Under The Knife 5/1/24
Trout Injures Knee, Expectations on Return
With this surprising news breaking last night on Mike Trout, let’s get right to the injuries:
MIKE TROUT, OF LAA (torn meniscus)
Alden Gonzalez broke the news late Tuesday afternoon that Mike Trout is dealing with another injury, this time a torn meniscus. There’s not yet detail on what surgery is planned, but how much time he misses depends on what the doctors decide to do. That won’t be decided until they see inside on Friday, when the surgery is scheduled. No word yet on who the doctor will be, though that matters less for a very common procedure like this.
There’s two key possibilities: removal and repair*. Removal is just that, taking out the damaged part of the meniscus by trimming and cutting, or in extreme cases, just pulling it out. The latter is very unusual now, though it was common back in the early days of arthroscopy. Repair is better in the long term, leaving the function and cushion of the meniscus, but it takes longer to heal - months, not weeks. It also doesn’t have a great success rate. Most studies have it around fifty percent, but changes in technique and rehab have likely improved that recently.
Removing the meniscus damage can be simple. Football players used to have it on the Monday of a bye week and come back the following, though the stress on the knee was generally not worth it. There’s a generation of football players in the 80s and 90s that by-and-large have knee replacements now because of how common those operations were. Today, they try to remove as little as possible, shaving it away finely rather than simply hacking it off. Better tools and even lasers make it fine.
It is not unusual for the exact nature of the surgery to be indeterminate. Even with the MRI, seeing the meniscus is difficult and the decision usually has to be made on the spot. The timeline that Perry Minasian gave indicates that they think it will be trimmed, but the option being there that Trout could miss months is interesting. Trout and his doctors will decide beforehand whether, if the surgeon determines the meniscus could be repaired, whether that will be done. The decision is better long term outcome or quicker return.
I dont need an excuse to post a picture of Selena Gomez, especially in a week where her new Selena + Restaurant show debuts.
The news is a bit surprising in that Trout didn’t come out of Monday’s game. In his press conference, he says he began feeling it in the third inning, but I don’t see any clear mechanism of injury. It doesn’t have to be much and this is one where Trout’s size might act against him. His speed and size combine for a lot of force, so one bad step could be it, or it could be wear and tear that decided to show up on a random Monday.
We’ll know more quickly on Friday. The surgery is usually done early in the morning and isn’t very long, even if the meniscus is repaired. Trout could be back at the stadium over the weekend as the rehab begins almost immediately. In the meantime, the Angels have no way of replacing Trout. They’ll slot someone in on the roster, likely one of Jake Marisnick or Willie Calhoun, though Mickey Moniak - once touted as a Trout type - will be the likely fill-in in the short term.
My guess is that Trout will be out six to eight weeks after a meniscal trim, which puts him back in mid to late June. (More players should get hurt on the 30th or 1st for calendar convenience.) I’m torn because if Trout is having it trimmed, there no reason not to let him back out as quickly as is reasonable, but it’s Trout and they tend to be conservative with him. Trout’s noted slow-healing with some injuries doesn’t really play here since nothing is really healing. The results tend to be very good so my guess is we’ll hear about Trout being on the Trajekt sometime around June 1. The Angels put Trout on the 10-day instead of the 60, so maybe they’re thinking along the same lines. Given how well Trout was playing in April, it’s bad for baseball to lose any time, but minimal would be nice.
*Remember that the word “repair” is often used colloquially, as in “I fixed it!” rather than “I stitched it back together!”
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