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Making Sense of James van Riemsdyk's Hip Injury

About a month ago, Paul Holmgren told the media that James van Riemsdyk had a torn labrum in his hip and would require surgery with a recovery time of about six weeks. Since that day, the surgery has been repeatedly delayed before being canceled last week.

This actually makes sense.

Whenever a surgeon sets up someone for surgery like this there is a process that is followed to make sure that the health of the patient is secured. In fact, this process can actually be outlined by the timeline of van Riemsdyk’s medical updates given by the team.

On May 19, Paul Holmgren announced the end of season surgery list. He based the updates off the original reports given to him from the Flyers medical staff, which the staff gathered from the end-of-season physicals given to each player.

Most of the reports were cut and dry. The players booked their surgeries and went in for the procedure. But, as we all know, the more times an event occurs the more likely one person will have something complicate the situation.

JvR probably wasn’t the person who elected to postpone the surgery; it was probably his doctor. The most likely explanation for this is that the original MRI was cloudy. A cloudy MRI can be caused by too much swelling in the area being examined or by the patient moving too much as the MRI is happening.

In van Riemsdyk’s case, the doctor who evaluated the MRI may have seen the swelling and clouded picture and would’ve told the Flyers something to the effect of, “There’s a lot of swelling that indicates a 100% tear- he will most likely need surgery- here’s the recovery time.”

Then, Paul Holmgren relayed the information to everyone via the injury statement.

This is where things began to get complicated.

The most likely explanation is that the surgeon who was assigned the procedure looked at the MRI and said, “I’m not doing this procedure until I see a clear MRI.”

Surgeons create ‘maps’ of the surgeries they perform in situations like this in order to make sure that the patient is safe during the procedure. They don’t start blindly cutting into a joint, doing so would be far too risky for the patient.

Also, hip surgeries are very complicated. Surgeons are far more cautious with hips than knees because the femoral artery runs through the hip. Accidentally cutting this artery would lead to death as the femoral artery is the primary bloody supply for the legs.

As time passed and the swelling decreased, another MRI would have been taken; this MRI would have shown that the first MRI, clouded by the swelling, masked the lack of a tear in JVR’s hip. The doctors would have looked at the new clean MRI and then determined that surgery would have been unnecessary.

 

Matt Bernot is currently working on a Master's Degree in Neuroscience-Psychology with a Bachelor's Degree in Psychology concentrating in Neuroscience and Concussion Research. In addition to writing for TCL, he is a Student Researcher working at researching different treatments for concussions.