ST. LOUIS Despite an MRI Monday that revealed no structural damage to Lance Berkman's right ACL, the Cardinals first baseman fears he will wake up from surgery Friday to find out it was replaced.
Monday's exam revealed a torn meniscus and cartilage damage in his right knee, which will likely be repaired Friday at The Steadman Clinic in Vail, Colorado. But doctors will also examine Berkman's ACL further and the possibility remains that it could end up being replaced during the same surgery.
Based on how it feels now, Berkman is preparing for the worst.
"All of the information that I'm getting plus what I'm feeling leads me to believe that there is an issue with the ACL," Berkman said Monday. "I'm hoping that's not the case but I'm not sure that's the case.
"It's not gone but it's effectiveness is debatable considering the way I got hurt. They wont know about that until I go under the knife."
Berkman went down Saturday while reaching for a throw while covering first base. He leaned on his knee before quickly falling to the ground. He was helped off the field and placed on the disabled list a day later. He walked through the Cardinals clubhouse Monday on crutches.
Despite not being torn, the 36-year-old is concerned that his right ACL has been stretched to a point where it will still need to be replaced. He pointed out multiple times Monday that the support of a healthy ACL wouldn't have allowed for a serious injury to happen during a routine play.
"The major concern at this point is, is it effective in protecting that joint from sliding around, which all the evidence points to its not," Berkman said. "But that doesn't mean when they get in there, they wont say well you had a little tear in your meniscus and that's what caused the sensation.
"To be perfectly honest, fearful is the wrong word but I'm certainly concerned that not just what the injury is but why did it happen? That's what needs to be addressed. Even if I get this thing fixed, if the joint is not stable, it's going to happen again. I talked to the doctors today and they said then you can really mess it up if you have the instability and try to go out there and play."
The plan is for Berkman to be examined Thursday afternoon in Colorado with the surgery coming the next day. Dr. Thomas Clanton, who performed a previous knee surgery on Berkman, will be involved in the consultation and surgery.
While doctors are repairing his torn meniscus, they will examine the ACL and determine whether or not it's strong enough to support his right knee joint. If they deem it in need of repair, they will replace it during the same surgery.
"It's either giving enough support or it's not," Berkman said. "And if it's not, it's got to be redone. You can't retighten it. You have to replace it. It's purely a judgment call on the part of the surgeon.
"Think of it like a rope. You can actually cut halfway through a rope and still use it to climb as long as it doesn't lengthen. But if it gets too long it doesn't matter if it's torn or not, it doesn't give you any support and that's the issue, the support of the joint.
"I'm going into the surgery preparing to have the ACL fixed. We'll have all the decisions made as to what kind of graph and that kind of thing in case they have to fix it."
General manager John Mozeliak pained a more positive picture, saying Berkman would receive a second opinion but that he was likely to miss six-to-eight weeks with the meniscus tear.
In 14 big-league seasons, Berkman is a career .294 hitter with 1,836 hits, 359 home runs, 1,197 RBI and 1,115 runs scored. He's played in just 13 games this season after already missing three weeks with a calf injury. He's hitting .333 with one home run and four RBI.
And while not allowing himself to fully think about possibilities, Berkman acknowledged that his career could be over should the ACL need to be replaced.
"I'm prepared for anything," Berkman said. "You certainly think about, Well if I have to get my ACL repaired, I might be done playing.' The doctor kind of said that. He said you're not a young man again and I said I know it. I look in the mirror and I see the grey in the beard.
"And having come back from one already, it's a tough deal. It's a very significant injury and it's very tough to come back from it. Not that its impossible but it is tough and you don't know where you're going to be at mentally, in terms of am I willing to make the commitment it will take to get back at a high level?"
Pressed as to whether or not already winning a World Series would be a factor in his decision to come back should the ACL be torn, Berkman said, "There's no doubt. The older you get, the more you accomplish, the more things you check off your list, the less motivation there is.
"It's like climbing Mt. Everest. Once you've climbed it once, do you really want to put yourself through that to climb it again? All those things come into play. I'm not saying I don't want to climb it again, I'm just being honest that that kind of thinking starts to enter your psyche.
"The good news is, anything like this, just from a quality of life standpoint, I want to get this thing rehabbed as good as I can because I still want to run around with the girls and kick a soccer ball and do things like that. The baseball ability is not going away so if I decided that's something I want to do, because of the timing of this, it would be pretty easy to be ready for spring training next year no problem, if that were the best case scenario."
Should the ACL not need to be fixed, Berkman would likely still be out until after the All-Star break due to the meniscus tear.
Berkman signed a one-year, 12 million extension with the Cardinals last September. He will be a free agent after the season.