Originally written on Fangraphs  |  Last updated 11/15/14
Mike Napoli‘s strange offseason has cost him a lot of money. After appearing to agree on a three year, $39 million contract with the Boston Red Sox in early December, he and the team finally agreed on a one-year contract worth just $5 million guaranteed dollars with up to an additional $8 million in incentives. As Eno Sarris wrote when the deal was announced, the team and player were both caught by surprise when a routine physical revealed that Napoli has a degenerative hip condition called avascular necrosis, which is what scared the Sox away from the multiyear deal. So what is avascular necrosis? The first thing you need to know: it’s what basically ended Bo Jackson‘s career. As the A.D.A.M. Medical Encyclopedia at the National Institutes of Health explains: avascular necrosis is “bone death caused by poor blood supply to the area.” Moreover, “Nonsurgical treatment can often slow the progression of osteonecrosis, but most people will need surgery.” Avascular necrosis is asymptomatic at first, which is why Napoli didn’t know he had it. But then it results in serious pain, limping, and a limited range of motion, which means that corrective surgery will almost certainly be necessary sooner or later. It’s also known as “osteonecrosis,” “ischemic bone necrosis,” “AVN,” and “aseptic necrosis,” in case you’re Googling. Also, as the Boston Globe notes: Among the listed causes of AVN are steroid use, trauma, hypertension, rheumatoid arthritis, and alcoholism, or it could be idiopathic, meaning no cause can be determined. Certainly Napoli has had his share of wear and tear, being a catcher. Jackson is the most famous athlete to suffer from avascular necrosis, but there are many others, across many different sports. One is backup Chicago Blackhawks goalie Ray Emery, who received the diagnosis in early 2010, underwent hip surgery including bone grafts, and then returned a year later, in March of 2011. Another is Floyd Landis. Lance Armstrong’s nemesis won the 2006 Tour de France and then had hip replacement surgery to correct his degenerative condition. He won the race while suffering, mounting his bike with his right leg first because he couldn’t do it with his left. But he also won it while doping, and his championship was taken away after a positive drug test. As the New York Times described his hip before it was replaced: “Essentially, the ball of Landis’s hip has withered and collapsed, resulting in bone that his doctors liken to a chunk of rotten wood, a sunbaked desert and a half-melted scoop of ice cream.” Steroids are one of the possible causes of necrosis, though we will never know if that’s what caused it in Landis’s case. Or, for that matter, Napoli’s. But people will wonder, and that almost certainly is what caused it for 1970s wrestler “Superstar” Billy Graham. “His body [back] then was a collection of muscles,” the Phoenix New Times reports, “the result of thousands of steroid injections 100 times greater than the recommended doses.” By 1986, he was suffering from burning hip pain, and his doctor told him he had avascular necrosis, as he writes in his autobiography: “‘It’s the steroids,’ he said. ‘They’ve eroded your joints.’” But avascular necrosis is often the result of trauma to the body, like you might see in a high-contact position in a contact sport. That’s what happened to Bo Jackson. As Dave Kindred wrote in The Sporting News, Jackson landed awkwardly following a tackle, and “that trauma ruined the joint where Jackson’s femur enters the pelvis. Cartilage, tissue and blood vessels were destroyed. Now it was bone on bone in there. And there wasn’t enough blood flowing in to sustain the bone’s life.” Jackson suffered the injury, had hip replacement surgery in 1992, and attempted a baseball comeback in 1993, but after 160 indifferent games over two years, and the strike in 1994, he called it quits for good. Another leg trauma-related case was John Montefusco, a reliever for the Giants and Yankees in the ’70s and ’80s. He got into an auto accident in 1984, pitched 7 innings and had hip surgery in 1985, and then retired after 12 1/3 innings in 1986. Then again, there’s the example of Brett Favre. When the Falcons traded him to the Packers in 1992, Favre failed his first physical in Green Bay because he was diagnosed with avascular necrosis. Former Packer general manager Ron Wolf chose to ignore the team doctor’s recommendation against the trade, opting instead to listen to the advice of an orthopedist who said Favre would likely have no immediate problems. “To this day, it bothers me from time to time,” Favre told the Associated Press in 2005. “I don’t have as much flexibility in that socket, but you’re kind of rolling the dice.” It’s hard to know quite how bad it will be for Napoli. His condition is asymptomatic, which is a good thing, because that means they caught it early. But it’s unclear when or whether he may need surgery. If he does need to undergo surgery, then he’ll be out for a year with uncertain future prospects. Of course, as Brett Favre’s example indicates, you just never know. But it’s no wonder the Red Sox wanted to hedge their bets.
GET THE YARDBARKER APP:
Ios_download En_app_rgb_wo_45
MORE FROM YARDBARKER

John Farrell: Pitchers need an approved gripping substance

Cam Newton: Nobody has ever been who I'm trying to be

Bears cut Ray McDonald after domestic violence arrest

Report: Paul Pierce could opt out of contract, join Clippers

Report: NBA exploring moving start of Finals up

LIKE WHAT YOU SEE?
GET THE DAILY NEWSLETTER:

Isaiah Thomas: Danny Ainge wants my input on free agents

Brian Matusz suspended eight games for substance on arm

Baseball players in the military: A tribute

'Free Tom Brady' rally draws about 150 Patriots fans

LeBron's triple-double leads Cavs to win in OT thriller

Report: Adrian Peterson will skip Vikings first OTAs

WATCH: Khris Davis trolls umps after controversial homer

Is Adrian Peterson leveraging himself out of the league?

Mascot creates controversy with 'Police Lives Matter' sign

The Talented Mr. Blatt

The curious case of Frank Kaminsky

Is the Cavs' Matthew Dellavedova a dirty player?

LeBron lifts Cavaliers to brink of Finals, but are they ready?

Will Phil Jackson give himself a chance to succeed with Knicks?

Most valuable non-QB for each NFL team

Federer unhappy with security after fan comes on court

WATCH: LeBron throws down ferocious dunk in traffic

WATCH: Al Horford ejected for elbowing Matthew Dellavedova

MLB News
Delivered to your inbox
You'll also receive Yardbarker's daily Top 10, featuring the best sports stories from around the web. Customize your newsletter to get articles on your favorite sports and teams. And the best part? It's free!

By clicking "Sign Me Up", you have read and agreed to the Fox Sports Digital Privacy Policy and Terms of Use. You can opt out at any time. For more information, please see our Privacy Policy.
the YARDBARKER app
Get it now!
Ios_download En_app_rgb_wo_45

Bears cut McDonald after incident

Report: Pierce could opt out of contract

Could the NBA Finals be moved up?

The Talented Mr. Blatt

Is Dellavedova a dirty player?

Ballplayers in the military: A tribute

Most valuable non-QB for each NFL team

WATCH: LeBron's ferocious dunk in traffic

Kelly drops hint about ND offense

John Madden: Last SB play will 'torment' Carroll

Eight biggest surprises of the MLB season

Bryan Price ejected before first pitch

Today's Best Stuff
For Bloggers

Join the Yardbarker Network for more promotion, traffic, and money.

Company Info
Help
What is Yardbarker?

Yardbarker is the largest network of sports blogs and pro athlete blogs on the web. This site is the hub of the Yardbarker Network, where our editors and algorithms curate the best sports content from our network and beyond.