What the Hell Is Going on With Joel Embiid?

MOC tries to make sense of the latest round of catastrophic developments regarding our franchise player.

The story of Joel Embiid’s confounding season took yet another turn on Sunday with a bombshell report from Lisa Salters during the ABC broadcast that Embiid had told her he might require another surgery on his knee, one that would have a “long recovery period” in order to get back to 100 percent. This report was a massive departure from everything that everyone in the organization has said regarding Embiid’s knee – in fact, in a press conference just a few days prior, Daryl Morey said that nearly 10 doctors have all agreed that Embiid’s knee will naturally get better over time and that his symptoms such as swelling and pain will hopefully be reduced to zero.

The obvious question is which of those conflicting accounts you should believe to be true, and just based on sheer logic, the first scenario – that Embiid may get another surgery – would seem to be far more likely. As it has been explained by orthopedic surgeons online, the problem in Embiid’s knee (like many other players who have had these types of issues) is that he has had so much of his meniscus damaged/removed that there is not enough cartilage left to protect his knee. This naturally leads to swelling and pain with any sort of heavy use, and there is no natural mechanism for it getting better, especially more than a year out from the initial injury. So, given the lack of success of the rest/load management/let it heal naturally strategy, plus Embiid’s comments, you’d have to assume that some form of surgery would be within the realm of possibility, and that Morey’s comments are not painting the full picture.

After the game, Embiid downplayed (but did not totally discount) the idea of getting surgery to The Inquirer’s Keith Pompey. If he were to get surgery, a simple Google search tells us that the most logical procedure for people with his issues and history is some type of meniscus and/or cartilage transplant, like the one that Lonzo Ball had. There are multiple versions of these procedures, including a full meniscus transplant and an osteochondral allograft transplantation (referred to as an OCA, which is essentially a cartilage transplant), all of which have the same approximate recovery timeline – and in some cases, like Ball’s, multiple versions are performed at the same time. In March of 2023, Ball had both a meniscus transplant and an OCA on the same day.

The downside of this surgery is significant – it is not successful or even possible in all cases, and it has a 9-12 month recovery timeline (which, given that Embiid said verbatim that his surgery would have a “long recovery period,” lends further credence to the possibility that this is the type of surgery he’d look into).

Let’s just be real for a second – while this report was a shocker, this surgery is something that Embiid probably has been thinking about in the back of his mind for some time now. It’s been over a year since his injury, and he’s still having regular periods of swelling and pain that prevent him from being on the court. And, of course, what’s equally as concerning is the fact that when he has played, he’s put up some of the worst numbers of his career, and his overall impact is a far cry from what it was in years past. His counting stats, while excellent compared to any regular player, are all down considerably from his previous few seasons, as are any stats that measure his overall impact.

For the first time in his entire career – including his rookie year, in which the team won just 28 games – the Sixers have a negative net rating (-3.9) when Embiid is on the floor. Last season, the team went 31-8 in Embiid’s 39 games. This year, they are 8-8 in his 16 games. Indeed, Embiid’s decline in overall impact is obvious both with the eye test and the stats – the team has a better net rating with Guerschon Yabusele at center than they do with Embiid.

We could certainly blame injury misfortune for a large portion of the Sixers’ disappointing season, but it’s particularly jarring to not be able to look at the stats and say, “See, look! If Embiid were on the court more often, everything would be fine.” That would be true for any version of Embiid prior to this year, but with this version of Embiid, it just isn’t the case; they’d surely be better, but there’s not a shred of evidence to suggest that the 2024-25 Sixers are a great team when Joel Embiid plays. They are losing the minutes that he’s on the court!

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Some fans probably heard this report and felt a sense of frustration or betrayal from the organization, assuming that the team must have been lying to them about the potential for another surgery on Embiid’s knee. But if I had to guess, I would say it points to something else – a disconnect between how he and the team view the injury. At this point, if Daryl Morey, Nick Nurse, and even Josh Harris have avoided mentioning the possibility of surgery, and Embiid just blurts it out in a pregame meeting with Lisa Salters and later partially backtracks, it’s likely just something the the big fella himself has gotten into his mind as a vague possibility.

I imagine that Morey and others have probably trusted the refrain they’ve heard from doctors – that their best bet is to hope the knee heals over time – whereas Embiid, fearing that his career is slipping away, is more of the mindset that something has to be done, even if the options out there are risky.

Again, this is all just me guessing and trying to piece together the puzzle. It’s hard to overstate what a bombshell this report was, and we are still in the early stages of interpreting it. But if Embiid’s fears are ultimately confirmed, and he does have that type of surgery, you can safely bet that he will miss all of next season, unless he were to hit the operating table within the next few weeks.

Such a blow would necessitate a major shift organizationally away from any illusion of contending next season. They would likely have to try to trade Paul George this summer for whatever they can get, and turn 2025-26 into something of an experiment for whether or not Tyrese Maxey and Jared McCain can coexist as the backcourt of the future. They likely would opt away from bringing back veterans like Kelly Oubre, and would make it a priority to sign younger players like Quentin Grimes and Justin Edwards to long-term deals. I’d imagine that retaining Guerschon Yabusele would still be a priority for the Sixers, given that he’s a beloved teammate and has not yet turned 30. Acquiring another center, even if it’s a rotation-level placeholder, might also become a priority for the Sixers.

Even after next season, I’m not at all sure how the Sixers would approach building the team around Embiid. It would likely be malpractice to push their chips in to try and become a contender with a 32-year-old Embiid coming off of a surgery of that magnitude. Lots can change between now and then, but it’s hard for me to imagine a scenario in which the Sixers are penciling Embiid in to be an MVP candidate that year even if his new meniscus feels fresh as a daisy.

Move Into My Apartment

The only thing that I feel I can confidently assume is that, given his quotes to Salters and Pompey, Embiid will pursue some sort of procedure this off-season if things continue along this trajectory. As he said to Pompey: “at some point we got to do something about it.”

Doing absolutely nothing besides rest and rehab would seem to me to be a waste of time; I have no idea how the Sixers could look themselves in the mirror and decide it’s a good idea to run this team back next season on a hope and a prayer that Embiid’s knee heals on its own. Maybe that means doing something relatively minor like stem cells and PRP injections, which many players with knee issues, including Pau Gasol and Karl-Anthony Towns have had done. Or, maybe it means going the Lonzo Ball route – which if Embiid’s commentary on having a “long recovery period” is any indication, seems to be the more likely route.

Regardless, it’s just hard to find a silver lining right now. If I had to bet on how this will play out, I’d wager that Embiid will continue to be in and out of the lineup, the team will sneak their way into the 10th seed, and Embiid will try to gut his way through those play-in games as well as a first round ass-kicking if they make it that far. After that, I think this latest batch of Embiid quotes, combined with the obvious reality that his knee is not healing, means that we get another procedure that knocks him out for most or all of 2025-26. So, no matter how it turns out – no matter how hard Daryl Morey asks me to squint – I can’t seem to see a path towards contention in this season or the next one.

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Mike O’Connor is the best O’Connor in basketball writing. Previously of The Athletic, you can find Mike on Twitter @MOConnor_NBA. Mike’s writing is brought to you by Body Bio, supplements based on science, focusing on your gut and brain health.