Inside Mike Napoli’s Hip Diagnosis and His Stride Forward

Mike Napoli and the Texas Rangers didn’t hide a thing from the Red Sox during his contract negotiations. As a matter of fact Napoli felt fine until a Red Sox physical discovered that he had a rare condition known as avascular necrosis. We’ll need to take a deep dive here to understand the condition, it’s possible causes and what it means for Napoli and Boston.

Sep 19, 2012; Anaheim, CA, USA; Texas Rangers catcher

(25) during a first inning at bat against the Los Angeles Angels at Angels Stadium of Anaheim. Mandatory Credit: Jake Roth-USA TODAY Sports

Avascular necrosis – also called Osteonecrosis, bone infarction, aseptic necrosis or ischemic bone necrosis – is quite simply bone death caused by poor blood supply, most commonly affecting either the shoulder or hip. If left untreated, the joint will deteriorate and degenerate into severe arthritis. Avascular necrosis is the same condition that cut short football and baseball great Bo Jackson‘s career.

I have a special personal interest in Napoli’s condition in that as a child I had a condition diagnosed as Legg-Calve-Perthes disease, a juvenile and potentially more serious form of Napoli’s condition. After a year and a half in a brace, crutches and physical therapy I experienced a full recovery and have lived a very active and normal life as an adult. Napoli’s condition, however, is not easily solved by rest and therapy. Treatment for avascular necrosis can include total hip replacement (THR) or metal on metal hip resurfacing (MOM – experimental). Other treatments include core decompression, where internal bone pressure is relieved by drilling a hole into the bone, and a living bone chip and an electrical device to stimulate new vascular growth are implanted; and the free vascular fibular graft (FVFG), in which a portion of the fibula, along with its blood supply, is removed and transplanted in the femoral head (source, Wikipedia).

"“As of now, I don’t have any symptoms from it,” Napoli told MLB.com’s Ian Browne. “I’m on medication to help me get through it. I haven’t had any symptoms from it. I played with it last year, and there’s no reason why I shouldn’t be able to be there Opening Day and be a starter Opening Day.”"

In the same article, Sox GM Ben Cherington said, “Obviously, we know he can catch. He’s done that a lot in the past. He’s been good at it and we would trust him back there. For a couple reasons we’re focusing right now on first base. No. 1, because that’s obviously our primary team need. That’s where the biggest opening is. And No. 2, we do feel like it makes sense in the short term to allow Mike to focus on that position to take a bit of a load, or a bit of stress, off the body, off the lower body in particular.”

The causes of Osteonecrosis are wide and varied; trauma, vascular compression, sickle cell anemia and deep diving to alcoholism and steroid use/therapy treatments are just a few of the possible causes.

Napoli, a power pull hitter is made for Fenway. He has a .307 average, nine homers, 20 RBIs and a 1.138 on-base plus slugging percentage in 75 career at-bats at Fenway Park. To make room for Napoli on the 40-man roster, the Red Sox designated right-hander Chris Carpenter for assignment.

What is hip?
Tell me, tell me, if you think you know.
What is hip?
If you’re really hip, 
the question, “Will it show?”
You’re into a hip trip.
Maybe hipper than hip.
What is hip?
– What Is Hip, Tower of Power