THIS STORY HAS BEEN FORMATTED FOR EASY PRINTING

A lost cause

Welker likely out at least 6 months

Wes Welker appears despondent on the bench after injuring his left knee after making a first-quarter catch Sunday. Wes Welker appears despondent on the bench after injuring his left knee after making a first-quarter catch Sunday. (Jim Davis/Globe Staff)
By Carolyn Johnson and Adam Kilgore
Globe Staff / January 5, 2010

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For the Patriots, the day after they lost Wes Welker for the playoffs brought dual concerns. In the short term, they have to figure out how to coax points out of an offense that just lost its steadiest, most prolific, and most valuable component. In the long term, they have to wonder how long Welker’s rehab and recovery will take.

The former is more pressing for the team, but the latter is more significant for the franchise. According to a league source, Welker tore the anterior cruciate and medial collateral ligaments in his left knee, the same injury that sidelined Tom Brady for almost all of 2008. Although more information about Welker’s injury is needed to shape the parameters of his recovery, experts say Welker will play football again, maybe, if not probably, by the start of next season.

Lonnie Paulos, the Florida-based physician who performed major knee surgery on Bengals quarterback Carson Palmer, said typical rehab for Welker’s injury will take about six months.

“The recovery should be very similar to what Tom’s was,’’ Paulos said. “I would anticipate him back getting in a timely fashion. He’ll make it.’’

Most likely, Paulos said, Welker will undergo an operation to replace his ACL using a graft from the patella ten don. Common practice is to allow the MCL to heal on its own as the ACL is rehabbed. In extreme cases, such as Palmer’s, a doctor has to surgically repair the MCL, too. But because Welker suffered a non-contact injury, “you can be more optimistic’’ that a standard, ACL-only operation will suffice, Paulos said.

Orthopedic surgeons said the nature of playing wide receiver, with constant cutting and accelerating, puts more stress on the knee than positions such as quarterback. Welker sustained the same injury as Brady, but it will be more difficult for Welker to overcome.

There are still a number of unknowns - the full extent of the injury to Welker’s ligaments, and whether there is cartilage damage - but the demands of his position could extend the recovery time. Welker might return to the field by Week 1, but he may not be himself until later in the season.

“It often times will take someone like him a little longer to get back to things than someone with a more sedentary position,’’ said Dr. John Richmond, chairman of orthopedics at New England Baptist Hospital. “To really be back to full performance, to be back to where he was two days ago before the injury, often times takes a whole year.’’

Between 80 and 90 percent of quarterbacks and offensive linemen play several years after operations, but the percentage is far lower for running backs and receivers, Paulos said. That doesn’t mean Welker can’t return and play at a high level.

“It’s not the death knell for him by any means,’’ Paulos said. “Is it a career-ending situation? No. The question is for how long he’ll play and how effective. It’s definitely going to be a challenge. But he can still do it.’’

Richmond said to an orthopedic surgeon, the injury was clear from watching the video. Welker’s ACL was injured when his knee gave forward slightly, Richmond said, and then the MCL was hurt when his knee buckled and collapsed to the inside.

“You just have to watch the injury in slow motion and just say, ‘Ouch,’ ’’ Richmond said.

The ACL is one of four major ligaments in the knee, a band of tissue that stretches from the thigh bone to the shin bone to provide stability. ACL injuries are among the most common knee injuries for athletes.

The MCL also connects the thigh and shin bones, and it controls the wobble - the sideways motion of the knee. One of the most important next steps in understanding Welker’s injury will be to know the extent of the damage to the MCL. Depending on the degree of injury, doctors might have to wait until the MCL is healed before operating on the ACL, Richmond said.

Dr. Rocco Monto, an orthopedic surgeon with practices on Nantucket and Martha’s Vineyard, said a big question would be whether there was cartilage damage.

“The good news is if he does return, the NFL statistics show his career will probably not be shortened significantly - as long as he does not have a cartilage injury,’’ Monto said.

Brady knows firsthand the challenge his favorite target is facing, and knows the injury likely will be more difficult to overcome for Welker. Brady pointed out that, as a quarterback, he can wear a knee brace, a device that would inhibit Welker’s skill set.

“We’re all going to get through it,’’ Brady said yesterday during a contractually obligated appearance on WEEI. “He’s going to get through it. He’s just a fighter. You never bet against a guy like Wes, because his heart and commitment to what it takes is stronger than just about anybody else’s. I’m sure there’s going to be a day or two when he’s pissed off. Because he loves competing so much, that’s going to be the hard part for him, hopefully for the next month.’’

It’s going to be hard for the Patriots, too, for however long they remain in the playoffs. Rookie Julian Edelman caught 10 passes Sunday in Welker’s absence, and he will be the primary sub for Welker. Edelman is often compared with Welker, whom he resembles in size and frenetic athleticism.

But the comparison also demeans what Welker means to the Patriots. Last year at this time, Welker was preparing for the Pro Bowl. Edelman recently had concluded a season of playing quarterback at Kent State.

“You’re talking about a rookie who, really, it’s his first year playing the position,’’ Patriots director of player personnel Nick Caserio said.

The majority of attention to replace Welker will fall on Edelman, but the Patriots know Welker is irreplaceable. He caught 123 passes this season, the second-most all time in one season, despite missing two games and the final 52 minutes Sunday.

“You’re talking about an excellent, Pro Bowl receiver,’’ wide receiver Sam Aiken said. “It’s going to be all of us.’’

Brady tried to derive something positive out of Welker’s absence. The most common criticisms of the Patriots offense have been predictable play-calling and lack of balance, problems that became more glaring as opponents adjusted during games. The Patriots scored 282 points in the first half this season, first in the NFL. They scored 145 points in the second half, 22d in the league.

Brady hoped that playing without Welker will force the Patriots to “evolve’’ as an offense and spread the ball around. He also believes the Ravens will have difficultly preparing for a Patriots offense sans Welker.

“It’s one less player they have to worry about, obviously,’’ Brady said. “But there’s going to be other things. We’re going to evolve a little bit as an offense now. It was a very Wes Welker-oriented offense. And now, maybe part of the advantage is Baltimore really doesn’t know what they’re going to see from us now.

“We’re going to have to shift focus. They’re really not sure where that focus is going to go. In some ways that’s an advantage for us. There’s a lot of things we’ve done with Wes that we don’t do with anyone else. We’re going to find other areas to exploit.’’

Brady spoke with confidence, but Welker’s injury is devastating for the Patriots and heart-wrenching for the receiver. After Welker played one of the finest seasons for a wide receiver in league history, he will have to watch the conclusion.

“It’s one of those situations where it doesn’t stop for anybody,’’ Brady said. “It rolls right on. But we love Wes. We love the commitment he’s made to us. Believe me, we’re all going to make that commitment to him. In the short term, we’re going to get over it real quick. We should be over it now. You realize we played a game without him, and that’s just the way it’s going to be.’’

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