Todd Gurley surely has something wrong with his left knee, no matter how aggressively the Rams will try to deny it. A new report has provided the first concrete diagnosis.

Jeff Howe of TheAthletic.com reports that Gurley has arthritis in the knee.

It’s the same knee that underwent an ACL repair in 2014. If the report is accurate, what will the Rams do about it? Coach Sean McVay discussed stem-cell treatment options for the knee this week at the Scouting Combine. If Gurley has arthritis that comes from a loss of cartilage, microfracture surgery presumably would be a possibility. However, the Rams have said that Gurley won’t have surgery.

The good news for Gurley, but the bad news for the Rams, is that Gurley’s contract gives him a high degree of financial security. As of the third day of the 2019 league year, he’ll have $34.5 million fully guaranteed and another $9.5 million still guaranteed for injury.

So the overriding question is whether and to what extent the Rams will get a return on their $45 million injury-guaranteed investment in Gurley. He generated more than 1,800 yards from scrimmage through the first 14 games of the year, but then it all started to fall apart for Gurley, with two missed regular-season games, a solid performance in the divisional round against Dallas, and two lackluster showings in the NFC title game and Super Bowl LIII.