Kyrie Irving's knee injury and second surgery, explained by an orthopedic surgeon

The Boston Celtics have locked up the No. 2 seed in the Eastern Conference, which would usually have a franchise and its fans excited about a long playoff run. But unfortunately for the Celtics, injuries to key players have made that unlikely. Most recently, the team announced that Kyrie Irving would be out for four to five months because of a second surgery he needed on his knee

Originally, Irving was expected to be out three to six weeks following a minimally invasive procedure to remove a tension wire that had been bothering him. But in the aftermath of that surgery, the medical staff discovered that some screws that had been implanted in Irving's knee after he fractured his patella in the 2015 NBA Finals had become infected. Irving need a follow-up procedure to remove those screws, but the Celtics said his knee was found to be structurally sound, and expect him to be healthy for training camp. 

Considering the uniqueness of this situation, as well as the impact it will have -- both in this season's playoffs and also potentially down the line -- CBS Sports spoke to Dr. Armin Tehrany about the procedure and Irving's recovery. 

Dr. Tehrany is the founder of Manhattan Orthopedic Care and Honorary Surgeon for the NYPD.

We've heard a lot about this tension wire and screws that Irving has had removed from his knee. So firstly, I was hoping you could give a brief explanation of the purpose of that hardware?

Dr. Tehrany: Sure. So for the original patella fracture, the surgeons decided to fix the fracture with two screws and supplement with wires around the patella fracture. It's not the best mechanical construct. The best construct is the screws, and in cases where the fracture needs additional fixation, such as a tension wire, that would be done.

Is it common for the wire or screws to cause irritation and need to be removed after a period of time?

Dr. Tehrany: Yeah, sure. It is common for hardware to become painful and problematic. And when it's problematic enough that it's appropriate for removal, then that is done.

We heard that the need for a second surgery was because the screws had become infected. How exactly do doctors determine that there was an infection there?

Dr. Tehrany: When the surgeons did the preliminary hardware removal surgery, they were planning to just remove the wires, they were thorough and checked for infection, which is always the right thing to do when doing hardware removal. And unfortunately, that picked up the infection. The test of the fluid around the screws and hardware were tested in the lab for infection. They can test the white blood cell count, they see if they can grow whatever tissue or specimen from the body to see if it grows out infection. That, I suspect, is how they were able to determine that there was an infection.

And secondly, is there any further concern in that regards? Or is the infection problem completely solved by removing the screws?

Dr. Tehrany: There needs to be time where the work-up continues and they check to make sure all the soft tissue and bone in that area are cleared of infection. But with a healthy athlete like Kyrie Irving, that should be no problem.

Just in general, is there any worry for re-injury now that the hardware is removed? Or were those items superfluous given that Irving's knee is structurally sound?

Dr. Tehrany: That's a good question. The screws that were removed leave areas of empty bone where the screws used to be. Over time the body heals that area with new bone. But that takes time, and that's one of the reasons for why he'll need some time off before he can resume his activity.

What sort of rehab process will Irving be going through following the procedure? Will it be any easier given that he didn't need to have a ligament or anything repaired, and was just having screws removed?

Dr. Tehrany: I think that when his infection is completely resolved, he'll make a fantastic recovery. I would feel cautiously optimistic.

Does the four-to-five month timeline sound correct to you for a return from this kind of surgery?

Dr. Tehrany: Yeah. It sounds reasonable. It takes into account the fact that he had screws removed, and he needs to recover from that. And for him to completely recover from the infection.

What level of concern -- if any -- should the Celtics have going forward about Irving's long-term health given that they say his knee is structurally sound?

Dr. Tehrany: As I said, I think they should be cautiously optimistic. This may have happened simply because in the past he had something as simple as a cold or a viral infection in the upper respiratory that traveled to the knee where the hardware was. Thankfully that was picked up by the surgical team so it could be rectified. So I would feel cautiously optimistic. 

NBA Writer

Jack Maloney lives and writes in Milwaukee, where, like the Bucks, he is trying to own the future. Full Bio

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