Julio Jones confirmed in an interview with Pete Prisco last week that he broke the screw that was inserted to fix a stress fracture in his foot in 2011. Stress fractures, broken surgical screws and multiple injuries to the same foot are worrisome, especially for a player known for his elite combination of power and speed.
Not surprisingly, the most common question I've seen in my email inbox and Twitter mentions since January is some variation of the following:
@JeneBramel any thoughts on Julio's foot - reinjury risk, increase risk of different injury, etc?— Sartman Bearfan (@sartmanbearfan) June 16, 2014
For many reasons, I'm often forced to speculate on the recovery timetable and risk of re-injury for NFL players. It's rare to see information about a player's surgical procedure reported in the media, even in the offseason.
However, Jones shared much about his October foot surgery in the above interview, telling Prisco that foot surgeon Dr. Robert Anderson "put in a large screw, a six" and took bone marrow from his hip to aid in healing. Those are two very specific -- and helpful -- details.
It's even less common to have access to good prognostic data, as procedures and rehab protocols are always changing for elite athletes. And it's impossible to find an article in the medical journals about the same procedure performed on the same complication by the same surgeon on a comparable patient population published in the past five years.
But that's exactly what we have in this case, with a journal article authored by Dr. Anderson specifically addressing this particular procedure.
It's a study I've referenced before when discussing the recoveries of Hakeem Nicks and Ahmad Bradshaw from similar injuries. Anderson's article describes the outcomes of 21 elite athletes (including 12 football players) who had a surgical procedure to replace their previous screw with a larger screw (usually in the 5.5 mm - 6.5 mm range) because of poor healing or re-injury, as Jones did. All 21 players in the study also underwent a bone graft procedure similar to the one Jones had.
Anderson's series reported the following results:
- Average return to sport was 12.3 weeks, with a range of 6-16 weeks.
- All fractures showed evidence of complete healing on imaging studies within four months.
- Only one patient suffered a refracture -- in a car accident.
- All athletes were able to return to their previous level of athletic participation.
Those results were significantly different from prior studies that showed multiple failures of smaller screws used in repeat surgeries in elite athletes. If Jones' recovery mirrors the majority of patients in Anderson's study, his prognosis looks to be very favorable.
Of course, that conclusion comes with the usual caveats. 21 patients is a relatively small sample size over an eight year study period (2003-2010). It's also retrospective, meaning that it can't be universally applied to every future case.
Limitations aside, the study paints a very promising picture for Jones' future. Should he avoid a re-conditioning or cascade injury -- an outcome Jones is trying hard to prevent by improving the strength and balance in his leg muscles -- it's reasonable to expect him to be at full strength during the early days of training camp and in full form for opening weekend.
Follow on Twitter @JeneBramel for breaking injury news, commentary and analysis of this injury and others around the NFL.
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Monday Injury Rounds: Week 16 - December 15
Gameday Injury Expectations: Week 15 - December 14
Sunday IDP Notes: Week 15 - December 14