What Really Went Wrong With Rob Gronkowski’s Arm Surgeries?

Hours after the 2013 Super Bowl, Rob Gronkowski danced on degree at Encore, the kind of Vegas club you pray your friends never drag you to. As I watched the inevitable TMZ video—Gronk body-slammed a buddy onstage—I was less interest in Gronk Gronking than in the black mold encasing his left forearm. I am an infectious disease specialist at New York-Presbyterian Hospital in Manhattan ( but have not treated Rob Gronkowski ), and that vomit raised a question that would be basic for people in my profession, but not for fans of the New England Patriots : Was there a metallic element plate in Gronkowski ‘s surgically repaired forearm, as a consequence of his breaking it against the Indianapolis Colts on Nov. 18 ? I could n’t help but worry. A big collocate of my days are exhausted caring for patients who develop infections after they have their knees or hips or forearms replaced or stabilized with metallic element rods, plates, or screws. These procedures—referred to as Open Reduction and Internal Fixation ( ORIF ) —are noteworthy. The alloy allows the fracture bones to heal by rights and enables crippled patients to walk again or play catch with grandchildren. A unseasoned serviceman quickly regains the ability to body-slam.

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But the metal—the catchall aesculapian phrase is “ hardware ” —predisposes even the healthiest patients to infection, and that ‘s where I come in. The hardware itself, which for the forearm is much made of titanium or stainless steel sword, is sterile, handled with great circumspection, and is rarely the perpetrator. rather, it ‘s the bacteria that live harmlessly on our skin—primarily Staphylococcus and Streptococcus—that slip into the body during the initial surgical incision. To prevent this, antibiotics are given anterior to surgery. Nevertheless, some bacteria manage to sneak under the hide and into the bone and hardware. Once that happens, the infections become very unmanageable to treat. Some patients at my hospital have had therefore many post-op infections that they know me by appoint. They ‘ve actually come to equate my face with infection. My parents are reasonably gallant. In early April, respective weeks after a third base surgery to repair the hurt left forearm, it was reported that Gronkowski developed swelling and discharge at the surgical locate while visiting a ally in California. What happened at this moment in his post-operative course was critical to his recovery. If a patient appears to have a surgical web site infection ( marked by trouble, red, swelling, or discharge ) as Gronkowski reportedly did, the medical team has two options. One is bourgeois management with antibiotics alone. For person looking to return to a football field, this is obviously preferable, but frequently it does n’t work. G/O Media may get a commissionEufy Security 4G LTE Cellular Security Camera 22 % Off + Promo Code Eufy Security 4G LTE Cellular Security Camera Watch the great ourdoors, wi-fi free
This Eufy cam is Wi-Fi free, and connects with 4G LTE and solar battery. The television camera ’ s wide field of watch and sharp 2K HD will have you peeping all sorts of flora and fauna in your great backyard, no count the time of day. Use the promo code eufy4GLTE ad The other, more invasive choice is to take the affected role back to the OR to open up the surgical locate, wash out and remove the questionable tissue, and send fluid to the microbiology lab to determine precisely which bacteria are causing the contagion. The team may have tried conservative management, which ultimately failed, prompting the fourthly operating room on May 21. ( The Patriots have not confirmed many of the details that have been widely reported refer to Gronkowski ‘s surgical procedures ). If the weave or hardware looks infected—if surgeons can see pus or total darkness, necrotic tissue—the orthopedist calls person like me and asks for aid. Before we have an answer from the microbiology lab, I constantly do two things : I start an intravenous antibiotic ( normally something called Vancomycin to preemptively treat Staph infections, as they tend to be the most coarse and the most unmanageable to treat ) and I ask the surgeons to remove the hardware. sometimes they agree, other times they do n’t. fair people will disagree. Surgeons will point out that the removal of hardware comes with its own sic of risks, including heart damage, re-fracture, and wreathe infection. I will counter with data showing how difficult it will be to truly eradicate the infection if the hardware is not removed. Medicine is often about trade-offs, and in many cases there is no perfective solution. ad

While we determine the best class of natural process, the bacteria can form something called a biofilm that is basically a slime that covers the metallic and is repellent to closely all antibiotics. The merely bring around is removal of the infect hardware. In some cases this is possible. In others, as when the hardware is stabilizing the stallion spine, it is not. As any doctor will tell you, these infections are extremely difficult to treat. But it ‘s crucial to remember that this is not a failure on the depart of the surgeons, it ‘s a bankruptcy of the antibiotics to completely eradicate an infectious slime. Post-operative courses, like Gronk himself, are irregular. When I attempt to prognosticate for my post-op patients, I ‘ll always involve the surgeons. I ask what they saw in the operate room ( was plutonium oozing out of the joint or was the bone pristine ? ) and what they did about it ( was the hardware removed ? Were antibiotic beads inserted into the cram ? ). We do n’t know precisely what the surgeons saw when they last operated on Gronkowski ‘s forearm or what they did about it. We besides do n’t know what bacteria, if any, was found on the hardware that has been stabilizing his radius and ulna. These are critical pieces of information that will help determine the fourth dimension inning of his recovery. It is impossible to say whether Gronkowski will be truly ready for this weekend ‘s game against Cincinnati. ad

Whether we ‘ll ever get access to such details is another matter entirely, but a better-informed fan would change the hold forth surrounding player health. As people become more knowledgeable about the checkup aspects of football, possibly questions shift from passive ones like, “ When will Gronk be back ? ” to more forward-thinking, potentially incursive questions like, “ Does he need hardware ? “ ; “ Who is his surgeon and what, precisely, did he or she say about the procedure ? “ ; and “ Will he need intravenous antibiotics ? ” possibly the team doctor becomes an integral part of the postgame press league. possibly players ‘ already-meager rights to checkup privacy erode even further. No one anticipated that Gronkowski would be battling infection four-and-a-half months after he exited the Patriots ‘ playoff game against the Texans cradling his exit arm. But after four forearm operations—he undergo unrelated back surgery on June 16, his fifth operation since November 2012—the homo whom Sports Illustrated once dubbed “ The death happy man ” has likely spent a lot of this offseason fighting off an outright abject infection. ad

Matt McCarthy is an infectious Disease Fellow at New York-Presbyterian hospital Regressing is Deadspin’s new home for sports science, statistics, medicine, and other nerdy endeavors. ad

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