"The question arises, 'What do you do with these two injuries?' There's not a consensus around the country among sports medicine people," Burkholder said. "The first thing we know is that the MCL has to heal before you can do anything with the ACL. That takes up to 4 to 6 weeks. With the ACL, you have to decide whether or not you're going to have to fix it through ACL reconstruction . . . If we fix it, he will be done for the season and he will have a long rehab. If you don't fix it and the MCL heals, he has a chance to play this year."
Dr. Ronald Grelsamer, associate professor of orthopedic surgery at New York's Mount Sinai Hospital, said Kelce's situation "is a common scenario" in sports medicine. He said there is a good chance Kelce's medial meniscus also is torn. Grelsamer said that while an MCL tear does not require surgery, he questioned Burkholder's 4-to-6-week timeframe.
"That can be an annoying injury for a long time," Grelsamer said. He said even a mild strain would require 4 to 6 weeks, and "if you have a complete MCL tear, like somebody took a pair of scissors and cut it in half, or even worse, shredded it by pulling on it, that's a multimonth injury . . . Even without the ACL tear, it could be tough for him to come back [this season]. He's a very big guy, in a very physically demanding role. It's not like he's a cyclist."
Grelsamer said DeLuca might not find the ACL issue cut-and-dried, when he looks with his scope today.
"That can be a very tough call, as to whether the ACL is good enough to still do its job or not," Grelsamer said. "There's no test you can do. It's a complete feel thing, meaning the surgeon takes a little probe and he pulls on it a little bit and he makes his determination of whether it should do the trick or whether it's beyond functioning, in which case you have to reconstruct it."
Dr. Art Bartolozzi, former Flyers and Eagles team orthopedist, said published data suggest the chance of a partial tear becoming a full tear is "very high in high-level athletes." Bartolozzi said ACL tears of less than 25 percent "progressed infrequently," but someone playing with a 75 percent tear would see the injury worsen 86 percent of the time. Bartolozzi said a sports-medicine journal survey showed only 44 percent of ACL victims who didn't get surgery were able to return to their sports at their preinjury level.
"So, for this reason, we are pretty aggressive on reconstructing ACL injuries," Bartolozzi said. "In general, we reconstruct ACL tears."
Kelce, who has started every game since arriving as a sixth-round pick from Cincinnati last year, is a centerpiece of Howard Mudd's system, which requires speed and athleticism from the center. Kelce often pulls and blocks downfield on running plays, which is what he was doing when Reed missed LeSean McCoy and slammed into Kelce's leg.
Asked Monday night if he thinks there is a good chance the ACL tear is minor, Kelce said: "I honestly have no idea. The extent of the tear will not be clear until [Tuesday]."
As Eagles coach Andy Reid noted Monday, there is a new type of injured reserve designation - each team can place one player on IR this season with the ability to bring him back in 8 weeks. But once that designation is used, it can't be used again this season. If it turns out Kelce needs ACL surgery, he will go on regular IR.
Reid said Monday that Dallas Reynolds, who filled in capably when Kelce went down Sunday, will continue as the starting center.
A source close to the situation said veteran O-lineman Steve Vallos, 28, visited the Eagles on Monday and will sign today to back up Reynolds. Vallos, drafted in the seventh round by Seattle in 2007, also has played for the Browns. He was with the Birds in training camp and in preseason. He was released in the final roster cutdown in favor of Reynolds, who had spent 3 years on the Eagles' practice squad.
Andy Reid was asked about the Ravens' contention that the Eagles were taking cheap shots Sunday. "I would tell you there was a little pushing and shoving and all that. I think it was probably both sides," Reid said. "I think it was two good football teams playing each other; you're going to get a little of that. It was a physical game." Reid said he wasn't sure the Ravens anticipated the Eagles "were maybe as tough as what they figured out, once we got there." . . . Reid said Jeremy Maclin added a hip contusion to his previous hip injury. Reid didn't venture a guess on whether Maclin might play in Arizona on Sunday.
Contact Les Bowen at firstname.lastname@example.org. Follow him on Twitter @LesBowen. For more Eagles coverage and opinion, read the Daily News' blog at eagletarian.com.