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Tua Tagovailoa Injury: Surgeon's Expert Insight on Dislocated Hip, Surgery, Rehabilitation, Prospects and More


The College Football Playoff and NFL Draft Landscape 2020 took unexpected turns this weekend when Alabama quarterback Tua Tagovailoa suffered a devastating season-ending hip injury. The injury, an offset hip with a crack in the back wall, occurred with 3:01 left before halftime of the Crimson Tide & # 39; s game against Mississippi State. The quarterback rolled to the left and was tracked by two Bulldogs defenders, who landed with all their body weight on top of Tagovailoa.

Coach Nick Saban revealed after the game that it was supposed to be Tagovailoo's last unit of the game – Alabama led 35-7 at the time – but he wanted to give him more exposure to two-minute crime scenarios.

In a statement after the game, the orthopedic surgeon, the Alabama team gave Dr. Lyle Cain, an early forecast: "Tua Tagovailoa received a right-sided offset that was immediately reduced at the stadium. He is undergoing further testing to determine the best treatment. Expected to make a full recovery but will miss the rest of the season."

This is a complex injury with some obstacles left for Tagovailoa before he can return to the pitch. As such, CBS Sports spoke with Dr. Louis Levitt, who serves as vice president and secretary of The Centers for Advanced Orthopedics in Washington, D.C.

"The problem is that we as laymen do not really know the extent of his injury. The injury itself is one of the few real orthopedic emergencies; it is short to break a bone and have the bones stick out through the skin, which did not happen – that was it [Joe] Theisman injury – for example, "Levitt explained.

"This was the case, when you shift your hip, that you have a limited amount of time to get the hip joint back into the socket because you compromise the blood flow to the ball in the ball and the socket, why the reason for the helicopter to get him to a reasonable trauma center so that they could have the hip joint reduced, Levitt continued.

"When the hip is back in the socket, probably perfectly in line with the socket – and I probably say too [that] we don't know – sometimes when you pull the ball back into the socket you catch some bone fragments. Therefore, you cannot leave it that way. You have to go in surgically and remove the bone fragments.

"When the ball is back in the socket again, through various tests you have to evaluate the extent to which the socket is damaged and what you would need to do to stabilize the socket. Often, the most common form of this movement is to remove part of the socket when the ball is released . "

Levitt said this type of injury is unusual and generally associated with violent car accidents.

"It takes tremendous power to move a hip in a young player like this. These are usually car accidents that push the leg into the socket and then out of the socket. Often you break the plinth in this," Levitt said. "I would speculate that he will more than likely require surgical intervention to at least stabilize the socket: plates and screws to put the pieces back. It's all speculation because we really don't know the extent of the injury."

Tagovailoa will miss the rest of the 2019 season and possibly the entire 2020 season. Many wonder if he will ever play football – at any level – again.

"The recovery for this, even in a young healthy guy, is 6-12 months. I tend to make mistakes on the side of 12 months," Levitt said. "Let's say that everything goes perfectly and that they can restore the anatomy, the bone heals and that he can start his rehabilitation process. The other problem you have with regard to months ahead is if the blood supply to the ball has been compromised. to die.

"That's why we give you Bo Jackson's story of why he ended up with avascular necrosis or AVN to his thigh head because he lost the blood supply. You can simply get a transfer, get it back quickly and lose the blood supply. You can not compromise with the blood supply, but when you go to repair the socket, you might actually have to pull the ball down or even loosen the hip again when you repair the socket and that compromises an already challenged blood supply. It's like two phases. Can they anatomically reconstruct his hip, let it heal "And will he then be subjected to some form of deformity in the ball that will lead him to severe arthritis and potentially hip replacement in the future like Bo Jackson?"

The damage occurred around 10 p.m. 13:30. ET on Saturday. Next week's events will be kept confidential but Levitt offered his expectations.

