Cutler escapes knife after test reveals tear

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Updated: August 4, 2011 4:20PM

The criticism of Jay Cutler didn’t dissipate Monday after the Bears quarterback missed all but one series in the second half of the NFC Championship Game with an injured left knee.

But Cutler won’t need surgery, and he should need only a few weeks to recover after an MRI exam Monday revealed a Grade II tear of the medial collateral ligament, as first reported by the Sun-Times.

Cutler’s fate could have been much worse.

“With a little bit more force, the next thing to go, in that situation, is the [anterior cruciate ligament],” said Dr. Neal ElAttrache, the orthopedic surgeon at Kerlan-Jobe Orthopaedic Clinic in Los Angeles and the head physician of the Los Angeles Dodgers. “So anybody who has a Grade II or Grade III that doesn’t have an ACL injury is lucky.”

ElAttrache, who performed reconstructive knee surgery on New England Patriots quarterback Tom Brady, said any player, “across the board,” would have had a hard time finishing the game with a Grade II MCL tear.

“I’m in no position to talk about his psyche or his drive to play or any of that stuff,” ElAttrache said. “But I can tell you that this injury, I don’t care what position it is, they’re not going to be 100 percent.

“And if you feel you’re not too mobile, you’re not only putting yourself but your team at risk.”

How Cutler and the Bears’ medical team staff handled the situation is consistent with standard protocol, ElAttrache said.

“Initially, as soon as it happens, [the patient] may say, ‘That feels unusual. Then keep playing,’   ” ElAttrache said. “But as the knee bleeds, it becomes more stiff and uncomfortable. So initially, you might find a guy who can play a couple of series. But then when he doesn’t move around, his knee will stiffen up.

“Looking at it, as time went on, he became less mobile and more uncomfortable.”

Dr. David Thorson, who works with the U.S. ski team, added that trying to continue to play would have increased the chances of Cutler tearing his ACL, a knee ligament that requires upward of six to nine months of rehabilitation after surgery.

With the Grade II MCL tear, the usual healing time, which doesn’t require surgery, is three to six weeks. Thorson said Grade II tears are the trickiest to diagnose. Grade III is a complete tear, and Grade I, he said, is just stretching with a couple of fibers potentially tearing. Grade II tears are somewhere in the middle.

“The reality is, it’s not black and white,” he said. “How do you know if Grade I doesn’t have a few fibers torn? You can’t tell it, until you do an imaging study. There’s a broad range in there.”

It’s dangerous, Thorson said, to compare one Grade II to another, as New Orleans Saints fullback Heath Evans did Monday on ESPN’s ‘‘First Take.’’ He noted that Saints quarterback Drew Brees played six weeks with a torn MCL. But Saints coach Sean Payton told reporters at the Senior Bowl in Mobile, Ala., that Brees suffered a “low-grade” MCL sprain.

ElAttrache also said pain in MCL tears can vary.

“You can have Grade III, with a lot of looseness, or laxity, but it doesn’t always cause much more pain than a Grade I,” ElAttrache said.

Bears linebacker Pisa Tinoisamoa has had several knee injuries, including an MCL tear, and he couldn’t believe Cutler even attempted to return for the second half.

“I knew right away something was wrong,” he said. “But for him to feel that instability and try to go for us? He didn’t have to do that to prove to me he’s tough.”

During the 2008 season, Pittsburgh Steelers receiver Hines Ward suffered an MCL injury in the AFC Championship Game and briefly returned only to leave the game.

In the Super Bowl two weeks later, Ward caught two passes for 43 yards.

Bears general manager Jerry Angelo mentioned Ward, and he lashed out at the players from other teams who have criticized his quarterback.

“I’m very surprised,” Angelo said. “I think it’s crap. I thought they were a union. If that’s the way they unionize themselves, they have bigger issues then the ones they have with the owners.”