CINCINNATI -- Carson Palmer's knee injury was "devastating and potentially career-ending," involving numerous ligament tears, a shredded ligament, damaged cartilage and a dislocated kneecap, his surgeon said Thursday.
The Cincinnati Bengals quarterback tore ligaments in his left knee when he was hit by Pittsburgh's Kimo von Oelhoffen on his first pass during the Steelers' 31-17 playoff victory Sunday.
The team announced that he had torn the anterior cruciate and medial collateral ligaments. The damage was much more extensive and severe, but Dr. Lonnie Paulos said surgery went well and Palmer could be back for the start of the season.
Palmer had surgery Tuesday in Houston. Doctors used grafts from other parts of his body and donated tissue to fix the damage during an operation that lasted more than two hours. Palmer headed back to California on Thursday to do his rehabilitation.
"It's not just like it was a torn ACL," Paulos said Thursday, in a phone interview from Houston. "It's a magnitude more difficult to recover from and repair. It can and has ended careers, without a doubt.
"However, I feel very comfortable with Carson as an athlete and the heart that he's got. In the end, that's the bottom line. I can see the look in his eye already. He's ready to get going," he said.
Paulos, an orthopedic surgeon who has worked with the U.S. Ski Team since 1983, replaced the anterior cruciate ligament, which runs through the middle of the knee and provides stability. He said the medial collateral ligament, which runs along the side of the knee, was damaged "real bad."
"On a scale of one to three, it was a four," he said. "It was off the chart. It was pretty badly damaged -- shredded is the better term."
The kneecap dislocated when Palmer was hit, damaging tissue around it. There was also some cartilage damage, he said.
Paulos was able to repair the knee without removing pieces of cartilage or soft tissue, a good sign.
"The things that were torn could be repaired," he said. "They were not torn beyond repair. So he's got all his parts in there, which is good. We're optimistic, actually."
If rehabilitation goes well, Palmer could be running in a couple months and might be able to play in the first regular-season game, Paulos said. The 2006 schedule hasn't been set.
The Bengals declined to comment on Paulos' description of the
injury, but released a statement from him late Thursday night
reiterating that he is optimistic about Palmer's recovery.
Palmer has worn a protective brace on the left knee since he sprained it near the end of the 2004 season. The knee bowed inward on von Oelhoffen's hit even though Palmer was wearing the brace.
"The brace didn't function well in this environment and should have done better than it did, frankly," Paulos said.
The plan is for Palmer to wear more substantial braces on both knees when he returns.
"No brace is perfect," Paulos said. "No brace can prevent every injury, but they do help."
Paulos saw the replay of the injury and wasn't surprised at the extent of the damage it caused. Palmer has absolved von Oelhoffen, saying he didn't think the lineman was trying to hurt him. The lineman said he was trying to sack Palmer, not injure him. He wasn't penalized for the hit.
Palmer made the Pro Bowl in only his second season as a starter, throwing an NFL-leading 32 touchdown passes. The club extended his contract through the 2014 season.
Jon Kitna, who has been Palmer's backup and mentor the last two years, can become a free agent. Palmer's injury will force the Bengals to make sure they have another reliable quarterback on board.