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Brawndo

Pilut Undergoes Shoulder Surgery -- Out 5-6 Months

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Not exactly good news when two of our top prospects have surgery that can (UPL) or will (Pilut) have them out for the beginning of next season.

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So June-July-August-September-October-November

And yes, I counted on my fingers for that. 

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Wow...more major surgeries...this means he is out for all of training camp and pre-season most likely and could miss some time into the regular season as well...

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1 minute ago, matter2003 said:

Wow...more major surgeries...this means he is out for all of training camp and pre-season most likely and could miss some time into the regular season as well...

He probably starts in a Rochester

With him and Bogo expected to miss time at the beginning of the season, we will probably see Borgen and ???? Up here to start the season 

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I wonder why he didn’t get it done in mid/late April. 

Anyway ... that sucks. Hope he fully recovers.

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12 minutes ago, Brawndo said:

He probably starts in a Rochester

With him and Bogo expected to miss time at the beginning of the season, we will probably see Borgen and ???? Up here to start the season 

RHD

Montour,

Risto, 

Nelson

LHD

Dahlin,

McCabe,

Hunwick,

Scandella

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35 minutes ago, Zamboni said:

I wonder why he didn’t get it done in mid/late April. 

Anyway ... that sucks. Hope he fully recovers.

Probably diagnosing it with MRI takes a while to schedule, labs for Gadolinium, checking for metal in his body if so, then needs a good CT scan and waiting for any swelling to subside if MRI. Could be a number of reasons for delay and often physical therapy is tried and cortisone shot or shots to see if that can alleviate problem.

Edited by North Buffalo

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33 minutes ago, LGR4GM said:

RHD

Montour,

Risto, 

Nelson

LHD

Dahlin,

McCabe,

Hunwick,

Scandella

I would still move Risto for the right deal. 

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6 minutes ago, Brawndo said:

I would still move Risto for the right deal. 

Miller and Cirelli or Miller and Foote/Cernak seems to be a possibility. 

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2 minutes ago, North Buffalo said:

Probably diagnosing it with MRI takes a while to schedule, labs for Gadolinium, checking for metal in his body if so, then needs a good CT scan and waiting for any swelling to subside if MRI. Could be a number of reasons for delay and often physical therapy is tried and cortisone shot or shots to see if that can alleviate problem.

I agree with most of what you said.

One does not get a CT scan for checking for foreign body metal.

the protocol is ... have you ever worked with metal before? Have you ever got anything metallic in your eye? Do you have any metal in your body?

IF either answer is yes, to any of it, you get an X-ray of the orbits. If the person has metal in the body elsewhere (like a joint), they will carry a card with them saying what the joint in comprised of. Titanium joints are nonferrous therefore pose no risk for an MRI. Small (very little) specks of metal will also pose no danger for an MRI as long as it’s not near a artery or organ. (Imbedded in the meaty part of a hand or thigh for example) A simple X-ray will clear this.

Now, he MAY have gotten a CT scan for diagnosis and to give the surgeon a great view of structures pre-op. But it wasn’t for clearing him of foreign bodies.

anyway .... all those imaging procedures and protocols could have been done in April,  even with swelling (largely assuming there was any). 

I’m sure there was good reason as you alluded to. It just sucks (in general) it couldn’t have been done sooner. Oh well ... it’s done.

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Not happy about this for 2 reasons: the obvious being he'll miss at least the 1st month of next season & possibly more unless his recovery is significantly quicker than expected.

The 2nd being, unless this is simply cleaning up a chronic injury from back when he was playing in Sweden, in this undersized D-man's 1st season going against the monsters that play in the NHL, he ended up injured.  Does not alleviate concerns that he's too small to play here.  (Hoping that's just being too pessimistic, but definitely something to watch for.)

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On the other hand, may account for the drop-off after good start.

5 hours ago, North Buffalo said:

Probably diagnosing it with MRI takes a while to schedule, labs for Gadolinium, checking for metal in his body if so, then needs a good CT scan and waiting for any swelling to subside if MRI. Could be a number of reasons for delay and often physical therapy is tried and cortisone shot or shots to see if that can alleviate problem.

Stop making sense.  This is a message forum.

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6 hours ago, Zamboni said:

I agree with most of what you said.

One does not get a CT scan for checking for foreign body metal.

the protocol is ... have you ever worked with metal before? Have you ever got anything metallic in your eye? Do you have any metal in your body?

IF either answer is yes, to any of it, you get an X-ray of the orbits. If the person has metal in the body elsewhere (like a joint), they will carry a card with them saying what the joint in comprised of. Titanium joints are nonferrous therefore pose no risk for an MRI. Small (very little) specks of metal will also pose no danger for an MRI as long as it’s not near a artery or organ. (Imbedded in the meaty part of a hand or thigh for example) A simple X-ray will clear this.

