One year ago, Brook Lopez was a first-time All-Star for the Nets, recently signed to a four-year, $60 million contract.
But now, one week away from the NBA’s annual All-Star bash, Lopez is recuperating from his fourth surgical procedure on his right foot.
There are reasons for optimism. But there are reasons for caution.
For Yao Ming, Houston’s 7-foot-6 All-Star center, the NBA became a succession of injuries and surgeries on his left foot and ankle. There was a bone spur, toe inflammation, fractures to foot and ankle. Yao retired in July, 2011 after missing 250 games in his last six seasons.
Zydrunas Ilgauskas, Cleveland’s 7-foot-3 center, had run out of options. He had several operations on his twice-broken left foot before he underwent a procedure in 1999 when doctors reshaped his foot. Ilgauskas played 10 more seasons with the Cavaliers and Heat and was an All-Star twice.
Lopez, at 7-0, underwent surgery again in January. Doctors reconstructed his foot to re-distribute the weight and the pounding he sustains. There are absolutely no guarantees but Lopez is stridently optimistic.
“It’s going to work,” Lopez said this week in his first public comments since his Jan. 4 operation. “I’m definitely thinking that way. Some people say, ‘If this doesn’t work …’ I won’t think that. I’m definitely thinking the other way.”
So are surgeons and the Nets, despite Lopez’s history. Lopez broke his foot in December of the 2011-12 lockout season. He returned, played five games and sprained his ankle. Doctors discovered a hairline crack near the screw from his first surgery. Another procedure followed, then another to replace the screw.
So forgive those who harbor pessimism after Lopez broke his foot again Dec. 20. But there is legitimate hope this is not a last call.
“You always come up with another plan to get him to heal. But this is the best option for now,” said Dr. Jonathan Deland, the co-chief of the Foot and Ankle Service at Hospital for Special Surgery. “It’s not like if it doesn’t, you could never get it to heal. It would mean it’s a tougher case. So you put everything into getting this one to heal.”
Given Ilgauskas’ history, which involved a similar procedure, there is cause of optimism. But then you might consider Yao.
“Put it this way, if this doesn’t work, there’s really no ‘Plan C,’ ” said Dr. Andrew Brief, an orthopedic foot and ankle surgeon with the Ridgewood (N.J.) Orthopedic Group. “That being said, the expectation is it will work. But there aren’t that many other options after this.”
In nutshell form, the procedure is “not just a fixation of the fracture, it’s a total reconstruction of the foot to balance the mechanics better so it’s less likely to occur,” Brief said.
Lopez plans to be ready for training camp. At the moment, the man who played every game in his first three seasons is just looking to get out of the house. Before attending Thursday’s game, Lopez, in a walking boot and on crutches, had been outside twice since his surgery.
“Both times for doctor’s visits,” said Lopez, who will have new sneakers custom made. “They’re going to take new molds of my foot and then build my shoes.”
So as Lopez heals, doing what rehab he can, one other big man who endured ankle/foot miseries offered some advice.
“Never compare injuries, never compare body types and situations,” Hall of Famer Bill Walton said. “I’ve known Brook since he was young. … He played all the time his first three seasons, so he’s proven that he can get it done.
What has changed? Are these impact injuries? Are they stress fractures?
“I had a structural cognitive defect and my feet just broke,” Walton said. “The more I played, they would just ultimately break and I eventually ground my feet into dust. Both my ankles are fused now. But it’s wrong to compare careers, injuries. Every person is absolutely unique.”
That’s why, while there is genuine optimism for Lopez, there are no assurances. You buy a car, it runs. It may break down. You get it fixed. But it may break down again. After Lopez re-broke the fifth metatarsal bone (on the outside) surgeons performed a procedure that included a “first metatarsal osteotomy.” First, they fixed the fracture. Then they attacked the alignment that caused Lopez to run and place pressure on the outside of the foot.
“If the foot is not even, if the first metatarsal — the bone that is on the ball of the foot, where the big toe meets the foot — if that bone is down too far, then when you hit the ground, it causes you to shift weight over to the outside, to the fifth metatarsal where that fracture is,” said Deland, who also is the foot and ankle specialist for the Mets.
So one bone was realigned to ease the stress on the fractured bone and decrease the chance of re-injury.
“You make the bottom of the foot even. … What was done, I believe, was to bring the first metatarsal up a little bit to make it even with the other metatarsals on the bottom of the foot,” Deland said.
Lopez’s procedure was performed by Dr. James Nunley, Duke University Medical Center’s department chair of Orthopedic Surgery; Nets’ foot and ankle specialist Dr. Martin O’Malley; and team medical director Dr. Riley Williams III.
“You had an All-Star team operating on him,” Brief said.
So the Nets are confident their starting center in 2014-15 with be the guy they drafted No. 10 out of Stanford in 2008.
Nets general manager Billy King enlisted advice from a battery of doctors before all involved agreed the best course was deleting the pressure. As frustrating as it is for King to have an All-Star big man on the sidelines, it is worse for Lopez.
“The frustration factor is more for Brook, rather than us as an organization or me as the general manager, because he’s such a good friend and he worked so hard to get back,” King said.
Jeff Van Gundy — the former Knicks and Rockets head coach, now an ESPN and ABC color commentator — lived through Yao’s early recoveries in Houston.
“The most troubling part of recurring injuries is where a guy gets hurt and he’s recovered and you’re always fearful of the reoccurrence of stress fractures, particularly to big players who do so much with the weight and the pounding they take,” Van Gundy said. “You’re trying to always pace that player correctly. It may not be a player who can go through every repetition in practice. … And a post player is a very dependent position, and you have, not so much a guy getting his rhythm back, but a team getting their rhythm back about how to play off him.”
With the Nets turning the season around even without Lopez, there have been trade whispers. King recently maintained the Nets are not shopping Lopez, but the team must listen to offers.
One opposing Eastern executive said he believes a trade of Lopez is unlikely, because the Nets would have to sell low.
The executive insisted there would be an eager, but cautious, Lopez market.
“There is a market for him, but [the Nets] would get hit over the head. The only way teams are going to be interested is if they have all the in-depth knowledge of his foot,” the executive said. “If they get a positive answer, then they might go in after him. But even at that, they’re going to try to get him for what their price is, not what Brooklyn wants.”
Rumors aside, healing the fracture is “the biggest challenge he’ll face,” said Deland. Forecasting the probability of Lopez being ready for training camp, Deland offered, “I’d say very good chance.”
What about Lopez’s size?
“It plays into it significantly, and there is a historical precedent,” said Brief, citing Yao and Walton, who “underwent so many reconstructive surgeries that … this was a career-ending injury.
“It’s not a failure of the technique or the surgeons so much as it is, mechanically, those 7-foot athletes are prone to those injuries recurring,” Brief said. “It in no way reflects a bad decision by the surgeons involved. It was just Brook Lopez’s foot.”
Walton predicted an emotional down time for Lopez. But he insisted a huge ally is Nets owner Mikhail Prokhorov.
“This is where playing for a great owner like Prokhorov, who is willing to do whatever it takes to get the job done, is beneficial,” Walton said. “Brook will go through all the emotions of, ‘This is my fault, I’m letting the team down.’
“You can’t panic, can’t go crazy and start blaming everybody. You’ve got to get healthy,” Walton said. “Nobody can predict health.”