Doc: Early detection should help Napoli's recovery

Providence (R.I.) Journal—January 25, 2013

According to his doctor, Mike Napoli’s hip condition was caught at the perfect time.

Dr. Joseph Lane of Hospital for Special Surgery has been treating Napoli this offseason. He said on Friday that Napoli’s hip injury — avascular necrosis, or AVN — has been caught early enough to prevent it from worsening.

In Napoli’s case, AVN consists of a loss of blood supply to the top of his hips, Lane said. If unrecognized or untreated, the inadequate blood supply would lead to degeneration in the bone to the point of collapse; in essence, the spherical head of the femur will no longer match the curve in the hip’s socket. Because the problem was discovered during his physical with the Red Sox in December, Napoli should be able to avoid that worst-case scenario.

“The earlier you know it, the better the chance to prevent regression and in some cases actually heal the process,” Lane said. “If you do it late, it’s just a matter of when will the hip fail. But [Napoli] doesn’t have that. It was caught, it appears, when his hip was absolutely perfectly round.”

Lane said that, with changes in his treatment, his training and his defensive position, Napoli “has a very good chance that that hip will heal and he’ll go on to a long, productive career.”

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Although the cause of Napoli’s condition isn’t clear, Lane said that’s true in about 40 percent of cases. Not knowing the exact cause can slow down the formation of a successful prevention strategy, meaning Napoli will have to be careful with, say, cortisone shots during the course of the season.

Napoli, though, is taking medication, and Lane said moving from behind the plate to first base should ease the stress placed on his hips.

“Now that they know they have this problem, he’s on drugs that will protect his hip, and in the course of time he will ultimately reestablish a blood supply there,” Lane said. “They’re going to make him into a first baseman. They’re aware they’re going to protect this person’s hip until he goes through a healing phase. And he will go through a healing phase.”

At the very least, the medication should postpone any degeneration in the hip.

“If you catch it early, a number of these will spontaneously heal. Also, the earlier you pick it, we now have drugs or tricks to treat this so that you can essentially heal this completely or slow it down so there is no collapse,” said Lane. “As long as there is no collapse in the ball, then the patient can function quite well.”

Read the full story at providencejournal.com.

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