Now, he MAY have gotten a CT scan for diagnosis and to give the surgeon a great view of structures pre-op. But it wasn’t for clearing him of foreign bodies.

anyway .... all those imaging procedures and protocols could have been done in April,  even with swelling (largely assuming there was any). 

I’m sure there was good reason as you alluded to. It just sucks (in general) it couldn’t have been done sooner. Oh well ... it’s done.

Sorry didn't state it well was tired last nite.  You are right about metal in eye and any metal prothesis-in body is nowadays non ferrous but serial numbers need to be checked. If not good a high resolution CT can get pretty close 256 slice machines or higher produce pretty amazing soft tissue results.

Edited by North Buffalo

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4 hours ago, Formerly Allan in MD said:

What next?  Sabres will likely hire the wrong coach, again.  Buffalo sports remain cursed!

Link? Evidence?

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I liked Pilut a lot more than Phil Housley did.

I hope he recovers well and maybe even faster than anticipated.

 

 

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3 hours ago, North Buffalo said:

Sorry didn't state it well was tired last nite.  You are right about metal in eye and any metal prothesis-in body is nowadays non ferrous but serial numbers need to be checked. If not good a high resolution CT can get pretty close 256 slice machines or higher produce pretty amazing soft tissue results.

True but it’s overkill. 128 slice, hell even 64 slice would do what’s needed for any pre-op evaluation/diagnosis for structures like shoulders. With reconstructions in all three planes.

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10 hours ago, North Buffalo said:

Probably diagnosing it with MRI takes a while to schedule, labs for Gadolinium, checking for metal in his body if so, then needs a good CT scan and waiting for any swelling to subside if MRI. Could be a number of reasons for delay and often physical therapy is tried and cortisone shot or shots to see if that can alleviate problem.

This is inaccurate, unless the injury was within the last 2 weeks. No one needs a CT to exclude metal in the body. Swelling usually subsides with 2 weeks. If this was a chronic injury (which it may not be), there would be no acute swelling. Testing a serum creatinine for gad administration takes less than 24 hours and we don’t live in Canada, extremity MRs can be obtained also within 24 hours, especially if you have the insurance the Sabres have. Why do I know this? Because I order extremity MRs a few times per week. I do agree with the conservative management of PT though, but it can waste time. Usually the team ortho will lay it out realistically. Usually PT is kicking the can down the road is not definitive treatment. 

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9 hours ago, Zamboni said:

True but it’s overkill. 128 slice, hell even 64 slice would do what’s needed for any pre-op evaluation/diagnosis for structures like shoulders. With reconstructions in all three planes.

you misunderstood 256 can be used in place of mri with 256 not talking clearance at that point

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9 hours ago, kas23 said:

This is inaccurate, unless the injury was within the last 2 weeks. No one needs a CT to exclude metal in the body. Swelling usually subsides with 2 weeks. If this was a chronic injury (which it may not be), there would be no acute swelling. Testing a serum creatinine for gad administration takes less than 24 hours and we don’t live in Canada, extremity MRs can be obtained also within 24 hours, especially if you have the insurance the Sabres have. Why do I know this? Because I order extremity MRs a few times per week. I do agree with the conservative management of PT though, but it can waste time. Usually the team ortho will lay it out realistically. Usually PT is kicking the can down the road is not definitive treatment. 

Again in lieu of 256 soft tissue images with 3d fly thru recons have amazing detail.  I know you guys are used to MRI images for that but have you seen the full capability of a 256?

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Plus 256 is about 10th the dose of a 64.  Can scan a whole body in just over a quarter of a second v mri can take an hour though you wouldnt want to do a whole body

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Yes the dosage is naturally lower with newer 256 scanners. 

A shoulder MRI (Piluts injury) in a 1.5T would take roughly 25 mins. In a newer 3T,  maybe 12-15 mins. And with the image quality, especially of the 3T, a CT (depending on the doctor and surgeon), is complete overkill and unnecessary for his injury diagnosis and course of treatment. Although most docs and surgeons still want a CT because they are more familiar and comfortable with “reading” CT images as opposed to MRI images. But that is slowly changing. Too slowly IMO.

i think this thread is getting off track a bit with discussing the merits of CT/MRI. Let’s turn the wheels and get back on Pulit Blvd. 

I want to see Pilut succeed here. With the right coach and right role/usage and partner, I think he could be a solid #4 in the NHL. 

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I wonder if the injury is what made him avoid contact like the plague. He would literally jump out of the way of oncoming forecheckers. 

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