Head athletic trainer Kevin Rand said Thursday that while Inge had non-surgical options, including a procedure in which Inge's plasma would be enriched with protein and re-injected into his knee, surgery was the one option that ensured he would be ready for the start of camp.
"Basically, we're looking at all of November, December and January [to recover and rehab]," Rand said. "He should be ready to do [baseball] activity at the beginning of Spring Training. That was the thing. Basically, what it boiled down to is that the timetable looked like it was going to be surer with the surgery."
While the surgery is relatively common in other sports, such as basketball and volleyball, Rand said it's less common in baseball simply because baseball players don't suffer this sort of injury nearly as often. Given the athleticism Inge uses at third base, however, it's a little different.
One recent example in baseball was Angels reliever and Michigan resident Scot Shields, who had season-ending surgery to correct patella tendinitis in his left knee in June.
The surgery isn't a complete surprise to Inge, who openly wondered about it last month. At the time, he said that his left knee, which had more damage than in his right, felt worse at times down the stretch than it did over the summer. When he made diving stops on two occasions in September, he said it was the worst his knee had felt in a while. Other days, however, it would feel better.
Inge had a follow-up MRI exam on both knees earlier this month to see if there was any difference, one way or the other. Rand said the results were basically the same from MRI results in June. That was good in the sense that Inge's playing had not worsened the damage, but it also dashed hopes that all the treatments over the past few months might've promoted healing.
"It was going to be what it was," Rand said. "Did it make it worse? No. Did it get better? No. It didn't show signs of getting better."
Had the signs been a little more encouraging, or if the Tigers had had more time before Spring Training, they might have tried to avoid surgery.
"It looked like we could go with the protein-rich plasma injections," Rand said. "The only problem with that is that if it didn't show improvement [in six weeks], we were probably going to have to do surgery anyway."
Inge's knees began bothering him early in the season and became a real problem in June. He felt something worsen in his left knee during the Tigers' Interleague series against the Cubs, and then further deteriorate in the ensuing weeks.
Around that time, Inge was diagnosed with microtears in the patella tendons of both knees.
The deterioration affected Inge's performance, both at the plate and in the field. Before the injury, he was having the best start to a season in his career, batting .275 with 18 home runs and 52 RBIs through June 30. He hit just .189 from July 1 to season's end, homering nine times and driving in 32 runs while striking out 99 times in 331 plate appearances.
Though some sort of dropoff might have been expected once pitchers adjusted to Inge's new approach at the plate, the injury hampered his ability to adjust. He fell out of some of the habits that improved his approach at the plate, and instead had to make adjustments aimed primarily at tempering the pain.
Inge continued to play, insisting that he wouldn't go on the disabled list unless doctors found a way to fix the injury with only the minimum 15-day stay on the DL. Tigers medical personnel tried everything they could short of surgery, including laser therapy and an experimental treatment called prolotherapy in which a glucose solution was injected into his left knee to promote healing. Nothing produced lasting results.
Though Inge set a career high with 84 RBIs and tied another with 27 homers, his .230 batting average was the second-lowest among Major League players with enough plate appearances to qualify for a batting title. Only Carlos Pena batted lower, at .227. Inge's 170 strikeouts ranked second among AL hitters to Jack Cust's 185.
There's no guarantee Inge will get back to his first-half form after surgery, just as it isn't guaranteed that Inge will have the old jump from his knees. Still, Rand likes his chances.
"You know Brandon as well as I do. He's a pretty tough kid," Rand said. "That same tenacity is going to do him well in rehab. He'll feel a lot better than what he did this year."