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BID Report: Lowell's hip injections

BID Report: Lowell's hip injections

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"There's something kind of 'eee-yew' about a boy who doesn't like baseball." -- Foghorn Leghorn

Mike Lowell strikes me as a guy who likes baseball. Having had the opportunity to observe the Sox's third baseman both on the field and in the locker room, he is a guy who rarely calls attention to himself, unless it's with his play. You never heard him crowing about his World Series MVP.

He doesn't complain either. There's been a lot of talk and even more written about his offseason hip surgery and the recent problems he's encountered, but you don't recall him squawking about the pain, do you?

You, on the other hand, might be complaining right now and calling to my attention the overuse of rooster references -- crowing, squawking, and a quote from that great Loony Tunes philosopher Foghorn Leghorn -- but I didn't just pluck those words out of nowhere. It all comes back to the choice of treatment for Lowell's recent hip discomfort: an injection of what is sometimes referred to as "rooster juice." But that's not what Dr. Arun Ramappa, chief of sports medicine in the department of orthopedic surgery at Beth Israel Deaconess Medical Center, calls it.

"He received Synvisc. That's a brand name for the injection of a gel-like material that's made up mostly of hyaluronan," explains Ramappa. "Hyaluronan is a natural substance and it's derived from rooster and chicken combs."

That's not a joke, son. Hyaluronan is one component of synovial fluid, the lubricating fluid produced in joints like the knee, shoulder or hip. It's been approved as a treatment for reducing pain in osteoarthritic knees for some time now.

"Osteoarthritis is a degradation of the joint cartilage and bone. Viscosupplementation, adding a substance like Synvisc, won't cure or repair the condition but it can offer some relief. If patients experience a reduction in pain it can delay the need for more invasive procedures, like joint replacement. Using it in a hip or shoulder would be considered 'off-label' use and the patient would be advised of that."

Lowell had offseason surgery to repair a torn labrum in his hip and seemed in fine form when the season started. In fact, his hip didn't seem to be at all bothersome until recently. He had played in 68 of the Sox first 76 games, missing seven of the last nine before being placed on the 15-day disabled list on June 30th.

That was the day after doctors removed about 15cc's of fluid (about a tablespoon) from his hip before injecting the Synvisc. Lowell reportedly told manager Terry Francona that he felt "great," but the Sox opted for more rest.

Given the kind of publicity and exposure that Lowell's treatment has gotten, you can be sure that more patients will be asking for "rooster juice," but Dr. Ramappa says they may not have the option.

"If it were you or me, it would be a lot tougher to get Synvisc," Ramappa says. "The injections are very expensive and not covered by a lot of insurance plans. Certainly not for the 'off-label' use."

But for the Sox, it would be well worth the cost if the result is a sure fielding, consistent-hitting third baseman -- especially if he is out there strutting his stuff for the second half of the season.

Gary Gillis is a contributor to MLB.com. The BID Injury Report is a regular column on redsox.com. Beth Israel Deaconess Medical Center is the official hospital of The Boston Red Sox. This story was not subject to the approval of Major League Baseball or its clubs.

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