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The Arizona Republic Interviews Dr. Mandelbaum about Arizona Cardinals' QB Drew Stanton's Knee Surgery


Arizona Cardinals QB Drew Stanton's injury status still murky

On Christmas Eve, Cardinals quarterback Drew Stanton's chance of starting a playoff game diminished with every cc of pus-laden fluid a doctor drained from his right knee.

Stanton had suffered the injury nearly two weeks before in St. Louis. The team called it a sprain, and the details weren't made public. But Stanton had suffered a partially torn ACL and a Grade 2 MCL sprain.

Surgery wasn't required and the hope was that Stanton could rehabilitate the injury and return, wearing a brace, by the season finale or the first week of the playoffs.

But for the 2014 Cardinals, nothing has been simple, certainly not what's happened to Stanton's right knee over the past week.

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Now, it appears certain Ryan Lindley will start his third consecutive game for the Cardinals on Saturday against Carolina in the wild-card round of the playoffs.

What happened to Stanton's knee since that night in St. Louis remains as murky as the fluid drained.

What is known is that Stanton's rehabilitation appeared to be on schedule until Dec. 22, a Monday. That day, he underwent a therapy session supervised by team-approved staff. By the next day, the knee had ballooned.


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It was decided that Stanton should rest for a day to see if the swelling lessened. Stanton's knee wasn't much better on Wednesday, so the fluid was drained.

Doctors feared infection, and it was decided that arthroscopic surgery was needed immediately.

Only those directly involved knew of the problem. NFL teams aren't required to reveal details of injuries other than the general nature of the injury, the level of participation in practice (out, limited, full) during the week, and the likelihood he will play in a game (out, doubtful, questionable, probable).

The Cardinals, like the vast majority of NFL teams, generally don't allow their athletic training and medical staff to be interviewed. The majority of injury information is dispensed by coach Bruce Arians, although the coach occasionally tells reporters they need to "check with the doctors" if they want details. But those doctors are not permitted to talk.

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Mike Jurecki of FoxSports 910 first reported the details of Stanton's injury. Last week, Ian Rapoport of the NFL Network and reported that Stanton had developed an infection, casting doubt on him returning in time for the playoffs.

The Cardinals were surprised the news got out. They quickly let it be known that their staff could not have caused the infection, because the arthroscopic surgery was the first invasive procedure it had performed.

So what caused the infection?

It's hard to say. In fact, Stanton might not even have an infection. Initial test results have been inconclusive, according to a source.

What is known is that Stanton has done everything he can to return from the injury. As with many players, that likely involves seeking treatment outside the team's medical community.

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Quarterback Carson Palmer did that earlier this year with the nerve injury in his shoulder. Among the therapies he sought were massages, acupuncture and something he called "dry needling."

He finally found relief from a Denver therapist who specializes in "Muscle Activation Techniques."

Players will do almost anything to return to the field. In training camp of 2013, running back Ryan Williams, then with the Cardinals, underwent "Platelet-Rich Plasma (PRP)" treatment in an effort to help an ailing knee.

In that procedure, a small amount of a patient's blood is drawn and then put in a centrifuge. The platelets are separated and then injected into the injured area in an effort to jump-start the healing process.

Other players have used ozone therapy, which involves injecting gas into the injured area.

It's unknown whether Stanton underwent such procedures.

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What's also unknown is exactly what the surgeon did during Stanton's arthroscopic surgery.

It seems optimistic to think Stanton could play 10 days after surgery, as the Cardinals have said is possible. But it's been done before, said Dr. Bert Mandelbaum, an orthopedic surgeon and co-chair of medical affairs at the Institute for Sports Sciences in Los Angeles.

"It's not unheard of," he said. "I don't think any of us like to do that routinely. It can be done relatively safely when the situation calls for it. The devil's in the details."

In the case of Stanton and most other professional athletes, there's a devil of a time in getting details of injuries, treatments and timetables for returns.

This much has become clear: If Stanton is to start a playoff game for the first time in his career, the Cardinals are going to have to win on Saturday, with Lindley at quarterback.

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