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Syndergaard's Mets surgery during coronavirus raises doctors concerns

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The tug-of-war between individual rights and sacrifice for the greater good has spilled into the sports arena with Noah Syndergaard’s looming Tommy John surgery.
The Mets right-hander is scheduled to undergo surgery Thursday in West Palm Beach, Fla., to repair a torn ulnar collateral ligament, with a rehab that will keep him sidelined into the 2021 season. According to sources, the team and pitcher have been told — Syndergaard was examined by Dr. David Altchek and received a second opinion from Dr. Neal El Attrache — that surgery fit necessary guidelines, at a time most procedures have been postponed to preserve resources following the COVID-19 outbreak.
Among those resources are surgical masks and ventilators.
“The indication for surgery is if there were a delay in surgery there would be harm to the patient and permanent damage,” said Dr. Eric Freeman, a Long Island-based orthopedic surgeon who has not examined Syndergaard. “In a case like Noah, if there was evidence of weakness in the hand and compromise of the ulna nerve there would be an indication. It typically is unusual to have permanent damage.”
Freeman noted he’s been forced to postpone performing most surgeries because he can’t justify them as necessary during this time of pandemic.
Syndergaard and the Mets were told, according to sources, the pitcher has an acutely torn UCL with an acute compression of the ulnar nerve, necessitating the surgery.
A New York-based orthopedist who asked not to be identified was skeptical that Syndergaard is facing necessary surgery and indicated the medical resources should be preserved.
“The reason they have [elective surgery] on hold is the masks, but the big picture is what if
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they need more ventilators in Manhattan?” the orthopedist said. “They are going to have to pull them from the ambulatory centers and they haven’t talked about that, but that is the end play. So the question becomes if they are doing elective surgery in Florida, are they not utilizing resources that should have been directed elsewhere?”
Other questions arise about Altchek, a Manhattan-based surgeon, potentially traveling to Florida to perform the surgery at a time the state has mandated a 14-day quarantine on all individuals flying into the state from New York and New Jersey. Altchek, who has spent time in Florida recently — leaving it possible he won’t be re-entering from New York — did not respond to a request for comment.
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The surgery is scheduled for the Hospital for Special Surgery in West Palm Beach, Fla., which according to the facility’s web site, opened in January.
If Syndergaard were to delay the surgery, it would prolong the amount of time he would miss in 2021 — the typical rehab is 14-15 months, meaning he likely wouldn’t pitch for the Mets until at least
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May or June of next year. As it stands, Syndergaard is scheduled to become a free agent after next season, but that could change dependent upon how service time is calculated as players wonder if there will be a season amid concerns about the coronavirus.
“Typically with an ulnar collateral ligament there is no neurologic damage on the onset,” Freeman said. “A patient can get neuritis of the ulna nerve from the instability in the elbow. However, it is typically resolved with rest. I haven’t had the opportunity to examine Noah, but if the Mets medical staff felt that Noah was suffering from a potential of neurologic injury due to the ulna nerve, then certainly there would be indication for surgery, but there would have to be documentation of neurologic injury to have the surgery approved under the current guidelines.”

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