Two weeks ago, Rob Gronkowski was all smiles while showing off a scar that ran the length of his forearm. He seemed optimistic that he would be cleared for full workouts this month. I wrote that I thought his optimism was reasonable, specifically noting that:

Post-surgical infections can be severe, but there have been no reports that Gronkowski needed to have his surgical plates removed or exchanged or that he needed repeated procedures to clear the infection.

Gronkowski’s infection is reportedly more concerning than he let on last month. (photo by AngieSix)

This morning, a report from Ron Borges and Karen Guregian of the Boston Herald noted that all of the above (and more) may be necessary. It’s more than enough to put an end to the optimism I expressed last month.

Borges and Guregian reported that there are fears Gronkowski’s infection has not cleared despite a six week course of antibiotics and that surgeons may need to operate a fourth time to remove the plate stabilizing his arm bone to treat the infection.

This isn’t uncommon when an infection occurs after surgery to fix a broken arm. Once an infection occurs around surgical hardware, it’s very difficult to clear. Bacteria tightly adhere to the surface of the metal plate. Antibiotics won’t fully clear the infection, because they can’t get from the blood vessels in the surrounding tissues to the plate.

But surgeons don’t want to remove the surgical plate before the bone heals. So they use antibiotics to buy time. The hope is that the antibiotics prevent the infection from spreading to the bone itself — which is also difficult to treat — while the infected plate continues to stabilize the bone and allow it to heal. Once the bone heals, the plate is removed and the infection is easier to clear.

The Herald report further states that surgeons may not be able to replace the plate right away if the surrounding tissue (read: the fractured bone) is infected. In that worst case scenario, Gronkowski could need an additional 10 weeks of recovery time once the tissue infection clears and it’s safe to replace the plate.

It’s this critical – and bothersome – piece of information that stands out in the report.

It’s been nearly 12 weeks since Gronkowski had surgery to fix his forearm after it was rebroken in early January. Though Gronkowski’s recovery has been complicated, that’s usually enough time for good bone healing to occur. Why then would Gronkowski need the plate replaced and need another 10 or more weeks of healing?

According to an orthopedic surgeon I spoke with today, such a scenario would likely mean that the infection spread to the bone near the fracture site and that Gronkowski’s bone hasn’t healed yet. Surgeons would then treat the injury like a new fracture and restart the rehab process from the point at which the hardware is replaced.

Let me emphasize that it’s not yet known if this is what has happened here. Surgeons will need to examine the hardware and surrounding bone before making that determination. But it’s not a good sign that the possibility is on the table.

It’s still possible that Gronkowski’s hardware won’t need to be exchanged and he’ll be able to return to workouts this summer. But if it’s decided that the bone will not heal properly without removing the hardware, Gronkowski could be looking at another six weeks of antibiotics before the hardware can be replaced and his rehab can start over once again.

In total, then, Gronkowski could be facing a minimum of four more months before being cleared for contact.

And that means Gronkowski’s progress may soon rival Robert Griffin III’s recovery as the major injury story of the offseason.

Categories: Injury Updates

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