Former NBA physician says Memphis Grizzlies correctly handled Steven Adams' knee injury

Steven Adams was progressing well.

He was playing in preseason games, full-court five-on-five scrimmages and his Memphis Grizzlies teammates and coaches said he looked great.

Then, boom. The news came tumbling down like an NBA defender falling to the hardwood after one of Adams' crushing screens.

The starting center needed surgery on his right posterior cruciate ligament after his knee wasn’t responding how the Grizzlies had hoped. Season-ending surgery and a 10-to-12 month recovery process awaits Adams, but the 30-year-old is expected to make a full recovery.

"The relationship between Steven and our medical team has been great as we were trying to uncover everything to make sure he had all the answers to make the best decision for him," coach Taylor Jenkins said.

Considering Adams initially suffered the knee injury in January, the idea of getting surgery in October left many puzzled. Why wasn’t surgery done in January? Or in March after Adams suffered his first setback? Or maybe in April when it was revealed that he wouldn’t be available for the playoffs?

Daniel Kharrazi, who is an orthopedic surgeon at Cedars-Sinai Kerlan-Jobe Institute in Los Angeles, provided context to The Commercial Appeal on why the Grizzlies and Adams took a while to get here.

Kharrazzi worked from 2000-17 as the Los Angeles Lakers team physician. If he was handling Adams’ knee injury, he would have likely managed it similarly to the Grizzlies.

“The art and science of medicine tells you that based on the nature of the injury to the posterior cruciate ligament, you should try between 6-to-12 weeks of conservative measures, and if the patient is progressing, you continue on that route,” Kharrazi said. “I think the Grizzlies organization did the right thing for him in trying the conservative non-surgical stuff first.”

How did we get here?

Adams was initially injured on Jan. 22 against the Phoenix Suns. The team announced that Adams suffered a PCL sprain and was expected to be sidelined 3 to 5 weeks.

On March 9, another announcement revealed that Adams was re-evaluated and underwent a stem-cell injection. Adams was re-evaluated again in April, but the Grizzlies said he wasn’t expected to be available for the playoffs.

General manager and president of basketball operations Zach Kleiman said after the season Adams would take a non-surgical recovery route in the summer. After playing in two preseason games and participating in practices, that’s when the team made announcement of surgery.

The Grizzlies reported Adams had ongoing knee instability.

“That instability is something you don’t know until you have basically been on the court and you’re practicing or playing, and then you notice that the instability persists,” Kharrazi said.

Explaining the PCL

PCL injuries are somewhat rare in the NBA. Kharrazi said that they’re about 1/20 as common as ACL injuries.

When a player suffers a grade 1 or 2 PCL sprain, doctors are recommended to try all non-operative methods before choosing reconstructive surgery. That includes possibly using PRP injections, or the stem cell injection that Adams and Grizzlies opted for in March.

Kharrazi said that in his NBA experience, players suffering PCL sprains recovered 90% of the time without surgery.

“You would never want to do PCL reconstruction if his body is able to heal and he’s stable,” Kharrazi said. “I think appropriate measures were done to give him the best chance of healing without surgery.”

The PCL focuses on your posterior and rotation ability. In other words, you’re not going to visibly see a player like Adams suffering from this injury. That’s why when he was playing in scrimmages and games, he may have appeared fine to the naked eye, but there was much more to the process.

“When he lands after he gets a rebound, or if he pivots and twists on his planted foot, then he’s going to get this sensation of instability that generally just the patient fills,” Kharrazi said. “It’s not something that you can see. They feel like they have no trust in their knee, so if they land awkwardly, they feel like it’s going to buckle or give out.”

Steven Adams recovery timeline

Adams has a chance to be back for Grizzlies training camp ahead of the 2024-25 season, but the process will be long. Like ACL surgery, PCL operation involves using a graft to reconstruct the torn ligament.

It generally takes a player 8-to-12 weeks to recover from the graft. Once that is healed, Adams will work on quadriceps and hamstring strengthening for three months. Then, he’ll move to light running and jogging before ramping up for a return.

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When next season rolls around, Adams will have one year remaining on his contract. He'll likely be playing for his NBA future, but it remains to be seen if he'll come back as the same dominant rebounder and screen-setter who has carved out an 11-year career.

“PCL reconstruction has very satisfactory results,” Kharrazi said. “But also, don’t forget Steven is 30 years old — not 18. There’s still a rehab that’s required.”

This article originally appeared on Memphis Commercial Appeal: Former NBA physician weighs in on Grizzlies, Steven Adams knee injury