Emotions came quick when Tua Tagovailoa was slowly loaded onto the flatbed cart Saturday in Starkville. What first looked routine was clearly serious -- a hip dislocation that
and possibly his Alabama career.
Next came assignment of blame and a search for why such a rare injury would occur in that moment. There were more questions than answers.
And that's where Dr. Michael Banffy can help. An orthopedic surgeon at Cedars-Sinai in Los Angeles, Banffy is also a team doctor for the Rams.
He spoke by phone Sunday with
AL.com and was able to answer many of the questions that surround an injury uncommon in football and associated with the shortened career of Bo Jackson. Banffy is not involved with the treatment of Tagovailoa but has experience with hip injuries.
The
dislocated hip and posterior wall fracture, Banffy estimates, accounts for one percent of injuries in college/pro football. It's rare enough that he's only treated a handful of athletes for this but is trained to handle injuries like that one Tagovailoa suffered Saturday in a costly 38-7 win at Mississippi State
How did this happen?
At first glance, it didn't seem that severe. Even Banffy didn't think it was so serious watching the play happen until going back to watch closer.
"So, he landed directly on that right knee and what that did -- particularly with the guys landing on his back -- just pushed the femur out of the back of the hip socket," Banffy said. "We have to remember the hip is a ball and socket joint so typically it's extremely stable so that's what makes this so unusual. Dislocating the hip generally requires a substantial amount of force."
It's something most commonly associated with a traumatic car accident, not a tackle in a football game.
With the dislocation of the hip comes the fracture.
"What that means is the socket has a little chip in it," Banffy said, "which makes it a little more unstable."
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The hit didn't look bad enough to create such a major injury in the moment. Tagovailoa was chased from the pocket with
two Bulldog defenders landing on him after launching the ball incomplete.
"When you have these guys going at the speed they're going with the muscles sparing and the power they have and having other people land on his back, it's definitely a possibility," Banffy said. "But yeah, to a common person, it doesn't seem like he just went through a car accident."
It wasn't immediately clear how serious this was to the doctor.
"Until he was barely putting any weight on it and then looking at the replay several times," Banffy said, "I was like 'Wow, that must be what that is when I saw him land directly on the knee."
Is this related to the high-ankle sprain?
The correlation between the hip dislocation and the high-ankle sprain suffered four weeks was made in the immediate aftermath.
But is it medically connected?
"Whenever we have an athlete, we're not only trying to get him to heal through whatever surgery they have but to get stronger to be able to protect themselves," Banffy said. "That's what people worry about so with regard to mobility, maybe he was more likely to get tackled than if he was completely healthy on that ankle that he could have had a little more speed.
"Other than that, I think it's otherwise a freak, freak accident."
Like Bo Jackson?
Instant fear surrounded the connection between Tagovailoa's injury and the one that ended Bo Jackson's pro football career.
Yes, Jackson dislocated his hip being tackled in a 1991 game for the Oakland Raiders. And he had the same fracture as Jackson.
So, what made Jackson's injury so life-changing? The multi-sport star suffered from Avascular necrosis or AVN in the aftermath of his dislocation and fracture.
"What can happen with the dislocation is that blood vessels will either tear or they'll be placed on stretch for so long that the bone itself will lose its blood supply and that will cause death of the bone," Banffy said. "If you get it reduced right away, the idea is that will minimize the risk. But this is still something that you have to watch and it might not even present itself for a couple of months, similar to the way it did with Bo Jackson."
The statement released by Alabama's team orthopedist Saturday night stated the hip was reduced at the stadium before being transported to St. Vincent's in Birmingham. Reducing a hip means putting it back in socket.