Russell Westbrook Injury Raises Maddening Questions for OKC Thunder

Russell Westbrook had a third surgery on his right knee on Friday, potentially undermining the Oklahoma City Thunder’s championship hopes for the second straight season.

Westbrook is expected to return sometime after the All-Star break, in late February, according to the team. He will miss 27 games, at a minimum. General manager Sam Presti cautioned that Westbrook would not necessarily return immediately after the break.

The news of Westbrook’s surgery—his third in seven months—came as a stunning setback for the Thunder, who had surged to a 23-5 record, the second-best mark in the league, with Westbrook playing as dominantly as ever.

There was no outward indication that Westbrook had any lingering issues following knee surgeries in May and October. He was averaging 21.3 points, 7.0 assists and 6.0 rebounds, and he posted a triple-double Wednesday against the New York Knicks, his last game before Friday’s surprise announcement.

“I think it’s fair to say that it’s disappointing and it’s unexpected,” Presti said in a conference call.

Westbrook had been playing pain-free, according to Presti, but there was swelling in the knee, and an MRI taken this week revealed “an area of concern.”

If any team can survive a two-month absence by an All-Star, it might be the Thunder, who have two other stars, Kevin Durant and Serge Ibaka, to lean on. The rapid development of Reggie Jackson and Jeremy Lamb should give the Thunder an extra cushion in the near term.

But there is little room for error in the ultracompetitive Western Conference, where the top six teams were within six games of each other as of Friday afternoon. The Thunder were a half-game behind Portland for the NBA’s best record, but just 4.5 games above the fifth seed.

If they stumble without Westbrook, the Thunder could lose their grip on home-court advantage in the playoffs, and with it, any chance of returning to the NBA Finals.

The greater concern is the long-term health of Westbrook’s right knee. Presti said repeatedly that the knee would have to be “managed” once Westbrook returns, but he offered no specifics about what limits might be set.

Will Westbrook be held out of back-to-back games, or have his minutes curtailed? Presti said it was “way too early” to know, but he emphasized that the Thunder would have to be “flexible.”

Also left unclear: whether the team expects to be managing Westbrook’s knee just this season, or for years to come.

“I wouldn’t want to forecast out years upon years,” Presti said. “I think more than anything, we just have to see how he responds to this. I don’t want to put a limit on Russell by any stretch.”

Presti added, “What we’re looking at first and foremost is one, getting him back on the floor this season when he’s healthy. The fact that he’s had no pain and his performance has been at an incredibly high level, those are all positive things.”

The need for a third knee surgery in such a short time span evoked immediate comparisons to other star guards whose careers were plagued by chronic issues, including Penny Hardaway and Gilbert Arenas. The Thunder seem optimistic that Westbrook’s issues are not that severe.

“We’re confident that Russ is going to play at an extremely high level,” Presti said. “But I think we have to understand that this is something that’s probably going to have to be managed.”

Westbrook was expected to miss the first four-to-six weeks of the season after having surgery in October, also because of persistent swelling. He made a surprise return on Nov. 3, weeks ahead of schedule.

That speedy return now raises questions of whether Westbrook returned too soon, but Presti said flatly, “The answer to that is no,” based on information from the medical staff.

This was shaping up as a resurgent season for the Thunder, who appeared primed for another Finals run after having their 2013 postseason ruined by Westbrook’s first knee injury. Westbrook was lost in the first round, after a collision with Houston guard Patrick Beverley. The injury, combined with the financially driven decision to trade James Harden before the season, left the Thunder without a clear No. 2 option to ease Durant’s burden.

The Thunder face the same challenge now, but they have seen enough growth in the surrounding cast to feel confident in the short term. Ibaka, once a defensive specialist, was averaging a career-high 14.4 points as of Friday. Jackson, now in his third season, was averaging career highs in scoring (12.5 points) and assists (3.4) in a backup role. Lamb, a second-year swingman acquired in the Harden trade, was averaging 9.5 points and showing promise.

There is no replacing Westbrook’s athleticism, playmaking and pure dynamism on the court, however. The mission now for the Thunder is to merely hold their ground for a couple of months until he returns—and then pray he recovers from his third knee surgery as brilliantly as he did, at least initially, from the second one.

Howard Beck covers the NBA for Bleacher Report.