Russell Westbrook Knee Surgery: Best-Case, Worst-Case Scenarios for Thunder Star

Will Carroll@injuryexpertSports Injuries Lead WriterApril 26, 2013

The news that Russell Westbrook, the Oklahoma City Thunder's star combo guard, is headed for surgery on his knee hit fans like, well, lightning.

Westbrook was injured in the second quarter of Game 2 when Houston Rockets rookie Patrick Beverley dove for a steal and collided with Westbrook's knee. That damaged Westbrook's meniscus and necessitated surgery.

The meniscus is a small piece of cartilage that acts as the shock absorber between the femur and tibia, the large bones of the upper and lower leg. On each step and jump, the meniscus is tasked with keeping the bones from pounding or grinding into each other. While it can be removed, the knee is not designed to function without it, and there are often consequences.

Westbrook is headed for surgery in the very near future, but even the Thunder aren't sure what the doctors will find or do to repair his knee.

What then are the best and worst case scenarios for Westbrook and the Thunder? 

Best-Case Scenario

Westbrook could be back in two to four weeks, though the normal timeline is usually quoted as four to six weeks. Amar'e Stoudemire is returning to the New York Knicks at the tail end of that time frame, though his knees have significant damage and can't be considered normal. 

The best case was recently demonstrated by Metta World Peace of the Los Angeles Lakers. Just 11 days after his meniscectomy, he was back on the court for the Lakers. More importantly, he has had no issues with the knee since then, even playing in back-to-back games.

I spoke with Dr. Daniel Kharrazi of Kerlan-Jobe and the team physician for the Los Angeles Lakers. He knows a bit about this kind of situation and may understand MWP's quick return better than anyone.

I asked him what would help an athlete return quickly, and he told me that "several factors help, including the athlete and his elite conditioning. It is also important that surgery is performed with exact precision, minimal trauma and disruption of tissues, and in a timely fashion to correct the problem immediately. This way, you give the best chance for a quick recovery with minimal atrophy and down time. It is literally like an exact military surgical strike with minimal disruption of the normal environment."

Surgical strike? Yes, that's a very apt description for what the surgeon will try to do in hopes of quickly getting Westbrook back to health. One of the keys to watch is how quickly he returns to weight bearing and then to any sort of basketball activity. We should see the former within a few days, and the basketball activity—something like dribbling or even just running on the court—could happen inside of 10 days.

Worst-Case Scenario

The worst-case scenario might actually be better long-term. If Westbrook were to have the meniscus repaired (assuming that is possible) rather than having it removed or even just resected, the recovery would be much longer, as much as six to eight weeks. 

The upside is that the meniscus would remain in place. That would prevent some problems down the line and perhaps protect Westbrook against late-career grinding inside the knee. It's the lack of meniscus and articular cartilage that leads to arthritis and the need for procedures such as microfracture surgery. 

The Thunder's medical staff will have a tough decision. Risk Westbrook's long-term future for a chance at a title now or play the long game and hope that finishing second (or worse) won't drive Kevin Durant over the edge?

The expression in baseball is that "flags fly forever," and the risk is almost always worth it for a championship. The surgeon won't know if the Thunder can get past the Los Angeles Clippers, Golden State Warriors or San Antonio Spurs in the next round, let alone the Miami Heat. Instead, he'll rely on his best judgement when he gets inside the knee.


Listen for one of two words after the surgery. The surgeon will either do a meniscectomy, removing the damaged meniscus, or a meniscal repair. The latter takes much longer and would rule Westbrook out for the duration of the playoffs.

After Westbrook returns, look for any sort of basketball activity. He could be ready to play at least limited minutes shortly thereafter.

Once on the floor, look for quick acceleration, fast stops and an ability to bounce, a sign that the knee is back to full functionality. How quickly all that happens could be the difference between a ring and another almost for the Thunder.

Will Carroll has been writing about sports injuries for 12 years. His work has appeared at SI.com, ESPN.com and Basketball Prospectus.