"I think [as of late Sunday morning] they judge him. They probably run a CAT scan because it is the best way to look at the bone and they assess the soft tissue damage. Then they will decide – probably in a good trauma center, sooner rather than later – [when] to go in and repair, "Levitt said." I suspect it would be anywhere from 48 hours to a week. Not every trauma center has doctors or orthopedics on board that are easy to do this type of deep pelvic reconstruction. They may need to move him again. If he is in a place that is a Level 1 trauma center where they do pelvic work, it would not surprise me if he does not perform surgery within 48-72 hours. "

There may also be neurological problems that result from the injury.

"Then it's about letting the wound heal, praying that he doesn't get an infection; he's young and healthy, hopefully he wouldn't do it. Then it's the rehabilitation process," Levitt said.

"I talked about one of the complications was that he loses blood supply and the ball dies in the long run – long term is within a year, it's not years, you will know that within a year. The other potential complication is that we don't know if he has any neurological damage. They will know that when they assess him … They will start the reconstruction and get him upright. They will not let him put any weight on it, but they will start him moving quite early. "

Some injuries leave athletes more susceptible to suffering a similar injury in the future. Levitt says Tagovailoa will not be more vulnerable to a second dislocated hip than he was before Saturday's game.

"It's so rare. When you see all the major car accidents and sports injuries, it's really rare. The chances of him being back in the same situation again are so rare. Because he had cracked the first time, if it heals with the plate and the screws in place are it's actually a stronger outlet in some respects, so I think his risks aren't made greater because he had the offense. This really is the case in high end athletes, "Levitt said.

"Bo Jackson played professional baseball after getting a hip change, and everyone thought it was the best thing since slicing bread. He probably puts back hipsters by about a decade because everyone thought they could go to the level to play professional ball. Jackson's hip loosened after 3-4 years and he had to have a second hip replacement and never recovered after that.

"That's why you hope, the perfect scenario, the ball is back in the socket, there are no loose fragments in the socket, it's a single piece of the socket that can easily be put back. He gets no complications and then, if all the gods are lit down on him, he can probably come back to playing and retaining his professional potential within a year. "

If everything goes in line with the operation, the focus is then shifted to the rehabilitation process.

"They will wait until his leg heals. What they will do, they will gently bend and extend his hip with minimal rotation on the hip. They can begin with it within ten days of the surgery. They probably won't let him lay full weight on this for at least 8-12 weeks, then they will put him in a pool early when the wound heals to put him in a non-gravity environment and then land-based exercises really start to accelerate between 3-6 months. him make the impact or swing sport too easy, I would guess 4-6 months. "

As a junior, Tagovailoa faces the choice to either return to Alabama for his high season or depart early for the 2020 NFL Draft. The deadline to declare is January 20, which would mean that the Hawaii native would be about two months into a potentially year-long recovery process.

There are many variables in the game, but Levitt said he would probably recommend Tagovailoa to sit out throughout the 2020 season, whether he is college or professional.

"He has a lot of obstacles in front of him. … I would make a mistake on the part of this young fellow who is conservative. Maybe I should keep him out," Levitt noted, citing how conservative Washington citizens were with the time for star recovery. pitcher Stephen Strasburg.

Most high school students have insurance for loss of value as a protection for loss of potential income in the event of a catastrophic injury. It is believed that Tagovailoa has such insurance.

Reasonably, the NFL team will have a hard time choosing him where he had been projected – the top five picks in the 2020 NFL Draft – based on unknowns for his injury. It would be neither a surprise nor a bad decision if he chooses to return to his peak season simply to sit out, heal and prepare to throw and train before the 2021 NFL Draft.

His brother, Taulia Tagovailoa, is a starting quarterback at Alabama.

The older Tagovailoa had already missed a game this season with an ankle injury, for which he underwent a tough rope. It was similar to the injury he suffered prior to the SEC SEC Championship Game 2018. He finished the year after completing 180-of-252 passes for 2,840 yards, 33 touchdowns and three interceptions.

Alabama turned to backup QB Mac Jones when Tagovailoa left the field. The Crimson Tide remains part of the College Football Playoff conversation with two remaining games, including an Iron Bowl showdown at Auburn this past week. Jones has completed 45 of 65 passes for 566 yards, four touchdowns and one interception this season.

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