The Oklahoma City Thunder have done everything they can to protect All-NBA point guard Russell Westbrook and his problematic right knee, but the health of that joint clearly remains beyond their control.
Forget the minutes limitations, restrictions on his availability for back-to-back sets or even that supersized supply of bubble wrap that now sits inside the Chesapeake Energy Arena.
Once Westbrook hits the NBA hardwood, all control is lost. Crossed fingers and wishful thoughts can only do so much, something the Thunder were brutally reminded of during their marathon 119-118 double-overtime victory over the Toronto Raptors Friday night.
Despite a 51-point, 12-rebound, seven-assist performance from Kevin Durant, all eyes were on Westbrook and his three-time surgically repaired joint, which buckled during a third-quarter collision with Raptors guard Kyle Lowry:
The initial diagnosis was a right knee sprain, per Darnell Mayberry of The Oklahoman, officially ending his night after only 19 minutes. Whether the end of Friday's game is all that he'll lose should become clearer after further evaluation Saturday.
Westbrook didn't sound concerned after the game.
"I don't expect to miss no time," he said, via Mayberry. "We’ll just see how it goes."
Maybe that isn't a lack of anxiety, though. Maybe it's an attempt at optimism with an all-too-deep understanding of what could go wrong.
Westbrook seemed fine after weathering a shot from Houston Rockets guard Patrick Beverley midway through the second quarter of Game 2 during the teams' opening-round meeting last season. Westbrook logged 37 minutes during that contest.
Two days later, OKC discovered he had suffered a torn meniscus during his run-in with Beverley.
By June, the point guard publicly ditched his crutches and made it seem as if his rehab couldn't be going any better. By October, he was back under the knife, this time to address some swelling in the knee.
Westbrook was supposed to be sidelined the first four-to-six weeks of the regular season. He wound up missing just two games, erupting for 21 points and seven assists in his 2013-14 debut.
Everything seemed to be going according to plan.
After missing those first two games, Westbrook appeared in 25 of OKC's next 26. Besides some struggles with a shooting form that wasn't the best to begin with, his game looked all the way back. He averaged 21.3 points, 7.0 assists and 6.0 rebounds over those 25 games, a line that only four-time MVP LeBron James has notched in the last decade.
After a 14-point, 13-rebound, 10-assist triple-double in OKC's Christmas Day rout of the New York Knicks, Westbrook looked like he had rediscovered all of his pre-injury ability—or maybe even added to it.
As quickly as it had returned, though, it was ripped away once again.
On Dec. 27, Thunder general manager Sam Presti announced that Westbrook had undergone a third operation on the knee, via ESPN:
On the most recent MRI, it was determined by the surgeon that there was an area of concern that had not previously existed nor was detectable in the previous procedures, and it was necessary to evaluate Russell further. The consulting physician determined that arthroscopic surgery was necessary to address the swelling that was taking place. We know that Russell's work ethic and commitment will help him return to the level of play that we have all come to appreciate.
There was no rapid recovery after this procedure.
Westbrook missed 27 games in a row, a stretch that saw Durant force his way to the front of the MVP race. Reggie Jackson, perhaps as close to a Westbrook clone as you'll find in the league, slipped into Westbrook's starting spot, and sharpshooting swingman Jeremy Lamb occupied the sixth-man spot vacated by Jackson.
The Thunder rattled off 20 wins over those 27 games, proving they'd at least learned how to survive a regular-season stretch without Westbrook. With championship thoughts running rampant through the Sooner State, though, the importance of his return was impossible to overstate.
"It's like trading for an All-Star," Durant said, via Sam Amick of USA Today. "We're looking forward to it, we're definitely excited for him to get back."
It took a while for that excitement to reach the box score.
OKC dropped three straight games after Westbrook's return and six of its first 11 after the All-Star break. The defense couldn't stop a nosebleed (eight of those 11 opponents broke triple digits), and the offense sputtered as complementary pieces slid back down the totem pole.
Jackson has struggled to find his form out of the break (41.5 field-goal percentage). Lamb has had a hard time finding minutes (12.6 over his last 14 games) or doing anything with the ones he's received (3.8 points on 29.9-percent shooting).
Westbrook himself has been more hit than miss (21 points on .452/.413/.846 shooting since the All-Star break), but there's only so much he can do with limited minutes. Not to mention how these repeated trips to the trainer's table make it hard to believe he's anywhere close to 100 percent.
"It takes an uber-optimist not to be concerned by the fact Westbrook's right knee has required three surgeries in the space of eight-plus months," ESPN's Marc Stein wrote after news broke of Westbrook's third surgery. "Worrisome is putting it mildly after three operations to repair one injury."
Especially when it seems that one injury still hasn't been corrected.
The Thunder appear to be (understandably) overly cautious in their handling of Westbrook. He's the player capable of drawing defenders away from three-time scoring champion Durant, a necessary piece to OKC's championship puzzle.
Westbrook is also wildly unpredictable—and no longer solely for a shot selection that teeters between questionable and shameful.
He has the volatility of an X-factor, but the responsibility of a featured star. His ceiling, when healthy, is high enough that his basement blunders have to be overlooked.
But when is the last time he was truly healthy? When can the Thunder expect him to get back to that point?
Presti has done a masterful job of building around Westbrook and Durant, but the executive needs his two-man centerpiece for this championship plan to come to fruition.
That's the reason behind the playing-time precautions, why the State of Oklahoma now holds its breath whenever a defender enters Westbrook's personal space. Whatever is going on with the point guard's right knee is clearly something this team has yet to get a handle on.
The longer these injury concerns linger, the harder it becomes for this franchise to win something of significance—the most convincing negotiating chip the organization could use to keep its transcendent talents happy in their small-market home.
It doesn't get any riskier than that. The real question here is, at what point is Westbrook no longer a risk? When can we stop worrying about his knee, and go back to worrying about his itchy trigger finger instead?