It has become the most dreaded word in basketball: microfracture.

The medical procedure claimed another victim this week, as Kenyon Martin woke up from knee surgery and learned he’ll be out for the season. He went in expecting to have arthroscopic knee surgery to clean up “loose bodies” (I love this phrase; it implies they’ll open up the knee and find Tara Reid and Pamela Anderson cavorting with the patellar tendon), and was expected to only miss a few weeks.

Unfortunately, if the damage to the knee cartilage is significant enough, surgeons now perform a much more radical procedure. It involves drilling small holes in the bone — thus the name microfracture — to stimulate scar tissue to grow over it as replacement cartilage, called fibrocartilage. This procedure is greatly preferable to the alternative (attempting to play with a bone-on-bone condition) but still involves an extended recovery time and a less-than-certain outcome.

And usually, it’s a surprise. Of late, most microfracture operations have resulted when doctors expected to do a simpler operation, only to discover additional damage when they opened the knee (in addition to Martin, this happened to another player this week, Portland’s Darius Miles).

Nets fans who remember Martin as the popular high-flying forward during his four years in New Jersey will be most displeased, because the NBA landscape is littered with microfracture victims. Here in New York, for example, Allan Houston was never the same after his microfracture surgery and eventually had to call it quits during last year’s training camp. Jamal Mashburn and Terrell Brandon are others who never recovered, while players like Chris Webber, Penny Hardaway, and Brian Grant returned to the hardwood but as shadows of their former selves.

However, the successes have been more frequent than many have been led to believe. Jason Kidd is probably the most notable success. Kidd had microfracture surgery and barely skipped a beat, missing only a brief chunk of time and then almost immediately regaining his footing as a star point guard. John Stockton had it too, and experienced similar results.

Another less well-known example is the Blazers’ Zach Randolph, who had his surgery in the summer of 2005 and, after hobbling through the 2005–06 season, has been absolutely destroying people this fall. Doug Christie was another, way back in the halcyon days before there were things like Web sites and PER. He was one of the first to have it done, as a collegian, and he came back so strong that he remained one of the NBA’s most athletic players for a decade.

I highlight Martin’s case today because it shows one of the major pitfalls of the surgery: coming back too soon. This is true of almost any injury, and there’s a natural tension with this in the world of sports since most teams and nearly all coaches have a win-today-and-we’ll-deal-with-tomorrow-later mentality.

Thus, Martin attempted to play last year when he really shouldn’t have, gritting his way through 56 games last season despite constant knee pain. Actually, he wasn’t the only one — Amare Stoudemire attempted a comeback at midseason, but fortunately his return was aborted after only three games.

In each case, the players suffered damage to their healthy knees as a result of overcompensating for the bad one, because the injured knee hadn’t healed yet enough to handle the rigors of NBA basketball. In Stoudemire’s case, the stress to his good knee stopped his recovery in its tracks and extended it all the way into this season. He looks as if he’s turning the corner, finally, but his season has gone in fits and starts so far and it could be much longer before we see the old Stoudemire — if ever.

In Martin’s case, things grew much worse because he played so much more. The damage to his formerly good knee was so extensive from playing last year that he’ll miss this season to allow that leg to recover. I should point out that it hasn’t been confirmed that Martin’s most recent surgery, on Wednesday, was a microfracture, but it doesn’t take too much reading between the lines when a player goes from “out 5–6 weeks” to “out for the season” in the same day. If Martin did indeed have a second microfracture, he’s believed to be the first player to have it done on both knees.

As I mentioned earlier, the surgery has had wildly varied outcomes, and several factors contribute to the result. The player’s age and size, the amount of cartilage that needs replacing, the exact location of the injury on the knee, and the player’s commitment to rehabbing the knee all play a factor in determining the surgery’s eventual success. So do other factors related to the knee — Hardaway and Webber, for instance, had arthritic knees in addition to requiring microfracture, which limited the extent of their recovery.

Nonetheless, Martin is probably closer to the Houston end of the spectrum than the Kidd end, for a variety of reasons. First, he’s dependent on his athleticism in a way that Kidd and Stockton simply were not. If the latter two lost a few inches off their vertical it was a mild annoyance; if it happens to Martin it’s catastrophic, because his entire stock in trade has been as above-the-rim guy.

Second, he faces a second major hurdle in recovering his timing and basketball conditioning after essentially spending two years on the shelf. Martin played in games last year but rarely practiced, so he was already a little off-kilter. Now he’ll miss one entire season, and there’s no guarantee as to how ready he’ll be when the next one starts.

If there’s good news here, it’s that teams are at least getting smart about not pushing convalescing microfracture patients to return to the court. Four months is the minimum recovery time for this surgery, but in practice it’s usually been much longer. So kudos to the Blazers and Nuggets for immediately announcing that Miles and Martin would miss the season, rather than holding out hope that the player would return sooner. Unfortunately, these lessons usually are learned the hard way — if Denver had done the same thing with Martin a year earlier, we might not be having this discussion.