Understanding Marwin Gonzalez's Patellar Debridement Knee Surgery

[Lucas Seehafer PT]

Minnesota Twins’ do-it-all utility man Marwin Gonzalez appeared in his first spring training action this past Tuesday in a (meaningless) victory over the Detroit Tigers, going 2-for-2 with a double and a homer run. It was an encouraging sign for the Twins and their faithful as Gonzalez figures to once again be a key member of the team’s regular rotation.However, The Athletic’s Dan Hayes sent a few ripples through the waters of Ft. Meyers and the some-10,000 lakes of Minnesota when he reported that Gonzalez underwent a patellar debridement procedure of his right knee after the season concluded this past October that prevented him from participating in baseball activities until December; Hayes also disclosed that Gonzalez had been playing through pain in his right knee “for the bulk of the 2019 season.”

 

Patellar debridement is a surgical procedure that is usually undergone when conservative treatment (i.e. physical rehabilitation) is unable to reduce pain - typically at the front of the knee - and improve function caused by patellar tendinopathy. The procedure usually involves excising any damaged patellar tendon tissue as well as drilling into and possibly even removing the distal pole of the patella - a “bump” at the bottom of the knee cap where the patellar tendon attaches; inflamed synovial tissue - the tissue that lines joints - and frayed cartilage may also be removed if it is deemed necessary. Return-to-sport rates are usually extremely good, ranging from 75-90%.

 

Rehabilitation after surgery focuses on regaining any lost range of motion of the knee, improving the strength of the quadriceps and the hip abductors - which are located at the side of the hip - to reduce the amount of pressure placed on and through the patellar tendon, and to, ultimately, resume baseball-related activities. This is completed in a graded, gradual manner with return-to-sport usually occurring after a couple of months. Prior to going under the knife, conservative rehabilitation focuses on similar areas, though a greater emphasis is often placed on eccentric strengthening - “strengthening while the muscle is lengthening” - of the quadriceps as well as soft tissue mobility and core strength.

 

By all accounts, Gonzalez has returned to his prior level of function - see statline above - and is in minimal - or at least manageable levels of - pain. Tendinopathies can be tricky injuries as they are often prone to flare-up and can cause significant pain and impaired function. However, with proper recovery and rehabilitation (i.e. rest days, maintaining quadriceps strength, etc.), potential for and occurrence of flare-ups can be minimized.

 

Footnote: For full transparency - I am in no way affiliated with the Twins and my articles focus on explaining what has already been reported in the media, not novel information. The Twins’ course of action, treatments, etc. may differ from what I lay out in my articles.

 

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[AceWrigley]

So . . . he's day to day like the rest of us.

 

Edit. Forgot to say good article. Hopefully Swiss-G has better results than Dustin Pedroia (thanks again Manny Machado).

[MN_ExPat]

Nice write up Lucas.   It's always very interesting to read the science behind the procedures that players have to go through, TY.

[tarheeltwinsfan]

Thanks Lucas. Very informative.

[jimbo92107]

I'm not forgiving and forgetting the horrid scandal Gonzalez participated in, but I don't want anybody to suffer like that. Good luck with recovery. 

[Trov]

Nice article.  It is nice read up on what these surgeries mean.  Sounds like he should be back to normal, but could linger into the future.  I would not be surprised if this is his last season here.  I know  I will not be cheering him on based on his Astro time.  I do not wish him any ill will though and hope Twins perform well. 

[stringer bell]

I read somewhere that the Twins were limiting his time in the outfield, which would probably give Jake Cave a leg up for the last bench position.

 

Could playing a corner outfield position a couple or three days in a row impact Gonzalez’ health and/or availability?

[Lucas Seehafer PT]

I read somewhere that the Twins were limiting his time in the outfield, which would probably give Jake Cave a leg up for the last bench position.

 

Could playing a corner outfield position a couple or three days in a row impact Gonzalez’ health and/or availability?

I guess it would depend on a number of factors including how often he'd play multiple days in a row, how demanding those games would be, etc. I guess my short answer is that I doubt it. I think the Twins thought process is more that Gonzalez is better and more needed in the infield.