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Tiger in race against time?
Tiger Woods' announcement Wednesday to have season-ending knee surgery raises some questions about his long-term future, in particular, whether he's racing the clock in his pursuit of Jack Nicklaus' record 18 major wins.
Until Woods' surprise announcement, it was a foregone conclusion that he would break Nicklaus' mark. But a planned third surgery in five years on his left knee, this one to be a reconstruction, has some medical experts wondering if Woods' career will end prematurely, before he tracks down the Golden Bear. Woods, 32, won his 14th major championship on Monday, defeating Rocco Mediate in a 19-hole playoff at Torrey Pines Golf Course in San Diego. Against the advice of his doctors, Woods played 91 holes with a torn anterior cruciate ligament and two stress fractures in his left tibia. Woods, who was diagnosed with a ruptured ACL last July, but opted against surgery, suffered the double stress fracture in late May.
"The long-term consequence of a delayed repair is that he's at a very high risk of developing arthritis in the knee in the next five to seven years," said Vijay Vad, MD, a sports medicine expert for GolfersMD.com and my co-author on the book Golf Rx. "The consequences are twofold: One, we don't know how he's going to perform if and when the arthritis develops; and two, we don't know what kind of impact it's going to have on the longevity of his career."
The encouraging news for Woods, however, is that in the next "five to seven years, several new technologies will be coming out to to treat early knee arthritis," says Vad. Woods is also in excellent physical condition, which was evident as he won the U.S. Open despite practicing very little in the past two months. Woods had arthroscopic surgery on his left knee in April to repair a torn meniscus.
"The chances of him playing competitively past 40, given the fact he's extremely fit, are very good," says Vad. "He's so fit going into the surgery that his recovery time is going to be a lot less than the average person."
Vad said Woods' recovery should take about four months. The surgery and resulting rehab will allow both stress fractures to heal, and Woods should be able to begin some sports-specific exercises in about six weeks. That includes putting and chipping. While Woods will miss the remaining two majors in 2008 and the Ryder Cup Matches, he should have no trouble being ready for the start of the 2009 PGA Tour season come January.
"It's not like they're getting him ready to play running back in the NFL," said Vad.
Some critics second-guessed Woods' decision to play in the U.S. Open, saying he put his career in jeopardy. But Vad believes Woods did no irreversible damage to the knee by playing last week. The wincing pain Woods was feeling came from the stress fractures in his leg, not the torn ACL. But the stress fractures Woods suffered were the direct result of delaying reconstructive surgery on the knee, as was the torn meniscus.
"It's like a loose knee, not a tight knee, so the stresses on the knee are greater," says Vad. "Think of it like a handle that's not fully screwed in, and it's rattling around a bit. The biomechanics had to be altered, and that's why he had the fractures."
Like everyone else, Vad is wondering what Woods will be able to accomplish with two healthy legs.
"The scary thing is if he can win a U.S. Open like this, what's going to happen when he comes back fully rehabbed, with no stress fracture and his ACL completely redone," said Vad.


