The latest news on Dwight Howard’s knee is not good at all

The Houston Rockets released an update this morning on Dwight Howard’s knee, and it’s not exactly encouraging:

This morning Dr. Walt Lowe of the Memorial Hermann Sports Medicine Institute conducted a bone marrow aspirate injection on Rockets center Dwight Howard’s right knee. Howard will begin rehabilitation immediately and will be re-evaluated in approximately four weeks.

We went from twisted ankle to this. Howard, who has missed the last four games, will miss a minimum of 13 more over the next four weeks, but the procedure that he underwent shows that the knee issue they’re trying to tackle is more serious than something that would just require rest.

The Rockets are known for not revealing much about player injuries, as we saw for some time with Terrence Jones, and we certainly don’t have all the facts about Dwight’s knee here, but a bone marrow aspirate injection suggests a cartilage issue. Dwight revealed as much back in early December, but it was hard to take his words as an actual medical diagnosis. Not anymore.

“The problem was my cartilage was wearing down, and it’s been wearing down because I’ve been playing basketball for a very long time,” said Howard at that time. “When you have the bone rubbing on bone, it brings a lot of pain.”

When there’s a cartilage issue in the knee and the words “bone on bone” are used, microfracture surgery is always feared.

Again, I’m not pretending to know the details of the situation and am in wait-and-see mode like the rest of us, but it’s hard to be too optimistic after reports like this.

UPDATE: While it’s still clear there has been some cartilage loss in Dwight’s knee, Dr. Walter Lowe did provide that optimism, speaking with local Fox’s Mark Berman to provide some context on why they went forward with the procedure.

It’s a biologically active injection that helps almost everything heal in the knee. We took some bone marrow out of his pelvis. It gives us some young, very strong platelets with a lot of healing factors. I think his prognosis is great. This is something we did today to try to hasten the recovery time. It’s really a shot. It’s not a surgical procedure. It’s a 20 minute deal. I don’t think it’s a big deal. We want to do everything we can to give Dwight the best chance of being back as fast as he can be back. The other side of that is we want him to feel like Dwight and be one hundred percent when he comes back. This sort of mixes those two things together. I think he would get well even without this today. We’re really treating this like a bone bruise. There is nothing structurally wrong with his knee. That soreness is what we’re trying to get rid of. So we’re really basically treating a bone bruise. The time frame for these bone bruises to heal is in that 4-6 week timeframe. The most important thing for Dwight is his pain (to be) gone. That’s more important than what the MRI is going to show me in four weeks. As long as we’re seeing a combination of bone bruise gone away (and) symptoms being better, then that’s when we’ll start the transition back to the court. What makes this heal is essentially rest. I would certainly expect him before the playoffs. I hope we have quite a few games before the playoffs. I really expect him to recover and play again this season.”