Surgery for Sano?

[KGB]

http://www.twincities.com/2017/09/27/twins-miguel-sano-takes-60-swings-after-seeing-two-more-specialists/

 

I think it's going to hard to blame they Twins medical staff after 2 outside specialists confirmed the diagnosis.

[cmoss84]

 

  On 10/5/2017 at 11:28 PM, Deduno Abides said:

It would be good to get a great defensive third baseman who is at least OK at the plate, if Sano doesn't project to be much more than a DH.

I could see us going after a guy like Todd Frazier on a 1 or 2 year deal. Decent fielder with good power. If Sano needs time to ease his way back, Frazier can take over. I'm sure he could also play a little 1st base. 

[PseudoSABR]

 

  On 10/6/2017 at 7:28 PM, h2oface said:

 but it would have been the safest and best long term for Sano and the team. 

That's not a fact (at best it's hindsight speculation).  And likely was not the diagnosis/prognosis at the time.  

[Deduno Abides]

  On 10/6/2017 at 3:41 PM, Doomtints said:

Dozier could move over to 3rd.

I assume you're thinking that Gordon could take second in that scenario. That could work, also, although I think it's unlikely that Gordon starts the year with the Twins, unless he shows up at training camp looking a lot stronger and proceeds to rip.

[Heezy1323]

 

  On 10/6/2017 at 7:28 PM, h2oface said:

Duh. There's nothing that chides me more than casual fans fansplaining the obvious that every casual fan knows. Of course it would have put him out (not wasted in my opinion) the rest of the season, but it would have been the safest and best long term for Sano and the team. Him being healed, and having the best opportunity to be ready and healthy for 2018 is why I don't understand it. After all, Falvey/Levine were sellers, and have done nothing to try to compete farther than the wild card game. At all. So the decision to drag this along is fair game for speculating...... as   a casual  an obsessive fan. Ugh.

If surgery is necessary for this (which I continue to believe is unlikely), the approximate healing time is likely around 6-10 weeks. As such, performing surgery Sept 1st or Oct 1st carries no additional benefit when compared to Nov 1st with respect to having him ready for ST in February. I suspect that is the reasoning. This is different from TJ or SLAP repair in a pitcher that requires a many months-long rehab. 

 In addition, surgery has risks (obviously). This particular surgery has specific risks as well, depending on the specific surgery performed. If a rod is used to 'fix' this stress fracture, pain in the front of the knee is common after surgery (since the rod is inserted just below the knee). If a plate/screw construct is used, there can be pain or tenderness at this site of the plate. Both of these things are relatively common. In the vast majority of cases, conservative treatment is appropriate for stress reactions/fractures and results in successful healing. I have no doubt that these options have and are being carefully considered. If he continues to have symptoms without significant improvement for another month or two, I suspect a firm decision will need to be made. 

[spinowner]

 

  On 10/6/2017 at 4:11 PM, Doomtints said:

As if any of us were qualified to read a medical report.....

Heezy1323 is an orthopedic surgeon. He (or she?--most orthopedic surgeons are male) gave us some briefings on Perkins' shoulder situation in the early part of the 2016 season.

[Squirrel]

  On 10/7/2017 at 1:00 PM, Heezy1323 said:

If surgery is necessary for this (which I continue to believe is unlikely), the approximate healing time is likely around 6-10 weeks. As such, performing surgery Sept 1st or Oct 1st carries no additional benefit when compared to Nov 1st with respect to having him ready for ST in February. I suspect that is the reasoning. This is different from TJ or SLAP repair in a pitcher that requires a many months-long rehab.

In addition, surgery has risks (obviously). This particular surgery has specific risks as well, depending on the specific surgery performed. If a rod is used to 'fix' this stress fracture, pain in the front of the knee is common after surgery (since the rod is inserted just below the knee). If a plate/screw construct is used, there can be pain or tenderness at this site of the plate. Both of these things are relatively common. In the vast majority of cases, conservative treatment is appropriate for stress reactions/fractures and results in successful healing. I have no doubt that these options have and are being carefully considered. If he continues to have symptoms without significant improvement for another month or two, I suspect a firm decision will need to be made.

Thank you, Heezy! It's really nice having you contribute like this. I know you yourself can only speculate on Sano specifically, but the medical expertise you bring to us regular fans helps a great deal with giving us better perspective.

[jctwins]

Is Plouffe available? I smell a reunion coming!!

[jimmer]

Mauer was 1st in UZR for MLB 1B and 6th in DRS for MLB 1B (only 6th due to innings). His performance at 1B was much better than 'Good'

 

Twins finished 8th in UZR and 10th in DRS.

 

And Sano optimal position has always been DH.

 

  On 10/7/2017 at 5:35 PM, Deduno Abides said:

The team's offense was good and likely to improve. The team's overall defense, however, even with a great year from Buxton and a good performance by Mauer, was not much better than league average. They also have a budget and greater needs. A lower cost, strong defensive third baseman could improve the pitching and allow for more money to be spent elsewhere, such as on actual pitchers. It would also allow Sano to DH, which, unfortunately, is starting to appear to be his optimal position, and to back up Mauer at first base.

