In wake of the news that Kyrie Irving would be undergoing season-ending knee surgery to deal with a recently discovered infection, there have been countless questions swirling about the status of the All-Star. How did Irving get this kind of infection? Is this a sign of more knee problems to come? To search for some answers, I caught up with BostonSportsJournal.com's medical expert Dr. Jessica Flynn for her insight on the situation and what comes next for Irving.
Q: Take us into the mindset of Irving's doctors. Obviously, they thought his initial procedure a couple weeks ago would help ease Irving's pain. How did they figure out that the infection was a problem and how long had he been dealing with it for?
Dr. Flynn: I think it was a surprise to everyone that Kyrie Irving has an infected knee joint. I think that everyone was surprised that the pathology reports came back showing an infection in his knee. This is standard operating procedure for a joint — it's really important to take tissue from a joint to test it for infection whenever there is chronic pain in the knee.
His (knee) injury was in 2015. He had surgery on it and at some point early on, this infection likely occurred. It's been there, quietly causing some pain but not causing typical infection symptoms like severe pain, swelling, fevers, chills, etc. It didn't cause any of that stuff because the body was keeping this infection in check. The only real symptom he had was this pain. It's very hard to diagnose an infection of hardware because the symptoms are so vague and a lot of patients have pain after surgery, near their hardware. You really have to be looking out for it.
It sounds like his construct from the beginning was what I had expected: screws and a wire. What I can gather from this information is that the plan was likely for them to remove the wire with the hope he could play in the playoffs, if it got rid of his pain and if he was able to recover from the procedure in time. The thought may have been that if there was still pain after that procedure, they may have needed to go back in at some point and take the screws out.
The revelation that there was an infection in the knee when that happens, you have to take all the hardware out because no matter how many antibiotics you give a patient, you won't be able to kill all the little bugs in the knee. You have to take out the hardware where the bugs like to sit and hide. You have to remove it to fully clean out the knee.
Q: What is the timing of the pathology report usually after surgery to find infections? Does that usually take a few days after surgery?
Dr. Flynn: It takes awhile. If this was a bad infection, they would have been able to tell right when they looked at the joints and from the symptoms. This is one of those quieter infections, that was very mild. They take the sample and plate it out. They have to grow the bacteria. It's a culture and it takes awhile for the culture to grow bacteria. Then, you have to identify what the bacteria is. They probably just recently got those results back.
Q: The main concern right now for a lot of people is his long-term prognosis. Is it normal for an infection like this to not be an issue long-term for an athlete, even when there is additional hardware on a knee?