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St. Paul, Minn. — After monitoring his workouts in Florida, Twins General Manager Terry Ryan says indications are that Joe Mauer will be ready to go by the start of spring training.
"He's back from Florida and he's done well. He's passed almost every exam that we've given him. He's passed the field exams, so there's, at this point in December, every reason to believe that he'll be ready to go 100 percent at Fort Meyers in February," according to Ryan.
Ryan and the Twins are eager to get Mauer back in the lineup. He has been considered the future star of the franchise since the Twins made him the first overall pick in the 2001 amateur draft. And in just 35 games in 2004 he demonstrated his enormous potential. Mauer's strong throwing arm and ability to handle pitchers make him an outstanding defensive catcher. On offense, he batted .308, showed home-run power and the kind of discipline as a hitter not normally seen in player who is only 21 years old.
But his season was cut short when he injured his left knee while sliding to catch a foul pop up in the Metrodome. Mauer apparently caught his shoe on the stiff plastic warning track at the edge of the Metrodome playing surface. The diagnosis was a torn medial meniscus.
Dr. Rob LaPrade, a leading knee specialist at the University of Minnesota, says the meniscus helps protect the knee joint from injury.
"The meniscus is the shock absorber for the joint. The medial meniscus takes up 50 percent of the shock of the inside part of the knee and it doesn't have a blood supply," he says.
The meniscus protects the thin strips of cartilage on the ends of the bones that come together in the knee. If the cartilage is damaged, the bones can rub against each other, causing pain, swelling and loss of flexibility. This condition, which can be debilitating, is known as osteoarthritis. LaPrade says when doctors operate on a torn meniscus, they hope it can be repaired.
It's (arthritis) a long way down the road and probably post playing for the kid and I don't think that's an issue while he's playing.
"Ideally, we want to try to repair the meniscus because everybody who has a piece taken out will have a higher risk of arthritis, but there are just times when we just can't repair it," he says. "It'll be so torn up that you can't actually put sutures in it, so about ten percent of the time we can actually do a repair. We'll put some sutures in and try to make the meniscus heal or least keep it stable in place and the rest of the time it's so torn that we really can't do anything about it so we have resect out and cut out the bad portion of the meniscus which is causing the pain and the part that's torn."
When doctors operated on Mauer's knee on April 8, they determined the damage was too severe to repair, so they removed what they described as a moderate to large piece of his medial meniscus. Dr. LaPrade says when a substantial part of the miniscus is removed, that puts extra stress on the knee.
"If you have a large tear that needs to be taken out, there's a very large risk that you'll develop arthritis. Most people who have a significant tear taken out within 20 years will develop significant arthritis in that side of the joint," according to LaPrade.
Twins GM Terry Ryan says he is aware that Mauer is likely to develop arthritis.
"I think that is an accurate statement, but it's 15, 20 years down the road. Our people have said about the same thing, but it's a long way down the road and probably post playing for the kid and I don't think that's an issue while he's playing," says Ryan.
But LaPrade says that after a meniscus injury, arthritis can develop quite quickly.
"The problem that happens is that we don't know whether somebody will get problems within a few months which we see very commonly in young people or whether it will take years to develop."
Two months after his surgery last year, Mauer returned to the Twins lineup, but a month later, after he stopped taking anti-inflamatory drugs, the knee pain returned. LaPrade says pain and swelling can be a warning sign.
"So if somebody has their meniscus taken out, say they're an athlete and they have a big meniscus tear and they start to have pain and swelling when they go back to activities, there has to be a red flag there that they're having some arthritis develop already. Over time what will happen is your body will form some bone spurs and actually limit the amount of motion you have. So you will get stiffer over time," LaPrade says.
Another factor is the position that Mauer plays. Catchers spend a lot of time squatting and LaPrade says that puts extra stress on the knees.
"The biggest amount of stress that we'll put on a knee is with maximal squatting and that's where the meniscus actually gets the highest rate of being pinched. So, if you're a catcher and you don't have your meniscus, you put so much extra stress across your knee that it really increases the risk of arthritis and it can accelerate the risk of arthritis because you've had a meniscus taken out," he says.
In addition, Mauer is 6' 4" which is tall for a catcher. Those long legs put extra stress on his knees when he squats and so does the artificial surface at the Metrodome.
Studies have shown that being a catcher can shorten a player's career by up to 30 percent, but the Twins say they have no plans to move Mauer to another position in hopes of extending his career. Terry Ryan says he thinks Mauer is the kind of player who will be able to catch for a long time.
"Catching is a tough position, but there are also people out there that have caught for 20-plus years and people a lot bigger than Joe Mauer. So I think it can be done, but you have to have health and you have to have luck. And Joe's such a good athlete and a great worker. I think he would be one of the types of guys that could catch a long time."
Mauer and the Twins plan to begin testing that theory when they start training camp in February.