 

[Heezy1323]

  On 10/7/2017 at 5:06 PM, ChiTownTwinsFan said:

Thank you, Heezy! It's really nice having you contribute like this. I know you yourself can only speculate on Sano specifically, but the medical expertise you bring to us regular fans helps a great deal with giving us better perspective.

I truly appreciate the compliment- enjoy contributing where I can and glad some find it helpful.

 

A big part of the reason I enjoy this site is that there are so many bright people with a broad range of backgrounds that all bring different perspectives.

[ashbury]

  On 10/7/2017 at 1:00 PM, Heezy1323 said:

If surgery is necessary for this (which I continue to believe is unlikely), the approximate healing time is likely around 6-10 weeks. As such, performing surgery Sept 1st or Oct 1st carries no additional benefit when compared to Nov 1st with respect to having him ready for ST in February. I suspect that is the reasoning. 

One advantage I can think of, for proceeding ASAP, is if the injury interferes with his overall conditioning program right now.

[Heezy1323]

 

  On 10/7/2017 at 7:29 PM, ashburyjohn said:

One advantage I can think of, for proceeding ASAP, is if the injury interferes with his overall conditioning program right now.

That's a pretty fair point. 

 

In these situations I often advise swimming or doing work on an underwater treadmill apparatus. There are also anti-gravity treadmills available that allow people to work out at as little as 50% of their bodyweight. These could allow conditioning with less risk of worsening a stress reaction. 

[Deduno Abides]

  On 10/7/2017 at 5:58 PM, jimmer said:

Mauer was 1st in UZR for MLB 1B and 6th in DRS for MLB 1B (only 6th due to innings). His performance at 1B was much better than 'Good'

 

Twins finished 8th in UZR and 10th in DRS.

 

And Sano optimal position has always been DH.

Where do you come up with your team stats? FanGraphs has Twins at 19th in DRS.

 

As for Mauer, being one of the better first basemen is "good," in my book, based on the overall impact, but I can see why others would consider it "great." Buxton was great; Mauer was not equivalent. Regardless, the team's overall defense, even with these two leaders, is just middle of the pack. A slick fielding third baseman who can be about league average at the plate could be an inexpensive way to improve the team while saving money for other positions - and letting Sano focus on his bat and his health.

[Deduno Abides]

  On 10/7/2017 at 5:58 PM, jimmer said:

Mauer was 1st in UZR for MLB 1B and 6th in DRS for MLB 1B (only 6th due to innings). His performance at 1B was much better than 'Good'

 

Twins finished 8th in UZR and 10th in DRS.

 

And Sano optimal position has always been DH.

 

 

  On 10/8/2017 at 8:05 PM, Deduno Abides said:

 

Where do you come up with your team stats? FanGraphs has Twins at 19th in DRS.

 

As for Mauer, being one of the better first basemen is "good," in my book, based on the overall impact, but I can see why others would consider it "great." Buxton was great; Mauer was not equivalent. Regardless, the team's overall defense, even with these two leaders, is just middle of the pack. A slick fielding third baseman who can be about league average at the plate could be an inexpensive way to improve the team while saving money for other positions - and letting Sano focus on his bat and his health.

 

  On 10/7/2017 at 5:58 PM, jimmer said:

Mauer was 1st in UZR for MLB 1B and 6th in DRS for MLB 1B (only 6th due to innings). His performance at 1B was much better than 'Good' Twins finished 8th in UZR and 10th in DRS. And Sano optimal position has always been DH.

And here, this is for you.

[jimmer]

 

  On 10/8/2017 at 8:05 PM, Deduno Abides said:

Where do you come up with your team stats? FanGraphs has Twins at 19th in DRS.

 

No, Fangraphs has the Twins DRS at 10th, not 19th. I have sorted it by DRS to make it easier:

 

http://www.fangraphs.com/leaders.aspx?pos=all&stats=fld&lg=all&qual=0&type=1&season=2017&month=0&season1=2017&ind=0&team=0,ts&rost=0&age=0&filter=&players=0&sort=8,d

 

I will agree that Buxton's supreme defensive greatness makes the team's defensive stats look better than the team's defense is, but four of our regular eight starters had a positive DRS.

 

 

 

[Doomtints]

 

  On 10/7/2017 at 5:58 PM, jimmer said:

Mauer was 1st in UZR for MLB 1B and 6th in DRS for MLB 1B (only 6th due to innings). His performance at 1B was much better than 'Good'

 

Unfortunately, SABR's wonky SDI ranking is 25% of the gold glove "vote" and they have him pegged as the 5th best 1B in the AL.

 

Buxton is the only guaranteed gold glove on the team.

 

But yes, Buxton, Mauer, Dozier all had good defensive years, even if some metrics don't pick it up.