Maurice Jones-Drew

Maurice Jones-Drew has been a consensus top four running back and fantasy selection this offseason. He's one of what has become the rarest of fantasy commodities, the true every-down back that contributes between the tackles, as a receiver out of the backfield and at the goal line. After multiple missed practices and a rumored surgical procedure on his left knee, Jones-Drew's status as a slam dunk top five fantasy pick is rightfully in question.

What's the injury?

Aaron Wilson and Jay Glazer both reported that Jones-Drew's injury was to the meniscus in his left knee and Glazer reported that it was the lateral meniscus that is the source of Jones-Drew's pain. After the rumors of a possible arthroscopic surgical procedure broke, Jones-Drew's agent immediately and emphatically denied the report, as did coach Jack Del Rio earlier this week.

The menisci are often described as the shock absorbers of the knee, a Dr. Scholl's gel insert of sorts. But they are much more than that. In addition to cushioning, adding lubrication to and distributing the load put on the knee joint, the two curved, cartilage-like structures on both the inside (medial) and outside (lateral) of the knee joint are also important in stabilizing the knee and providing nutrition to other cartilage on top of the thigh bone and shin bone. Meniscal tears can happen after a hit or a non-contact twisting motion. Athletes commonly complain of pain, stiffness and a catching, locking or pinching sensation after a tear, as fragments of the meniscus move around inside the joint.

Jones-Drew's condition has been described as lingering and as a “balky" knee and he was frequently on the injury report in 2009 with a non-specific knee condition. I can't find any definitive indication that Jones-Drew's issues last year were meniscal in nature or even that it was his left knee that was involved, but it's being implied that this injury isn't a new injury sustained during this training camp.

What's the medical prognosis?

There's no standard meniscal tear and the prognosis is dependent on the size, location and character of the tear. Some meniscal tears may heal with rest and rehabilitation, as the tear fragments may wear down over time and stop causing symptoms. In other cases, the poor blood supply to these tissues may keep even relatively small tears from completely healing, resulting in chronic pain and the risk of a fragment dislodging and causing the joint to catch or lock.

When surgery is necessary, any damaged fragments are often removed rather than repaired. Often, the surgery is done arthroscopically (likely the clean-out process that Jones-Drew was rumored to have had) and players can return to play within 2-3 weeks. More extensive repairs may require rehabilitation for 6-12 weeks. Removing the damaged fragments rather than repairing them isn't without cost. Because the meniscal tissues do not regenerate well, the loss of load-bearing capability, cushioning, stability and nutrition of the cartilage overlying the bones of the joint itself puts the athlete at risk of degenerative changes and arthritis. It's worth noting that not repairing the damaged menisci or repairing instead of removing carries similar risk.

Any meniscal injury to a running back is concerning. In Jones-Drew's case, the possibility that this particular condition has been bothering him since early last season and recurred after a few training camp practices could be a concerning sign for his short and long term future. If last season's knee issues weren't related and reports that the current injury is minor and that Jones-Drew was seen running easily in the parking lot are accurate, there may in fact be little to worry about.

What's the fantasy prognosis?

Unfortunately, there's not enough information to know whether the 2009 injury was related to the current injury or how strongly surgical intervention may have been considered two weeks ago. If it was related, Jones-Drew clearly has the pain tolerance to put it behind him on game days, as evidenced by his 365 touches last year (over half of which came during the second half of the season). There's no guarantee that he can do the same this year, however, as any meniscal injury could change character with one unexpected twisting motion or the repetitive pounding of one game. There's certainly a risk that Jones-Drew could be limited in practice in many weeks or that he could choose to undergo the cleanout procedure and miss 1-4 games during the season.

Should you decide that the always tough Jones-Drew can play through any potential discomfort and has upside more than worth the risk with your top five pick, make sure you grab Rashad Jennings as a handcuff, and do so a round or two earlier than his ADP might suggest. I made the argument in the tier series I wrote with Sigmund Bloom earlier this summer that Frank Gore belonged in the top tier (and Michael Turner in a non-PPR) and I think I'd draft Gore over Jones-Drew right now. However, I would still lean toward risking Jones-Drew's upside and prioritizing Jennings as a handcuff at the fifth pick and certainly with any pick later than the fifth overall.

Questions, suggestions and comments are always welcome to bramel@footballguys.com.