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LOUIS -- An MRI exam on Monday revealed that Cardinals first baseman Lance Berkman has suffered a substantial meniscus tear in his right knee, as well as some torn cartilage. A more severe injury to the anterior cruciate ligament was not found on the MRI, but it has also not yet been ruled out.
It won't be until Berkman travels to Vail, Colo., later this week that he will know for certain whether he has a torn or compromised ACL. In a candid session with the media on Monday, Berkman said he expects doctors will find evidence of ACL damage.
It was a differing take from the one general manager John Mozeliak offered, when he characterized the club as "cautiously optimistic" that the damage in Berkman's knee is limited to the meniscus.
Dr. Richard Steadman, a noted surgeon and knee specialist, will provide the second opinion on either Thursday or Friday. At a minimum, Berkman will undergo a scope to repair damage to the meniscus. During that procedure, if it is determined that the ACL has been compromised, that, too will be repaired.
If there is no ACL damage, Berkman will be sidelined at least 6-8 weeks. If surgery is needed to repair the ACL, the first baseman will miss the rest of the 2012 season. It could also end Berkman's career, if the 36-year-old opts not to go through the rehabilitation process, something he is currently undecided upon.
"I'm prepared for anything," said Berkman, leaning on crutches as he discussed his diagnosis and outlook following Monday's MRI. "You certainly think about, if I have to get my ACL repaired, I might be done playing. It's a tough deal. It's a very significant injury and it's tough to come back from it. Not that it's impossible, but it is tough.
"You just don't know where you're going to be mentally -- am I able to make the commitment that it's going to [need to] come back to a high level? I don't know. Those are questions I'm trying not to speculate too much on, because they might go in and say the thing looks pretty good."
Berkman does not anticipate that to be the case, even after being told of Monday's inconclusive MRI results. Berkman said his assessment is based largely by what he felt in his knee before and at the time of the injury.
Berkman's primary concern is why such an ordinary movement -- catching a routine putout at first base -- would cause such significant damage to the meniscus if there wasn't an underlying problem.
"We can all agree that you shouldn't get hurt stretching for a ball at first base," Berkman said. "That was a very unusual way to get injured. It's just a routine, bent leg, stretch for a baseball. It leads me to believe that there might be some instability that needs to be addressed."
That instability isn't new, either. Berkman said he has felt it going all the way back to the 2011 postseason, and doctors told him on Monday that a damaged meniscus likely isn't the cause of such an issue.
"All of the information that I'm getting, plus what I felt, leads me to believe there is an issue with the ACL," Berkman said. "I'm hoping that's not the case, but I'm not sure that's the case. The major concern right now is: Is it effective in protecting that joint from sliding around? All the evidence points to that it's not."
Berkman has already had his right ACL surgically repaired once before, back in November 2004. He suffered that knee injury while playing flag football.
This latest knee injury occurred as the second inning ended in Saturday's loss to the Dodgers. After catching a ball at first, he took a few hops before sitting on the infield grass. He could not leave the field without assistance and afterward described the knee as twice buckling on him.
Even if it is just to repair the meniscus, this will be the fifth procedure Berkman has had on his knees. He has had two other meniscus repairs, but noted that "this feels worse than the other ones."
He also revealed on Monday that an MRI taken during Spring Training revealed a much smaller meniscus tear in the knee. No procedure was done at the time, because Berkman was told he could play through the issue.
Now, he is forced to wait a few more days to receive a clear diagnosis and contemplate what it means long term.
"Fearful is the wrong word, but I'm certainly considered about not just what the injury is, but why did it happen," Berkman said. "To me, that's what needs to be addressed. Even if I get this thing fixed, if the joint is still not stable, it could happen again."