Angels first baseman Kendrys Morales lies on the ground in agony after breaking… (Gina Ferazzi / Los Angeles…)
It has been almost a year since Kendrys Morales broke his left ankle while jumping onto home plate in celebration of a walk-off home run. But it wasn't until this week that the Angels used the term "fracture/dislocation" to describe the first baseman's injury.
That term provides insight as to why Morales was slow to recover from surgery last June and why he elected to have a second surgery that will sideline him for the 2011 season.
"From a layman's perspective, it didn't seem right — a simple ankle fracture, you fix it and you're back in three months," said Dr. Tim Gibson, an orthopedic surgeon at Orange Coast Memorial Medical Center in Fountain Valley. "But a fracture/dislocation is more serious. You have to worry about soft tissues — ligaments, cartilage, cysts, arthritis."
Under federal privacy rules about personal health information, Morales would have to give the Angels permission to release all of the details about his injury.
Morales, who had a pin and six screws inserted into the bone just above the ankle last June, will undergo a second procedure to clean out scar tissue, degenerative cysts and debris. Dr. Lewis Yocum, the Angels' team physician, said a bone graft might also be necessary.
Recovery time will be at least six months, meaning Morales will have missed almost two full seasons if he returns by 2012. The Angels predicted Morales would be ready this season, but that prognosis may not have been as overly ambitious as it seems.
"At the time of the first surgery, it's impossible to predict how much cartilage damage there is, because the cartilage may look pretty normal at first," said Dr. Andrew Bulczynski, an orthopedic surgeon at Marina del Rey Hospital.
"But there's microscopic damage to the cartilage, which is difficult to perceive. Only time will tell if cartilage breaks down and degenerative arthritic conditions develop."
Those conditions clearly developed for Morales, whose rehabilitation was slowed by a lack of flexibility and strength. The 6-foot-1, 235-pound slugger was unable to take turns on the bases or run straight ahead at full speed.
"His ankle has spoken, and he can't play on it," said Gibson, a knee-and-ankle specialist who has worked 15 years as a surgeon. "It sounds like the bone has healed, but there's got to be cartilage damage and arthritis in there."
As Gibson watched a replay Thursday of Morales' fateful leap onto home plate, it was obvious this was not a simple fracture.
"His whole body weight went right into the plate, like a jackhammer," Gibson said. "His ankle turned inward and dislocated. [The rehab] they did sounds normal for that injury, but sometimes cartilage damage doesn't show up until later."
Gibson says Morales' long-term prognosis will depend on how much arthritis is found during surgery.
"If it's in a small area and localized, he has a good chance for a full recovery," Gibson said. "If it's spread over a larger area, all bets are off."