RGIII's injury and making sense of the optimism from the Redskins and Dr. James Andrews

Matt Sullivan

Dr. James Andrews has been using stem cell injections to help decrease the recovery time of athletes' knee injuries, which explains the optimism for RGIII's quick recovery timeline.

When it was announced RGIII had reconstructive surgery on his LCL and ACL, pretty much every doctor that was not named Dr. James Andrews expected a 10-12 month recovery. That's why it came as a surprise to me to hear the Redskins and their team doctor publicly say they expect Robert Griffin III to be ready by the season opener.

"Robert Griffin III had successful knee surgery early this morning. He had a direct repair of his LCL and a re-do of his previous ACL reconstruction. We expect a full recovery and it is everybody's hope and belief that due to Robert's high motivation, he will be ready for the 2013 season."

Naturally, many people, myself included, thought perhaps the obvious reason for such a statement is to ensure that the team does not lose any season ticket holders. However, with time comes clarity and more information. John Keim answered a question in his weekly mailbag that Dr. Andrews has been using stem cell research on his patients for some time. Adrian Peterson of course had a "miraculous" nine-month return from ACL/MCL surgery performed by Dr. Andrews. Miracle or stem cell?

For the past three years, however, Andrews has been experimenting with a new strategy. "Stem cells," he says. "What we call biologics. They're on their way, and that will be a transformational event." Very quietly -- "We don't advertise it," Andrews says, "and we don't want to sensationalize it" -- he and his colleagues at clinics in Birmingham, Ala., and Gulf Breeze, Fla., have been performing stem cell injections on professional athletes. He won't name names, but Andrews has mostly employed stem cells in the deteriorated knees of football players, and virtually all of them have reported significant decreases in pain and inflammation. "It's early," he says, "but the results have been remarkable." [ESPN]

Stem cell usually carries religious connotations with it from people, but it is legal if the cells are pulled from the same patient (and not, say, unborn babies):

Andrews mines them from the marrow in the patient's pelvic bone and then injects them directly into the damaged joint. That's the only stem cell procedure the FDA presently allows -- the self-donation of unaltered adult stem cells.

Well, that certainly explains a lot. I heard from a source that RGIII's operation with Dr. Andrews took six and half hours. That is quite a long operation. In speaking with SB Nation's medical expert, Dr. Ali Mohamadi, he had this to say on the topic:

In recent years, there's been an increasing amount of research, especially in animal models, looking at the ability of stem cell injections to aid the process of repairing torn ligaments. These particular type of stem cells are known as mesenchymal stem cells (MSCs), which can be taken from the patient's own bone marrow or joint fluid and injected back into the site of ligament damage. MSCs are particularly exciting because they tend to home in on the site of injury and promote a degree of regeneration of ligament tissue.

Most of the studies in animals have looked at use of MSCs in partially torn ACLs that did not require surgery, and they were fairly promising. What little evidence exists regarding use of MSCs in animals who required ACL reconstruction seems to indicate that the repaired ACL of those receiving MSCs "took" more quickly than those who didn't and appeared stronger ad early as eight weeks following the injection.

So to be clear, early animal studies seem to provide an argument that stem cell injections in patients following ACL repairs may in fact speed up the healing process, but it can't be stated enough that to this point, this association remains largely anecdotal in human patients.

Either way, given the state of RGIII's knee history, this gives me a lot more optimism for a healthy return and long-term success than I thought.

I also think the Redskins organization had another good reason to broadcast the optimistic timetable: Free Agency. The Redskins have 19 free agents from their own team to account for this off-season. More importantly, there's the free agency period to bring in other top talent. The Redskins have done well in that department with Garcon, Bowen, and Cofield to name a few. Surely, having the news out there that RGIII will be healthy week one will be an important part of negotiations. The Redskins were a playoff team last year, which is a card they have not been able to play for some time. Surely, any prospective free agent will want to know what RGIII's status is, and if the Dr. says he'll be ready week one, than surely the Redskins should be making their team better as a result.

(H/T to HogHunter for linking to this Keim and ESPN story earlier this week in the comments)

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