor, 4.2 points better than with him on the court. Of course, the offense has cratered in that time as well. They didn’t break 80 points for a reason Wednesday night against the Raptors.
The Celtics will be a tough out in the playoffs. Rookie Jayson Tatum has scored 17.8 points per 36 minutes without Irving on the floor, and the 20-year-old’s shooting percentages are almost identical to when Irving plays. He hasn’t shown he’s shaken by an increased spotlight. That could change come playoff time. Until that does, or some other spate of bad luck hits Boston, it’s tough to bet against the Celtics at least reaching the conference semifinals.
Tom Haberstroh has covered the NBA full time since 2010 and joined B/R Mag after seven years with ESPN as an NBA insider and analytics expert. Haberstroh regularly co-hosts the Back To Back podcast on the Count The Dings network. Follow him on Twitter: @tomhaberstroh.