Les Bowen | Westbrook case presents dilemma
by Les Bowen
IT WON'T HAPPEN this week, with the game of the year, decade, century, epoch, millennium - choose whatever hyperbolic time reference you prefer - on tap.
Andy Reid said yesterday he expects to have Brian Westbrook in the lineup Sunday against Dallas, though he said Westbrook probably won't practice today. Reid didn't admit it, but that was probably why Westbrook was a surprise scratch from Monday night's game, so he would be able to go against the Cowboys, which is all many Eagles fans care about right now.
But as unfathomable as it might seem, the Birds' season won't end Sunday afternoon, whether Terrell Owens goes home with a smiley face or a scowl. The Eagles will still play 11 more games, with hopes of more in the postseason. And that is where we might have a problem.
Reid reluctantly has acknowledged that Westbrook's injury is a bone bruise, which might involve cartilage damage, and that it might be something that dogs the team's offensive catalyst all season.
The Eagles don't let their team physicians talk to reporters, but former team physicians and unaffiliated sports orthopedists are not under their control. Dr. Art Bartolozzi, former team orthopedist for the Eagles and the Flyers, said yesterday that while he doesn't know the specifics of Westbrook's case, it sounds pretty familiar. When a knee suffers a bone bruise, Bartolozzi said, the covering articular cartilage, the smooth, glistening, sliding surface at the end of a bone, tends to flake or peel off and create inflammation. The first treatment is rest, which the Eagles now have tried. The second is draining fluid that develops because of the irritation, which the Eagles also have tried. The third would be a cortico-steroid injection, to mitigate the irritation and cut down on the fluid being produced. We don't know if the Eagles have tried that.
If none of those options offers lasting relief, the next step is an arthroscopic cleanout. Recovery time could be anywhere from 2 to 6 weeks, Bartolozzi said, depending on how much work is necessary. Bartolozzi emphasized that he wasn't saying Westbrook needs surgery, that he can't say that without examining him.
Another sports orthopedist, the Hospital of the University of Pennsylvania's Dr. Brian Sennett, cautioned that even a "cleanout'' involves removing cartilage, and that there is no guarantee a surgeon wouldn't discover more damage than was apparent, lengthening the projected recovery time. Sennett said trying a longer rest period - say, several weeks - might be preferable to immediate surgery, should Westbrook not be A-OK after playing against the Cowboys.
Neither Bartolozzi nor Stennett seemed all that optimistic about taking a week-to-week approach over several months, given the level of discomfort Westbrook seems to be experiencing, and that sitting out practices doesn't seem to have helped Westbrook much so far. From the sideline, this looks very much like last season's dilemma, when the Eagles and Donovan McNabb thought the quarterback somehow could limp through the season with a sports hernia. We all know how that turned out.
Again, there's no way Westbrook doesn't try to play against the Cowboys. But after that, if more lengthy rest or an arthroscope can provide more benefit than crossing their fingers every week, wouldn't it make sense to take a loss or two if necessary, and give the offense a fighting chance down the stretch?
"I'm concerned about a knee that constantly swells,'' Bartolozzi said. "That indicates subtle damage to the cartilage or joint lining.''
These situations come up a lot in sports, and it's amazing how rarely teams are willing to err on the side of the long run. (Maybe if a surgeon eventually scopes Westbrook's knee, he could poke around in Antero Niittymaki's hip as well.)
Fletcher Smith is Westbrook's agent, and McNabb's agent, as well. Smith said yesterday that he and Westbrook haven't discussed whether an arthroscope would be advisable. "Honestly, I don't know'' whether such a decision could be coming, Smith said.
Smith reiterated that it was McNabb who felt confident he could soldier on last season, and that they felt surgery back then wasn't much of an option - Smith and McNabb felt the quarterback's season would be over if he let a surgeon open up his abdomen. This, obviously, is different.
"Right now, there's a gray area,'' Reid said yesterday, when asked whether Westbrook's knee could be a seasonlong concern. "Until he can get back out there and play on it, we'll keep an eye on it.''
Chances are, it won't be quite that simple.