The impact of the Ben Simmons, Jaren Jackson Jr., and Jonathan Isaac knee injuries

A rash of significant knee injuries in the NBA may have an impact on not only the playoff picture but also next season as well.

The injury bug bit again in the NBA this past week with three more players expected to miss a good chunk of time following various knee injuries. Let’s discuss each in part.

Ben Simmons may miss the remainder of the season

ESPN’s Adrian Wojnarowski reported Saturday afternoon that Philadelphia 76ers star Ben Simmons may miss the remainder of the 2020 NBA season — including the playoffs — after it was determined that he would go under the knife to remove a loose body in his left knee; according to Wojnarowski, the loose body is believed to have arisen following the left patellar (i.e. kneecap) subluxation that Simmons suffered in a recent win over the Washington Wizards.

“Loose body” is a term used to signify a piece of bone or soft tissue matter that has become dislodged and is currently free-floating within or around the joint in which it is housed. As Wojnarowski states is the case with Simmons, these injuries are often treated by removing the substance with a minimally invasive arthroscopic procedure — often referred to as a “scope” — and are usually of little concern long-term.

It isn’t uncommon for joint subluxations — which are a less severe version of a dislocation — and dislocations to produce loose bodies, so the fact that Simmons is having this procedure shouldn’t come as overly surprising. However, that doesn’t stop the injury and resulting surgery from being any less devastating for the 76ers’ potential playoff success. Athletes usually return to the court in a matter of weeks — 3-6 on average — but with the playoffs right around the corner, the clock is ticking.

The main focus of rehabilitation following a patellar subluxation is, ultimately, to prevent further occurrences of the injury. Subluxations — as well as full-out dislocations — are more likely to occur following the first, so regaining full quadriceps strength and improving faulty biomechanics is imperative; it also isn’t uncommon for athletes to wear a knee brace or sleeve to help stabilize the patella, at least for the first year or two following the injury.

That said, this isn’t the type of injury that should hurt Simmons’ performance in the long-term as long as recurrence is prevented. In the grand scheme, it is a relatively minor injury, despite its unfortunate impact on the 76ers current season.

Jaren Jackson Jr. out with a meniscus injury

The Memphis Grizzlies will be without forward Jaren Jackson Jr. for the foreseeable future after the future All-Star was diagnosed with a meniscus tear in this left knee last week. It is unknown as of this writing if he will be undergoing surgery — and if he does, which procedure — in the near future.

The two menisci in each knee act as shock absorbers and assist the four major ligaments – the ACL, PCL, MCL, and LCL — in stabilizing the oft-injured joint. The menisci are most frequently injured in an acute manner when the knee is subjected to a rotational force while the foot is planted; this commonly occurs when taking off and landing from a jump or while making a cut.

Meniscus tears are typically treated in one of three ways — rehabilitation alone, a meniscectomy, or a meniscal repair. The treatment that is ultimately decided on depends on the severity and location of the tear. Blood is supplied sufficiently to only the outer third of the meniscus in adults, meaning that only tears in this location may be eligible for a true repair (i.e. the tear is sewn together); meniscal repairs typically sideline an athlete for 4-6 months.

A meniscectomy involves removing the area of the meniscus that is torn. The upside of a meniscectomy is that athletes return relatively quickly — usually, 3-6 weeks — however, the procedure may result in impaired stability and shock-absorbing capabilities of the knee; meniscectomy procedures have been linked to increased rates of arthritis as well as bone bruises.

Simply undergoing rehabilitation has also been found to successfully treat acute meniscal tears with a return to play, again, usually occurring within 3-6 weeks; however, the downside is that if rehabilitation fails to provide good results, surgery will ultimately be performed, causing the athlete to miss an additional 3-6 weeks of action.

Meniscal tears are one of the most common injuries suffered in basketball and most NBA athletes return to their pre-injury levels of performance in a relatively quick manner. Jackson Jr. will have plenty of time to recover from this injury before next season starts.

Jonathan Isaac tears his ACL

Orlando Magic forward Jonathan Isaac suffered another significant left knee injury last week, ultimately tearing his ACL and meniscus while driving to the hoop in a win over the Sacramento Kings; Isaac also suffered a severe posterolateral corner sprain this past January that would have sidelined him for the rest of the 2019-20 season if not for the COVID-19 pandemic.

Isaac has already undergone successful ACL reconstruction surgery and will be sidelined at least 9-12 months; the addition of the meniscal tear — whether it was addressed by a meniscectomy or true repair — likely won’t add any time to his recovery.

Isaac’s injury occurred when his knee collapsed inwards — biomechanically known as dynamic valgus collapse — when preparing to jump for a dunk attempt, a common mode of ACL rupture. The Magic forward was wearing a brace — likely to provide stability and as a result of his prior injury — however, doing so is, obviously, not a fail-safe for preventing injury. In fact, knee braces often fail to protect an athlete’s knee, no matter the ligament or sport.

The injury is unfortunate and its impact is potentially compounded by Isaac’s previous left knee injury; it usually takes around one to two years before athletes return to their previous statistical level of play after ACL rupture alone. Unfortunately, we may not know the true impact of Isaac’s knee injury until three to five years down the road, though many athletes have been able to return to their pre-injury levels of play with time.