Shaquille O’Neal could have surgery on his arthritic toe sometime in the next two weeks in Los Angeles, and his recovery could linger into the early part of the Lakers’ regular season, according to sources close to O’Neal.
A date for the surgery could be set as early as today.
Dr. Robert Mohr, chief of podiatric surgery at UCLA Medical Center, is expected to perform the procedure, called a cheilectomy, in an effort to relieve the source of the pain in O’Neal’s big right toe last season.
In cases like O’Neal’s, bone spurs form on the top of the main joint in the big toe and can bump together when the toe bends upward, causing intense pain.
A cheilectomy is a simple procedure in which the surgeon chisels away the bone spurs on both sides of the joint so that they no longer bump together.
It usually lasts 20 to 30 minutes and can be performed under either a local or a general anesthetic in an outpatient operation. Healing typically requires about three months.
O’Neal has been told that he should be able to walk the day of the procedure, could be running in less than six weeks and playing by early to mid-November.
The Lakers open training camp in El Segundo on Oct. 1 and the regular season on Oct. 29, when they will celebrate their third consecutive NBA title before a game against the San Antonio Spurs.
If O’Neal returns on Nov. 15, he will have missed eight games. O’Neal, most valuable player of the NBA Finals for three consecutive seasons and regarded as the most dominant player in the league, sat out 15 games last season; the Lakers won seven of them.
Several months ago, Mohr warned of the uncertainty of surgery and frequently championed a more conservative course.
“These are conditions where, with all the scans and all the X-rays, there’s really no way to determine exactly what the conditions of the cartilage is prior to looking at it,” he had said, always adding that the first goal was to avoid surgery.
In the weeks since the conclusion of the NBA Finals, O’Neal and his agent, Perry Rogers, have sought opinions from specialists across the country; those recommendations ranged from radical surgery amounting to reconstruction of the toe to a course of rehabilitation designed to avoid surgery.
While they, like Laker management, had hoped for a clear and speedy conclusion to their decision to undergo surgery, Rogers and O’Neal agreed not to rush to a conclusion that might risk O’Neal’s career.
On Tuesday, after reviewing O’Neal’s options, Laker officials believed it was the best course.
As O’Neal’s X-rays were sent from one specialist to another, O’Neal conferred with others who had experienced cheilectomies, and then he consented to the surgery, finally insisting on it.
When at least one doctor strongly recommended rehabilitation exercises, more shoe inserts and anti-inflammatory medication, O’Neal declined.
He told friends that he would not play another season as he did last, when he was in nearly constant pain, often limped away from games, and frequently lacked his signature mobility and explosion.
He averaged 27.2 points and 10.7 rebounds, impressive numbers but below averages for his career, and was less of a defensive force.
Also, O’Neal so feared the long-term effect of his frequent consumption of anti-inflammatory medication that late in the season he asked to be tested for kidney damage.
Tests revealed that O’Neal had no irregularities, but he continued to suffer from frequent nausea and occasional vomiting, side effects of the medication.
“In the best hands, [cheilectomies are] successful 85% to 90% of the time,” said Dr. Carol Frey of Orthopaedic Hospital in Los Angeles.
About 9% of the time, the patient receives no benefit, and in 1% of cases it actually gets worse, either from infection or progression of the arthritis, she said.
“Yes, I do think he’ll get better,” Frey said. “The question is, ‘How much?’ ”
It would be O’Neal’s second consecutive summer of foot surgery. A month before last training camp he had surgery to correct a claw toe deformity in the smallest toe of his left foot.
While he returned in time for the regular season, the toe frequently bothered him during the season.
The Lakers have not acquired the prototype backup center, which was among their off-season goals. The re-signing of Devean George proved expensive, leaving the Lakers with only their $1.4 million salary-cap exception.
Samaki Walker, at 6 feet 9, played most of the minutes at center behind O’Neal last season, and he has recovered from a bruised knee that limited his playoff effectiveness.
General Manager Mitch Kupchak could revisit the idea of signing a veteran front-court player--Charles Oakley, for example--not to replace O’Neal, but to add early season depth to the likes of Robert Horry, Slava Medvedenko, Mark Madsen and Walker.
Times staff writer Thomas H. Maugh II contributed to this report.