When the sports world found out that Alabama star quarterback Tua Tagovailoa had not only dislocated his hip, but also broke the back wall of the hip socket, thoughts immediately turned to the worst-case scenario. Three ugly, little letters came to mind: AVN.
Avascular necrosis is when, due to the lack of blood flow, the bone tissue dies. It is what ended Bo Jackson's career, and immediate panic set in that the potential top pick could suffer the same fate. With that in mind, Tagovailoa's surgeon had a message for the player's family.
From Dr. Chip Routt of The University of Texas Health Science Center at Houston, it was this: Tua is more likely to get mauled by a bear than get AVN, sources say Routt told the family. In other words, this was far from worst-case.
With Tagovailoa expected to make a full recovery, it's worth noting he has not yet made a decision about his future, sources say. One consideration is returning to school even if that doesn't including playing. Another, of course, is entering the draft.
If he does, according to five high-ranking executives, Tagovailoa is still expected to be taken in the first round, with all believing he'll end up in the first half of the round. He may not be the top-three pick he was slated to be before the injury, but the fall from the ailment is not expected to be catastrophic -- pending the results of his medical evaluations.
Tua's health figures to be one of the biggest stories of the offseason.
"We lost a great leader, a great player on our team and we're all hurting because of it," coach Nick Saban has said of his quarterback, who also broke his nose. "We're pleased that the surgery went successfully and they expect him to have a full recovery."
In fact, when Alabama team doctor and respected physician Dr. Lyle Cain announced Tagovailoa would fully recover, it was backed up by a mountain of evidence and the word of one of the world's experts in trauma surgery. That would be Routt, who was the consensus recommendation to perform the surgery because Tua's injury resembled one encountered in a motor vehicle accident or serious trauma as opposed to football.
Some of the best work was done on the scene, as Tua's hip was immediately reduced in the stadium. As another expert surgeon said, if the hip is reduced within six hours, the risk of AVN is about 5 percent. That's Tua.
It was a rare injury for 'Bama, with the only dislocated hip in recent memory coming from former Alabama star and now Jets linebacker C.J. Mosley, who did it in the 2011 national title game (but didn't break the socket) and was fine by the next season. It hasn't affected him since.
For Tua, the game was Saturday, he flew out Sunday morning from Birmingham to Houston, and Routt fixed it. Surgery went as well as possible, sources say. The view was that AVN was extremely rare and highly unlikely. It was all positive, even with the catastrophic injury.
Based on the protocol from Routt, the first six weeks should feature extremely limited activity, sources say. The goal is simply for the fracture to heal like any other break, and then he'll have tests and scans to make sure that's happened.
Then it's on the rehab train, working on range of motion and weight-bearing activities. After six weeks of rehab, if he's feeling good and progressing, it's on to football activities at three months overall.
He could be running and throwing, or at least sedentary throwing. The goal, sources say, is to be throwing from the early-to-mid-spring, then see how his body responds. It's even possible Tagovailoa could throw for teams before the draft (if he declares) if that's something that makes sense for him. There are, obviously, possible what-ifs. If the bone doesn't heal quickly, it puts progress off. But throwing for teams before the draft is not physically impossible. There is a 25 percent chance he has arthritis later in life, but no one is worried about that now.
If Tagovailoa does declare for the draft, and his prognosis continues to be positive, it now seems likely he'll only have slipped a few spots, top evaluators say.
At this point, LSU quarterback Joe Burrow is in the running to be the top QB taken, with Oregon's Justin Herbert having a shot, as well. Tagovailoa was in the mix, too, though probably not now with the injury.
That said, none of the personnel executives polled believe he falls out of the first round. One said the best-case scenario for Tua is to go late in the first round to a team with a veteran QB already. Another said the sweet spot is picks 10 to 12, with someone trading up to take him. Another said the injury history affects him, but in this QB-needy league, not enough for him to fall out of the first day.
A small sample, but a consensus. That said, it's a rare injury, and teams will put the onus on finding out key information on his status. The fact that Routt believes Tua is in good shape with a low risk will likely weigh heavily.
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