Maybe it's time for the Baltimore Orioles to start getting concerned.

Not this season, but a few years from now. With star third baseman Manny Machado undergoing knee surgery on Wednesday — his second in less than a year — it might be time for the Orioles to worry about how his body, and more specifically, his knees, are going to hold up as they continue to get tested by the wear and tear of the long Major League Baseball season.

Machado's problem was that he had "abnormalities" in his knees, according to Los Angeles Dodgers team doctor Neal ElAttrache. ElAttrache, who performed the surgery on Wednesday to repair the medial patellofemoral ligament in his right knee that was torn on Aug. 11, corrected the same problem in Machado's left knee in 2013. That injury caused him to miss the end of last season and the beginning of this year, as well as time in 2011, when he hurt it in the minor leagues.

The surgeries, while certainly a necessity to help the damaged ligaments fully heal, were also necessary to remove the abnormalities in his knees, in the hopes that it would alleviate any future problems. But no matter how you slice it, even if the surgeries are seen as a way to help improve his future health, any procedure of this magnitude this early in a career sets up the risk for it to have significant impact on a player's career down the road.

And maybe the most concerning part is that Machado is only 22. This type of stuff isn't supposed to happen to someone who is in the prime stage of health. Machado shouldn't have to worry about what will happen if he legs out a groundball, or if he's forced to range deep into foul territory, jump and throw, like we've seen him do so many times. In fact, it's those exact plays that have transformed him into one of the game's best third basemen.


A gaping hole: While it's not the first time Baltimore has had to deal without its injury-riddled All-Star, this might be the worst time to lose him. He was a key part in the Orioles making the postseason back in 2012, but with last year's season lost by the time he went down, his health was vital in the team's success this year.

While he limped through much of the first half while still trying to get back into a rhythm following last season's surgery, he started to heat up during the summer. After serving a five-game suspension, Machado hit .351 with five home runs in the 28 games before his injury, with Baltimore going 19-9 during the span.

Now with the Orioles finally looking like a possible World Series contender and running away with the American League East, it's tough to imagine what this team can do without Machado.

Without him manning the hot corner on a nightly basis, Baltimore has shuffled through a platoon of players at the position. Predictably so, the production has been down and the defense isn't nearly what it was when Machado was there. It almost begs the question if the Orioles have a plan in place for the future to replace a guy who is on the disabled list as much as he's in the starting lineup.

Looking ahead: It's inevitable that as players age, their bodies gradually wear down. We've seen MLB greats lose a step defensively at the tail ends of their careers without even suffering significant injuries. Now, with Machado struggling to even make it through a full season in his early 20s, it's hard to imagine him having anything in the tank physically when his early 30s roll around. Bo Jackson, one of the most-gifted athletes of all time, had to succumb to chronic hip problems and retire from athletics at only 31.

In the knee, Machado is dealing with a body part so unpredictable, that a simple plant to throw, or stretch to beat out a close play at first base, could potentially rupture the ligaments holding it in place. These surgeries may be something that will fix his abnormalities and allow him to continue playing baseball for years to come, but, at the same time, it's also just as likely that the new repairs will fail him.

Machado is viewed as one of the game's up-and-coming stars, along with Mike Trout, Bryce Harper and Stephen Strasburg. Together they were going to carry the game forward.

But with his career now more dependent on the work of a doctor, than his own training and ability, there's a real possibility that we could see a star beginning to fall before he ever had a chance to rise.

— Reach Patrick Strohecker at