Pondering the implications of Saito’s surgery

When the Traveling A-Rod Circus makes its way up to Boston this year for the first time, the Yanks’ third baseman is sure to be greeted with a louder-than-usual chorus of Bronx cheers. Not one to engender much love in the Hub, A-Rod and his off-season steroid revelations simply give the Fenway Faithful more ammunition. I have to wonder though if this isn’t some huge act of hypocrisy perpetrated by baseball fans throughout the nation.

Yesterday, as I was procrastinating work on an appellate brief browsing my usual baseball sites, I came across an article on Takashi Saito from the Oct. 3, 2008 edition of the Los Angeles Times. Saito, now the Red Sox set-up man was with the Dodgers at the time, and the article is about a medically groundbreaking procedure Saito received last July when he suffered what should have been a season-ending tear of his elbow’s ulnar collateral ligament.

Generally such an injury leads to Tommy John surgery, but in Saito’s case, it led to an injection of a medicine designed to greatly enhance his body’s natural healing process. That almost sounds like Human Growth Hormone, but it’s not. Here’s how the LA paper described the process:

Saito credited his unlikely recovery from a partially torn ulnar collateral ligament in his elbow that he suffered in July to a cutting-edge medical procedure, which, to his knowledge, had never been tried on a major league pitcher. To this day, team physician Dr. Neal ElAttrache can’t definitively say that injecting platelet-rich plasma into Saito’s elbow is what allowed him to avoid Tommy John surgery. ElAttrache also won’t guarantee how long the elbow will hold up or that Saito won’t have to have surgery in the future…

Trainer Stan Conte said he estimated that Saito had a 20% chance of pitching again this season and told management not to count on him being back. So when ElAttrache offered using PRP as an option, Conte was open to the idea.

Within a week of hurting his elbow, Saito had blood drawn and spun to isolate the platelets, which clot and promote healing. The platelets, 10 times more concentrated than in normal blood, were injected into the site of the tear in the elbow. ElAttrache said he used PRP in the past to repair tendons, but never ligaments.

So what’s the difference? Medically, Saito’s doctor took something found naturally in his body — platelets — concentrated them into a super-high dosage and then reinjected the platelets into the site of Saito’s injury. When a baseball player injects himself with a steroid, as far as my medical knowledge goes, he is basically doing the same thing. He takes a super-high dosage of testosterone, something found naturally in the body, or a synthetic substance and injecting into his body to promote quick healing and an unnatural edge.

Of course, what Saito did doesn’t run afoul of medical ethics, U.S. law or baseball rules. So the Red Sox fans will cheer him — or ignore him — as he contributes during the season, and A-Rod who went looking down illegal paths for that edge will get booed. It’s quite the conflict in baseball’s PED policy. How and where do you draw the line between acceptable forms of over-medicating?