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Sims: Breaking Down Kobe Bryant's Knee Injury

By Abby Sims
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When Kobe Bryant returned to the court on December 8 following months of rehab on the repaired left Achilles he'd torn in April, he did so confidently – at least in words. In actions, not so much.

The 35–year-old was clearly a different player and it didn't take a trained eye to see that it wasn't just about the numbers he put up. Bryant avoided going airborne and when his feet left the ground he pushed off and landed primarily on his right. His quickness and agility were impaired. The $24-million man may have felt OK, but if function gives us a window into the degree of recovery, he had a ways to go.

After playing in only six games, averaging 13.8 points, 6.3 assists and 4.3 rebounds, the Lakers announced today that Bryant will be out for six weeks with a fracture in his lateral left tibial plateau. It was reported that Bryant twisted the knee in Tuesday's game and complained of subsequent stiffness.

Though his newest injury could be a fluke – something that may have happened regardless – one can't help but think that Kobe remained vulnerable.  His left lower extremity was a target because it was not entirely up to speed, and the right because he was relying on that side to carry his game.

More about tibial plateau fractures:

There are two concave condylar surfaces at the uppermost portion of the tibia – one is the medial (inner) tibial plateau and the other is the lateral (outer). The tibia is the larger of the two bones in the lower leg, and the top portion serves as the base of the knee joint.  This is an area important for weight-bearing through the lower extremity. The medial and lateral plateaus are separated by a prominent peak known as the intercondylar eminence that fits like a puzzle piece – though allowing for adequate joint space – with a corresponding notch at the base of the femur above.

(View image of a lateral tibial plateau fracture here.)

Though tibial plateau fractures can disrupt soft tissues at the knee joint, they are often isolated injuries. According to Wheeless' Textbook of Orthopaedics, 60 percent of tibial plateau fractures are, like Kobe's, exclusively on the lateral side. Studies have shown that 25 percent occur to both medial and lateral plateaus – referred to as bicondylar fractures. There are six different classifications of plateau fractures, some of which require operative management.

Fortunately, it appears that Kobe will escape the knife this time, though six weeks out is likely best-case scenario. With weakness from disuse likely to occur once again in his left leg, Kobe may need more time to restore the level of function he demonstrated just prior to this setback. Keep in mind that even his prior strength was not sufficient to protect him from injury, and his age is working against him. Don't look for the old Kobe Bryant to return any time soon.

Note: Apologies for my absence of late. I am recovering from a fractured wrist!

Happy, healthy holidays and New Year to all!

Follow Abby on Twitter at @abcsims

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