Paletta on Carpenter

by bgodar on Jul 26, 2007 3:13 PM EDT

In this interview with Matthew Leach, the Doctor explains how it took so long to determine that Carp needed Tommy John surgery. An excerpt:

"This is unfortunately a classic example of slow, gradual failure of the ligament," Paletta said. "Not all ligaments suddenly tear and rupture. And sometimes the way the ligament fails is over the course of many months or many seasons, and it doesn't become as obviously apparent except through things like spurs and arthritis."

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will carroll on paletta:

http://www.baseballprospectus.com/article.php?articleid=6501

"I'll admit that I'm confused by some of the statements made by Dr. George Paletta in this article. More on this soon..."

Panic!!!

by SleepyCA on Jul 26, 2007 3:13 PM EDT 0 recs

It makes sense...

If a ligament stretches, increased stress is placed on the joint - especially with high stress activities such as pitching. The stress on the elbow joint is increased due to the increased lateral motion of a joint that should just have an anterior-posterior motion (the elbow is a hinge joint).

Either the ligament blows out or it gets loose. Looks like Carpenter's got loose.

by silent_bob on Jul 26, 2007 3:32 PM EDT up 0 recs

Directly from the horse's (M.D) mouth:

"As the ligament starts to fail, and gets gradually a little bit looser, it allows a little bit more play in the elbow," Paletta said. "The way the elbow responds to that is to try to stabilize itself by forming these bony spurs that increase the stability of it. That little bit of shear and play lets the cartilage surfaces wear a little faster and get arthritis. So the body is trying to basically counteract the gradual failure of that ligament by forming these spurs, and the arthritis is a manifestation of that little bit of extra play."

Exactly as I was saying...

by silent_bob on Jul 26, 2007 3:53 PM EDT up 0 recs

This seems odd

In the article, Paletta says he was aware at the time of the initial diagnosis that the ligament might be failing, but "it was impossible to tell the player that."

What the hell does that mean? Does this mean he was literally barred from telling Carpenter? Does it mean his best judgment as a doctor prevented him from telling Carp? It's an incredibly vague statement. I'll be interested to see Will Carroll's follow-up.

by bgodar on Jul 26, 2007 11:28 PM EDT up 0 recs

explanation

I know Will jumped on that comment too. And I think it's being overparsed. The point of the comment, and maybe I should have done a better job of positioning/transitioning/explaining the quote, was this, as I read it:

He realized at the time that there was some chance, be it 10% or 20% or 33%, that in the end the ligament was going to turn out to be the big issue. But you don't make any effort to convince a guy to do reconstruction based on that percentage. At no point in my conversation with him did I get the sense that any of those concerns -- actually unable to tell him a diagnosis, or something like that -- was what was going on.

-M.

Any comments, opinions, or observations I post here are mine and mine alone. They should not be taken as any sort of statement on behalf of my employer.

by MatthewHLeach on Jul 26, 2007 11:49 PM EDT up 0 recs

makes sense...

...thanks for chiming in. Don't we think that Carpenter too must have known that there was a slight (15%, 33%, whatever) chance of TJ?

by cardsfaninmass on Jul 27, 2007 12:02 AM EDT up 0 recs

Prolly so, to some extent

Yea, I think somewhere in his mind he realized it was potentially on the radar. But if you're the doc, you don't want the guy thinking about that any more than he needs to while he's rehabbing.

-M.

Any comments, opinions, or observations I post here are mine and mine alone. They should not be taken as any sort of statement on behalf of my employer.

by MatthewHLeach on Jul 27, 2007 12:12 AM EDT up 0 recs

Paletta's response

I'll buy it. It makes sense and seems to fit the ideas I had about it medically. I'll be interested to see what Will Carroll says about it, but even thought I've been skeptical of the Doc in the past, I'll take his word on this issue.

Interested in pre-1990 Cardinals games on tape

by Hardcore Legend on Jul 26, 2007 4:02 PM EDT 0 recs

Me too

Maybe some people would say I'm too trusting, but it seems more realistic that we just never heard the full story until now, as opposed to the theory that they intentionally held information back for some alterior motive.

by john vb on Jul 27, 2007 10:40 AM EDT up 0 recs

This is welcome stuff

Even if it had to come as a result of some public pressure -- it's nice to see the club give an on-the-record, transparent explanation of an injury situation. Let's hope this is the sign of a more forthcoming approach in the future.

by DCRedbird on Jul 27, 2007 12:48 PM EDT up 0 recs

Carpenter on Paletta

Joe Strauss has an article up today with Carpenter's side of things. Matthew has much the same stuff in today's notes.

Quoting from the official site piece:

I had the option to go see anybody I wanted to go see, and I chose Paletta to do it because I trust him. I respect him. I think he's a great surgeon. To be honest with you, I wouldn't be here if it wasn't for him. He's the one who fixed my shoulder [in 2003].

Real quick addition from the Strauss piece: