Because of Cousins' importance to a team battling for a playoff spot in the competitive Western Conference, his injury has wide-reaching implications for the franchise. And with Cousins headed into unrestricted free agency this summer, his own future is now uncertain.
Let's answer a few key questions about where Cousins and the Pelicans go from here.
Can New Orleans still make the playoffs?
Cousins was injured in the late stages of Friday's thrilling win over the Houston Rockets, the Pelicans' fourth in a row and seventh in their past eight games. While that run has been built more on close wins than dominant play -- none of the seven have come by more than seven points, and three have been decided in overtime -- those games are still booked in the standings.
New Orleans is now sixth in the West, three games ahead of the ninth-place LA Clippers. The Pelicans are actually closer to having home-court advantage in the first round of the playoffs (they're 2½ games behind the Minnesota Timberwolves for fourth) than missing them altogether.
As a result, playoff projection systems considered New Orleans a heavy favorite to return to the postseason for the first time since 2015. Before Friday's game, the Pelicans made the playoffs in 88 percent of simulations using ESPN's Basketball Power Index. Factoring in Friday's win, FiveThirtyEight's CARM-Elo projections give New Orleans an 89 percent chance of reaching the playoffs.
Of course, neither projection factors in Cousins' injury, which will surely hurt the Pelicans' chances. Though New Orleans has performed much better this season with just fellow All-Star Anthony Davis on the court (plus-6.9 points per 100 possessions, according to NBA Advanced Stats) than Cousins alone (minus-2.4 net rating) or even both All-Star big men (plus-4.1), as I've noted those stats are largely the product of opponent 3-point shooting. Opponents are making 40 percent of their 3s this season with Davis on the bench and 32.8 percent when Cousins rests. Neither mark is sustainable.
The other key issue is adding Cousins before last year's trade deadline meant Pelicans coach Alvin Gentry was able to almost always keep at least one All-Star big man on the court at any given time. Per Second Spectrum data powered by NBA Advanced Stats, New Orleans has played just 352 possessions all season with both Cousins and Davis on the bench.
Before adding Cousins, the Pelicans were 23-34 last season, which would translate to a 14-20 record over their remaining 34 games. That would put New Orleans precisely at .500 -- right on the borderline of being one of the eight teams to make the playoffs. The Clippers currently sit in ninth with a .500 record.
Can this season's Pelicans be better than last season's version without Cousins? On the plus side, they've largely abandoned lineups pairing Davis with other centers, which were typically ineffective. Including games Cousins missed after the trade, New Orleans went 13-17 in 2016-17 when Davis started at center, a slightly superior record. The Pelicans also have a deeper wing rotation with Jrue Holiday playing more off the ball after the additions of Jameer Nelson and Rajon Rondo -- although the starting lineup that features Holiday, Rondo and fellow guard E'Twaun Moore might cause more problems on the defensive glass without Cousins patrolling the interior alongside Davis.
One key wild card is the potential return of Solomon Hill, who started 71 games last season and probably would be New Orleans' best option to replace Cousins in the starting five if healthy. After undergoing surgery to repair a torn hamstring before training camp, Hill has yet to play this season but has targeted a February return. According to Scott Kushner of the Advocate, Hill went through an individual workout before Friday's game, progressing in his rehab.
Considering all of that, I'd make the Pelicans slight favorites to make the playoffs at even odds. However, one interesting question is how Cousins' injury will affect the way other teams approach the trade deadline.
Will Cousins' absence convince the Clippers and Jazz to go for the playoffs?
Both the Clippers and the Utah Jazz, who are currently in 10th place in the West, face decisions before the trade deadline about impending free agents on their rosters. The Clippers have two of the top free agents to be in DeAndre Jordan and Lou Williams, and the Jazz are considering what to do with Derrick Favors and Rodney Hood.
New Orleans' vulnerability without Cousins could embolden both teams to change course. Keeping Jordan and Williams makes more sense for the Clippers if they expect to make the playoffs, and Utah's slim hopes of a playoff berth now seem slightly more realistic. Depending how the Jazz feel about Favors and Hood, they could still move one or both while also making an aggressive deadline move like adding Chicago Bulls forward Nikola Mirotic.
As for the Pelicans, they'll be hard-pressed to deal for help replacing Cousins at the deadline because of their cap situation. ESPN's Bobby Marks notes New Orleans has just $1.2 million in wiggle room below the luxury-tax apron, a hard cap triggered when the Pelicans used their non-taxpayer midlevel exception to sign both Rondo and Darius Miller as free agents.
What will the Pelicans do this summer?
After two seasons in the lottery, this looked like a make-or-break campaign for Gentry and New Orleans GM Dell Demps. It's tough to say now whether that would still hold without Cousins. The Pelicans changing course because they miss the playoffs now would be a harsh fate for Demps and Gentry.
Whoever is running the show this summer will have to figure out how to handle Cousins' free agency. Offering him a max deal to re-sign as an unrestricted free agent looked like an easy call, given Cousins would be impossible to replace with New Orleans' meager cap space. His injury complicates matters.
Can the Pelicans still feel comfortable committing max money to Cousins coming off one of the most serious injuries an NBA player can suffer? Perhaps not, particularly given that maxing out Cousins would force New Orleans to make drastic cuts elsewhere to avoid going into the luxury tax.
Davis' future with the Pelicans looms over every decision the organization makes. He's only a little more than two years away from potentially becoming an unrestricted free agent -- in the summer of 2020 -- and the easiest way for New Orleans to assure Davis will be willing to sign a designated veteran extension would be building a contending team. That task now becomes even more difficult.
How will Cousins' play and next contract suffer?
Cousins suffering an injury five months before hitting free agency is an especially cruel blow because in an alternate scenario, he might already be playing on a designated veteran extension of his own for the Sacramento Kings. Before being unexpectedly traded to the Pelicans, Cousins had signaled his willingness to sign such an extension last summer, when he would have been eligible to do so.
No longer eligible for a supermax deal starting at 35 percent of the salary cap, Cousins now must worry no team will offer him even the conventional 30 percent max for a player of his experience level -- a contract worth an estimated $130 million over four years with another team, or up to more than $175 million over five years if he re-signs in New Orleans.
Just a handful of teams will have enough cap space to make such a max offer to Cousins, a group that could include the Atlanta Hawks, Chicago Bulls, Dallas Mavericks, Indiana Pacers, Los Angeles Lakers and Philadelphia 76ers. Of those teams, the Mavericks and Lakers look like the most realistic Cousins suitors. If they're scared off by the Achilles injury, Cousins could find the market unexpectedly tepid given his accomplishments -- he was just named to his fourth All-Star team -- and be forced to return to the Pelicans on a sub-max deal.
I recently wrote about how players have performed coming back from Achilles injuries, noting that Rudy Gay of the San Antonio Spurs is on track to become only the fourth player out of 18 comebacks since 1990 to meet or exceed his pre-injury projection the following season.
Gay's example provides hope but, on average, players coming back from Achilles injuries see their production decline by about 8 percent compared to what we would project based on their past performance and age. The good news is Cousins is so dominant he can afford to decline by 8 percent and remain a very good player. Nonetheless, it's possible that this injury will rob us of the peak Boogie we saw this season in New Orleans. And that has huge ramifications for both him and the Pelicans.