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Writer's pictureRandon Hall, MD

Why is Kyrie Irving's Knee Still Giving Him Problems?


What Actually Happens With a Knee Cap Fracture?

Kyrie Irving sustained a knee cap fracture in 2015, which ended his season and required surgery. The fracture likely required surgery due to the spacing between the fracture fragments (above). If the fracture fragments were greater than 2 mm apart then the surgeon needs to pull the pieces together in order to align the fragments. This is usually done using a surgical wire or surgical screws. What wasn't reported is that the entire under surface of the knee cap is covered with cartilage. If the knee cap breaks so does the cartilage underneath the bone. The difficult issue with this type of surgery is that one has to be able to align the cartilage back perfectly to be able to get the smooth and painless motion you had prior to the surgery. That is if the fracture did not occur in a way that caused the cartilage to be damaged permanently, such as a chipped fragment that was too small to be repaired. Once the cartilage is injured arthritis will inevitably follow at some point.

Kyrie's Current Status

Likely Kyrie's status is that the wear and tear of basketball is irritating the cartilage under his knee cap, that never quite returned back to pre-injury levels. My guess is that he probably has persistent swelling and fluid on the knee that improves when he rests. In some cases this can be responsive to cortisone injections but only temporarily so. Also over time injections to the knee become less beneficial.

Possible Second Opinion

I would suspect that his second opinion would involve some discussion regarding the health of the cartilage underneath the knee cap. I am by no means an expert on cartilage injuries, but cartilage stem cell implantation is a viable option and one that could potentially revive the health of the knee cap. Whatever the recommendation, clearly rest and physical therapy is not cutting it at this point.

Horizontal Fracture of Patella

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