The Los Angeles Rams are most concerned about trying to replicate their run to the Super Bowl in 2019, but it's hard to move away from the concerns about Todd Gurley's injury. We've been asking about Gurley's injury for weeks now, with no real answers in sight. Gurley first hurt the knee back in December (we think). Our own John Breech reported the Rams are considering stem-cell treatment for Gurley's knee.

But it may be something else and something even more concerning for Gurley. According to Jeff Howe of the Athletic, the injury Gurley's battling is specifically arthritis. Mike Florio of Pro Football Talk reports that the arthritis is present in Gurley's left knee, 

This is problematic because arthritis is something you expect to hear a 65-year-old man battling. Arthritis might mean bone-on-bone action, or at least a lack/deterioration of cartilage in and around the knee. Short term it is obviously creating some problems, and long term it could be a major issue for Gurley. 

Such an injury would be scary for the Rams because Gurley recently signed a hefty, $60 million extension. That contract is fresh enough and legit enough that the Rams don't have a realistic out until 2022

Gurley will be locked into a total of $34.5 million guaranteed in money by the third day of the league year (by virtue of a $5 million base salary for 2019 that becomes fully guaranteed) plus another $9.5 million guaranteed for injury. That's a lot of cheese.

Worth remembering now: Gurley declined to let at least one team and one GM examine his knee before he was drafted in 2015.

So where does this go? Arthritis would typically be the type of injury that requires surgery, although the Rams have repeatedly said they don't intend to have Gurley undergo surgery. Stem cell, as Breech reported, could very well be the alternative method to going under the knife. 

For what it's worth, Sean McVay denied the notion of the Rams utilizing stem-cell treatment, although he did acknowledge there are always new methods of utilizing modern medicine in order to try and get the running back right. 

Surgery right now, in early March, would certainly put the start of Gurley's 2019 season at risk. If it was microfracture surgery, there would be even more at risk than just Week 1 of next year. 

All of this is very much up in the air and it's all very nebulous. We don't know what's wrong with Gurley and it is difficult to ascertain if the Rams really know what's wrong with Gurley. The running back isn't right -- that's about all we can definitively ascertain at this point -- and all parties involved are still trying to figure out the best way to maximize what he can do on the field next year.