JASON Culina will undergo the same surgical procedure that saved Manly fullback Brett Stewart’s NRL career.
A frustrated and ‘‘devastated’’ Culina confirmed yesterday that he would have a knee osteotomy in Sydney next week to realign his bowed left leg and insisted that it was to alleviate a problem unrelated to the surgery he had on his left knee in January.
The 31-year-old Socceroo said the osteotomy, to be performed by orthopaedic surgeon Leo Pinczewski, the same surgeon who operated on him in January, was a ‘‘last resort’’.
‘‘I’m going to align my leg so it aligns right with the knee and puts a good load through the knee. It is a straightening, yes,’’ Culina said.
The Newcastle Herald has been told that when Pinczewski operated on Culina in January he repaired an osteochondral defect, or a bone lesion, in the knuckle of the knee joint.
In performing that procedure, the surgeon generally treats the lesion then creates microfractures at the end of the bone to stimulate blood flow and bone marrow production. That leads to the creation of cartilage to fill up the ulcerated area.
Melbourne-based orthopaedic surgeon Julian Feller, whom Culina saw two weeks ago for another opinion, said the usual recovery period from such a procedure was three to six months.
Stressing that he was speaking generally, and not specifically about Culina, Feller said it was ‘‘not unusual’’ for patients who had an osteochondral defect repaired surgically to then require an osteotomy ‘‘but variable, and also different types of operations may be required’’.
Feller said osteochondral defects in knees could ‘‘occur with all shapes, sizes and alignments’’, and were ‘‘more difficult to treat if associated with bowed legs or knock knees’’.
He said osteotomies were ‘‘not commonly done in people still playing elite sport’’ and a ‘‘decision to proceed with an osteotomy would be on the basis that they can’t play without it, so nothing to lose, and a good chance of being able to return to their sport’’.
The Herald has been told Pinczewski performed an osteotomy to realign Stewart’s left leg after the former NSW and Australian representative suffered cartilage damage in his knee in the first game of the 2010 NRL season.
Apart from confirming torn cartilage, scans revealed osteochondral lesions in Stewart’s knee.
According to sources, after consultation with Pinczewski and Manly’s medical staff, Stewart had an osteotomy. Though he did not play again last season, Stewart, now 26, has since made a successful return and will play for the Sea Eagles in their preliminary final against Brisbane at the Sydney Football Stadium tomorrow.
Jets chief executive Robbie Middleby would not reveal details but said the A-League club were aware of other athletes who had made successful returns after the same surgery.
‘‘We’ve looked at every angle possible and sat down with Jason on many occasions in the last couple of weeks and talked through what’s going to happen with this procedure, and we as a club, and Jason himself, think this is the best way to go forward and get him back on the park as quick as possible,’’ Middleby said.
‘‘There is quite a bit of research that some very influential sports people have come back from this operation, so we’re happy with that.
‘‘I don’t want to give certain names, because it’s confidential, but I’ve been honest the whole way through. We’ve done our research and these players have come back, so we’re confident.’’
Culina said he had exhausted all other options since limping off the training paddock on August 30, a day before he intended making his first appearance for the Jets in a trial in Wollongong.
On Tuesday last week, the Jets announced Culina intended having injections of his own platelet-rich plasma to expedite the healing process, but those plans were shelved after further consultation with medical staff in the past week.
‘‘We went through all the options, we’ve tried everything, and this was the last resort,’’ Culina said.
‘‘Playing football is what I do best and having surgery is something that is probably last on your list. We did go through all the other options and unfortunately this has been the outcome.’’
Culina said he always felt confident of making a successful return from the surgery he had in January, until feeling a ‘‘different’’ kind of pain at training on August 30.
‘‘When I look at my rehab, I can tick every box and say I’ve done that properly,’’ he said.
‘‘It’s taken me eight months to get to where I am ... I was in top shape and I felt really, really good, and nothing was holding me back, but unfortunately something like this has happened.
‘‘I started to feel some pain ... it’s something different, it’s not the same injury, it’s not a recurrence of the old one, it’s something new, it’s an alignment issue with my knee.
‘‘ ... It’s not something we’ve rushed into. It’s been a few weeks now since it first occurred, but unfortunately those things haven’t worked.’’
Former Knights rugby league captain Paul Harragon suffered from an osteochondral defect in the final years of his career and had to retire in 1999 at the age of 30.
Harragon’s left knee had degenerated to the point where there was insufficient articular cartilage remaining and the joint had worn down to bone rubbing against bone.