Doctor sends alarming Lynch warning to Tigers
Leading sports physician Dr Peter Larkins says Tom Lynch's prolonged PCL knee struggles have potentially put the Richmond recruit at risk of never getting back to his best.
Lynch missed the last three games of 2017, a month in early 2018 and didn't play after Round 14 - going under the knife when rest failed to cure his knee pain at the Gold Coast Suns.
"At his best he's obviously a really good player, but sometimes there are injuries that mean guys never get back to their best and you recruit them thinking you're going to be a genius," Larkins told the Herald Sun.
"Clubs are sometimes more optimistic than they need to be on certain things."
Lynch remains determined to face Carlton in Richmond's season-opener, but this week conceded: "I'm not sure".
Jarryd Roughead, Luke Hodge, Cyril Rioli, Grant Birchall and Nakia Cockatoo have all undergone PCL operations in recent years, with varying degrees of success.
PCL surgery, while refined by modern medicine, is still considered rare given the complexity and risks with the procedure.
"Lynch is interesting because if he turns out to be a Luke Hodge, who we've almost forgot had one, he'll be fine," Larkins said.
"But you look at Lynch and it was a case of will-he or won't-he (have surgery) and as the months go on the knee usually gets more wear in it and more cartilage damage.
"So even though you might have a PCL operation to make the knee stable, athletes have often got advanced change in the knee by the time you do it so the soreness continues afterwards. The secondary damage to the joint surface and cartilage is already established.
"Quite often clubs are leaving it a long time before they get it done. You can tighten the PCL looseness, but if you've got cartilage damage, that is what's irreversible."
Lynch, 26, joined Richmond as a restricted free agent, signing a seven-year deal to partner Jack Riewoldt in Damien Hardwick's forward line.
The Tigers have cautiously eased him into their pre-season program and already ruled him out of both JLT Community Series pre-season matches.
"If you took 50 knee surgeons in Melbourne and asked how many do ACLs I reckon 50 will put their hand up. (But) if you ask those 50 how many do PCL reconstructions you might find four or five put their hand up," Larkins said.
"The PCL is totally different from the ACL in the sense it runs in the opposite direction. Everything in surgery is back to front so it's more tricky.
"In our Epworth Hospital network between 2016-2017 we did 1,730 ACL reconstructions and we've done around 14 PCLs so there's the sign.
"Clearly the successful ones are the ones we like to talk about, but the problem is there's a whole bunch that are slow."
The Tigers face the Blues at the MCG on March 21 with Lynch desperate to make his Richmond debut in the traditional blockbuster.
"I don't know if Round 1 is realistic because Round 1 is less than four weeks away," Larkins said.
"It will come down to him being really confident and ready to go and not having a setback, because you only get one go at it."