Posted: 11:15 p.m.
Although his patient suffered what he called "severe ligament damage," Carson Palmer's surgeon is optimistic that the Bengals quarterback can return in time for the start of the regular season.
Dr. Lonnie Paulos also said Thursday that much hinges on the next few months of rehab and how it heals "things that are really out of my control and Carson's control. We need to give it a few months. But he's got an excellent chance to be back playing as well as he did before."
Paulos says the normal timeframe for recovery for reconstructive knee surgery is nine to 12 months, but he thinks Palmer will be back "long before that," even though he called it an atypical tear of the anterior cruciate ligament.
"The kneecap slipped off to the side and caused some damage," Paulos said. "It's not the usual ACL tear, but we don't believe this is going to be a career-ending injury. Really, it comes down to rehab and determination, and knowing Carson, he's going to do what he has to do."
Palmer left for home Thursday to begin rehab in California after Paulos operated Tuesday in Houston.
Paulos, 59, surfaced as the surgeon once Palmer and his people told the Bengals they preferred an independent doctor rather than a team doctor to do the operation. The landscape in pro sports has changed since Paulos was literally on the cutting edge of sports medicine in Cincinnati a generation ago.
"Now it's a more involved process with the family, the agents, the team," Paulos said. "I know the sports medicine community very well in Cincinnati and he'll be well taken care of by the team with the Bengals. He's in excellent hands."
The Bengals know Paulos well enough that they referred him to Palmer and Palmer decided to go with the recommendation. In 1978, Paulos and Dr. Frank Noyes formed Cincinnati's first sports medicine clinic at One Lytle Place, where Paulos worked on some Bengals and Reds. It is Noyes, Paulos says, that did much of the definitive research on the ACL.
"Frank showed that it was the athlete's ligament," Paulos said. "It's the one that's used for running and jumping and pivoting. He demonstrated that without it, you can't do it. Before Frank did that work, people didn't think the ACL was very important."
During the three–hour procedure to repair the ACL as well as the medial collateral ligament, Paulos grafted Palmer's own tissue as well as tissue from organ donors to reconstitute and augment the damaged anatomy in the region between the tibia and femur.
Palmer wore a brace on his knee since he sprained his MCL in the same knee back in December of 2004, and Paulos said he and the team could end up opting to wear a brace that provides more protection.
Like everyone else, Paulos, who is a partner in the group that administers to the Texans and University of Houston, came away impressed with Palmer.
"He's bright, he's committed, you can see it in his eyes," he said.
Yes, Paulos did look at the play before surgery, and watched Steelers defensive end Kimo von Oelhoffen's hit on Palmer's knee a few times.
"Sometimes the speed of the play, the angle, can give you a better idea of what you're going to find," Paulos said. "But no matter how much you see it, you really don't know until he's asleep on the table and you go into the knee with the microscope."
And here's a second opinion from the good doctor:
"A clean hit," Paulos said. "It was an accident. No athlete would ever do something to another athlete like that on purpose."
Late Thursday night after conducting a series of media interviews, Paulos, through the Bengals public relations department, released the following clarification:
"I believe and regret that media reports, based on interviews with me, have misinterpreted my view of Carson Palmer's knee injury. Though the injury was serious, the essential facts remain his ACL and MCL have been repaired. I would consider this a typical MCL-ACL football injury. My comments attributed to me that the knee injury was "devastating and potentially career ending" were meant to describe such injuries in general, not Carson's particular case.
"I was accurately quoted by the Associated Press that my bottom line is optimism regarding Carson's prognosis. With a successful rehabilitation program, he has an excellent chance of being medically cleared for play at the beginning of the 2006 NFL regular season."