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On Monday, New York Yankee Aaron Judge underwent arthroscopic surgery on his left, non-throwing shoulder in Los Angeles. “The shoulder had bothered him throughout the year and he had an MRI and they found a loose body in there,” said Brian Cashman, general manager. Judge was seen frequently during the season with a massive ice wrap over his left shoulder; he had banged into the outfield wall on several occasions and toppled over the short wall along the right-field line while making a catch in April. In late August, Judge was granted a few off days, during which he admitted he “iced [his] shoulders, knees…The whole body is kind of beat up.”
The Dodgers’ team doctor, Neal ElAttrache, removed the loose body and damaged cartilage and Judge is expected to be ready at the start of spring training. The issue for Judge and the Yankees becomes more of a long-term one. When doctors talk about removing loose bodies, it begs the question: Where did they come from?
To answer the question, let’s take a step back. The shoulder joint is a ball (the humerus) and socket (the glenoid). The bones are coated with cartilage, which are the smooth, gliding surfaces at the end of the bones. Loose bodies in the shoulder are typically fragments of cartilage that have broken off the from the end of the humerus. Sometimes these fragments break off during a traumatic event such as a direct hit to the area or if one dislocates their shoulder. Other times it can be do to repetitive overuse. There was no report of a repair in Judge’s surgery, so it is unlikely to have occurred as a result of a dislocation. If that was the cause, other stabilizing structures in the shoulder (such as the labrum) would typically be repaired at the same time.
In my opinion, the best-case scenario would be that this was due to one event and it was just a small, isolated piece of cartilage that broke off. If this was part of a larger spectrum of arthritis (which admittedly would be much less likely in a young athlete), where large portions of the cartilage on either the humerus, glenoid, or both start to wear away, it would portend a much poorer long term prognosis.
Clearly not having examined Judge nor seen his imaging studies, I cannot say for certain what the pathogenesis of his shoulder pain was, but if the surgery was limited to a “clean up” of loose bodies, it is likely that he will be ready for spring training in 3 months. Hopefully, he will be back to his previous level of play, if not better. Only time will tell, though, how this will affect him in the long term.