Nizaiah Smith is passionate about basketball.

The 6-foot-4 junior is a standout on Georgiana School’s basketball team, but an injury last season threatened to end his promising basketball career.

“He was at practice and somehow injured his knee,” said Donetha Smith, Nizaiah’s mother. “He didn’t think it was that bad, and he tried to keep playing. He didn’t want to miss any of the season, but his knee kept swelling. Finally I had enough and took him to the doctor. We knew something had to be done.”

After seeing two doctors, Smith’s basketball career appeared to be in jeopardy.

“His injury was very rare,” said Dr. Raj Chavan, an orthopedic surgeon who spearheads L.V. Stabler Memorial Hospital’s sports medicine program. “He lost a piece of cartilage from his knee. That happens when someone has a traumatic injury like this guy had playing ball, or they lose blood supply and the cartilage just flakes off.”

Due to the amount of cartilage lost in his knee, microfracture surgery, which has gained popularity in sports in recent years with a number of professional athletes undergoing the procedure, was not a viable option.

“Microfracture is done for smaller defects,” Chavan said. “You drill into the bone and then you depend on the patient’s bone marrow to form the scar tissue. If the defect size is larger, your option is just to do the cartilage transplant because the marrow stimulation is not going to work.”

Since cartilage transplant surgery is still considered by some to be experimental, and therefore not covered by many insurance policies, not all surgeons are willing to attempt the procedure. Chavan, who has worked with the Buffalo Bills of the NFL and the Buffalo Sabres of the NHL, was.

L.V. Stabler Memorial Hospital was also willing to help cover the costs associated with the transplant procedure since Smith’s plan did not cover the procedure.

In a cartilage transplant, a plug of the tissue is removed from a person who recently has died — similar to the process of organ donation. That plug then can be surgically inserted into the joint of a person with a cartilage defect, where it integrates to the surrounding bones.

Smith underwent two surgeries: one to clean up where the cartilage was injured, shaving rough edges of damaged cartilage, and a second to insert the “plug.”

Smith was forced to wait five months between surgeries while a match was located.

“After the surgery Nizaiah was really depressed,” Donetha Smith said. “He was worried that he would have to miss this season, and he had already missed half of last season because of the injury.”

It turns out the wait for a donor could have been much longer.

“We only found it then because we agreed to do it from the opposite side,” Chavan said. “We couldn’t find a same side match.”

After the match was found, the real work began.

“They sent me half the knee joint surface,” Chavan said. “We found one spot that we could match. I pulled the plug out and we trimmed it down to the correct size. Once we put the plug inside he had good fixation where I did not have to put a screw in. We let him go home the same day or the next morning.”

Three months later, Smith was pain free. He had no swelling and he was beginning to jog again.

Five months later, he was back on the basketball court. He’s able to run and jump like he was before the injury.

Chavan said he’s even dunking the basketball again.

“Without this surgery his basketball career likely would have been over,” Chavan said.

Donetha Smith credits Chavan with helping keep her son’s dream of playing college basketball alive.

“I’m so grateful for Dr. Chavan,” she said. “He took the time to go over all the options with us and he made sure Nizaiah understood what it would mean to do this surgery and how hard he’d have to work to get back on the basketball court.

“Nizaiah was determined to get back on the court, and he worked extremely hard at physical therapy to make sure he was back out there at the start of the season. Now, it’s almost like he was never injured. If it hadn’t been for this surgery, I don’t know if he would ever have been able to play again.”