There is a chance that celebrated athlete Bo Jackson could return to baseball, but his days on the football field probably are over, say Baltimore orthopedic surgeons.
Jackson's release yesterday by the Kansas City Royals baseball team is a strong indication that bad things have happened that will mar his future in competitive sports, the orthopedists said.
"But sometimes people surprise you. They have a terrible joint and they function relatively well," said Dr. Kenneth Krackow, an orthopedic surgeon at Good Samaritan Hospital. "This may be the basis for his doctors saying, 'Hey, don't write him off just yet.' "
Jackson suffered a fracture dislocation in which the ball of the socket in his hip has been pushed forward and chipped. As a result, he has already begun to have joint deterioration, his doctors said. Jackson has been on crutches since he sustained the football-related hip injury in January while playing for the Los Angeles Raiders.
At the same time, his doctors have refused to elaborate on news reports that Jackson may have avascular osteo-necrosis, or bone death, caused by a lack of blood flowing to the hip.
But Krackow said he believes the presumption is that Jackson also has bone death.
Krackow is an associate of Dr. David S. Hungerford, an osteo-necrosis expert who reportedly has been consulted in the Jackson case.
"Of course, I don't have his X-rays and lab tests in front of me, but this guy has had bad things happen to his hip and that's why he's been released from his $2.3 million contract," Krackow said.
"If the Royals thought Jackson had a problem that would be over by the end of the year, they would not turn him loose. . ." said Dr. William Howard, a general surgeon and medical director of the sports medicine department at Union Memorial Hospital.
"I think they suspect he's developing avascular osteo-necrosis. That's why they've dumped him," Howard said.
An estimated 10 million Americans are at substantially higher risk than the rest of the population for osteo-necrosis, Hungerford said in an interview 2 1/2 years ago.
Cortisone and steroids, particularly in high doses, and more than two or three alcoholic drinks a day can cause pressure to build up in the bones, but no one knows why. This, in turn, restricts blood flow and leads to bone collapse and eventually to the need for knee or hip replacements.
Early diagnosis and an early simple surgical intervention, in which a pencil-size hole is drilled in the side of the hip or the knee, can avoid costly knee and hip replacements which are major surgery.
But bone death also can arise from a sudden injury, some experts say.
Dr. John Kenzora, head of orthopedic surgery at the University of Maryland Medical System, said Jackson may be developing osteo-necrosis.
"What he more than likely has is direct trauma to the surface of the hip joint from the fracture and probably will develop post-traumatic arthritis," Kenzora said. "The end result will work out to be the same. Whether it's osteo-necrosis or sheer trauma to the joint -- or both -- it's very serious and a dark cloud hangs over his future in competitive sports."
A fracture dislocation of the hip, one of the major weight-bearing joints of the body, will take a person out of sports competition for at least a year and perhaps longer, he said.
"We don't want to predoom the guy, but in our experience, and in similar situations, people have rarely gone back to doing heavy work," Kenzora said.
The degeneration of Jackson's hip joint could lead to the need for a hip replacement, which is not good news for young people. While the initial replacement lasts 10 to about 15 years, second and third replacements might not last as long and are more prone to infections, Kenzora said.
According to Krackow, the first hip replacement might not stop a determined athlete from playing baseball. "With a hip replacement, you can still run and slide and that's what [Jackson] would have to do," he said.