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Matthews out for season with MCL tear

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32 Thoughts: Player safety a hot topic at GMs meetings

In this edition of 32 Thoughts, Elliotte Friedman covers why player safety was a hot topic at the GMs meetings, who checked in on Matthew Knies, superstar injury updates and much more.
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4. We’ll see when it happens, but it sounds like surgery will be part of Auston Matthews’ recovery. There is still plenty of confidence he will start next season on time.
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L K said:
MCL tear is better than MCL + ACL. Presumably Matthews had at very least an ultrasound and more likely MRI so the likelihood of a missed ACL injury is pretty low. Clinical assessment of the knee in the first week or so can be somewhat difficult due to the acute swelling and the associated quad contusion might confound range of motion testing.

There isn't a benefit of surgery vs. non-operative for even complete tears like this so its probably unlikely that they go the surgical route. It will definitely be more in the 2-3 month range for Matthews getting back on the ice in any meaningful way. The good news is that there is a lot of strength/conditioning stuff he will be able to do outside of this.

What is less good is that there is usually persistent laxity in the joint after a tear like this. Matthews isn't likely to blow out his knee just doing routine stuff, but the next time a Gudas runs him like this there is a greater chance that this happens again.

5 games for a plug to injure a star player is a joke.
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Just curious... would there not be some benefit of surgery some of the time? Otherwise, why would surgery ever be done or recommended? Hard to believe they would do something not necessary for what they believe to be optimal recovery.
 
Bender said:
Just curious... would there not be some benefit of surgery some of the time? Otherwise, why would surgery ever be done or recommended? Hard to believe they would do something not necessary for what they believe to be optimal recovery.
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Long term outcomes of surgery vs. non-operative don't show a significant difference in injury recurrence. There are soft benefits to surgery for quicker return to activity but if we are looking at whether Matthews is more or less likely to re-injure his knee, there really isn't a benefit one way or the other. Without direct access to his knee imaging though, there could be enough additional ligament fraying or lesser meniscal tears that they have just suggested getting the cleanup to address other minor problems. that's just stuff I'd never be able to give a clear answer on because we won't ever see it.

The biggest difference of choosing surgery now vs. rehab (aside from the obvious Matthews jumps the queue in a way that most everyday people can't) is that that SOME high grade MCL tears will need surgery. Most of them will recovery fine without it, but you do run the risk that Matthews gets 2 months into recovery and is struggling with the residual laxity in his knee. This is more definitive but any time you go into the knee, you risk additional injury or surgical complication and long term the knee doesn't end up healthier than if treated conservatively with physio.
 
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