Return-to-Play and Performance Outcomes of Professional Athletes in North America After Hip Arthroscopy From 1999 to 2016

2018 ◽  
Vol 46 (8) ◽  
pp. 1959-1969 ◽  
Author(s):  
Michael S. Schallmo ◽  
Thomas H. Fitzpatrick ◽  
Hunter B. Yancey ◽  
Alejandro Marquez-Lara ◽  
T. David Luo ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
National Football League ◽  
Scoring Systems ◽  
Similar Rate ◽  
Performance Outcomes ◽  
High Rate ◽  
Return To Play ◽  
Professional Athletes ◽  
Basketball Players ◽  
Return Rates

Background: The effect of hip arthroscopy on athletic performance compared with preinjury levels for professional athletes in different sports remains unknown. In addition, while return rates have been reported for professional baseball, football, and hockey players, return rates have not been reported for professional basketball players. Hypothesis: Professional athletes in 4 major North American sports would be able to return to their sport and preoperative level of performance at a high rate after arthroscopic hip surgery. Study Design: Descriptive epidemiology study. Methods: Major League Baseball (MLB), National Basketball Association (NBA), National Football League (NFL), and National Hockey League (NHL) athletes who underwent hip arthroscopy were identified through a previously reported protocol based on public sources. Successful return to play (RTP) was defined as returning for at least 1 professional regular season game after surgery. Performance scores were calculated by use of previously established scoring systems. Each player served as his own control, with the season prior to surgery defined as baseline. To make comparisons across sports, the authors adjusted for expected season and career length differences between sports and calculated percentage changes in performance. Results: The authors identified 227 procedures performed on 180 professional athletes between 1999 and 2016. Successful RTP was achieved in 84.6% (192/227) of the procedures. Compared with all other athletes, NBA athletes returned at a similar rate (85.7%, P ≥ .999). NFL offensive linemen returned at a significantly lower rate than all other athletes (61.1%, P = .010). NHL athletes returned at a significantly higher rate than all other athletes (91.8%, P = .048) and demonstrated significantly decreased performance during postoperative season 1 compared with baseline (–35.1%, P = .002). Lead leg surgery for MLB athletes (batting stance for hitters, pitching stance for pitchers) resulted in a 12.7% reduction in hitter performance score ( P = .041), a 1.3% reduction in pitcher fastball velocity ( P = .004), and a 60.7% reduction in pitch count ( P = .007) one season after surgery compared with baseline. Players in nearly every sport demonstrated significant reductions in game participation after surgery. Conclusion: This study supports the hypothesis that hip arthroscopy in professional athletes is associated with excellent rates of return at the professional level. However, postoperative performance outcomes varied based on sport and position.

Femoroacetabular Impingement in Professional Basketball Players: Return to Play, Career Length, and Performance After Hip Arthroscopy

2018 ◽  
Vol 46 (13) ◽  
pp. 3090-3096 ◽  
Author(s):  
J.P. Begly ◽  
Patrick S. Buckley ◽  
Hajime Utsunomiya ◽  
Karen K. Briggs ◽  
Marc J. Philippon
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Case Series ◽  
High Rate ◽  
Return To Play ◽  
Basketball Players ◽  
Level Of Evidence ◽  
Professional Basketball ◽  
Postoperative Performance ◽  
The Mean

Background: Previous studies have demonstrated that hip arthroscopy is an effective treatment for symptomatic femoroacetabular impingement (FAI) in professional athletes across a variety of sports. However, the return-to-play rates and postoperative performance of elite basketball players after hip arthroscopy are currently unknown. Purpose: To determine return-to-play rates and postoperative performance among professional basketball athletes after hip arthroscopy. Study Design: Case series; Level of evidence, 3. Methods: Eighteen professional basketball players underwent hip arthroscopy (24 hips) for symptomatic FAI between 2001 and 2016 by a single surgeon. Return to play was defined as competing in a single professional game of equal level after surgery. Data were retrospectively obtained for each player from basketball-reference.com , ESPN.com , eurobasket.com, and individual team websites. Matched controls were selected from the websites to compare performances. Results: The mean age at the time of surgery was 25.6 years, and the mean body mass index was 24.4 kg/m2. All players returned to their previous levels of competition, with a mean number of 4 seasons played after surgery (median, 3; range, 1-12). The mean ± SD time between the date of surgery and return to a professional game was 7.1 ± 4.4 months. There was no change in player efficiency rating when pre- and postinjury performance were compared. When compared with controls, players undergoing surgery also had no significant decline in player efficiency rating. Conclusion: Elite basketball athletes who undergo hip arthroscopy for the treatment of FAI return to their presurgical levels of competition at a high rate. These athletes demonstrate no significant overall decrease in performance upon their return to play.

Performance-Based Outcomes After Anterior Cruciate Ligament Reconstruction in Professional Athletes Differ Between Sports

2017 ◽  
Vol 45 (10) ◽  
pp. 2226-2232 ◽  
Author(s):  
Harry T. Mai ◽  
Danielle S. Chun ◽  
Andrew D. Schneider ◽  
Brandon J. Erickson ◽  
Ryan D. Freshman ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
National Football League ◽  
Cruciate Ligament ◽  
Survival Rates ◽  
The Other ◽  
Return To Play ◽  
Professional Athletes ◽  
Level Of Evidence ◽  
Performance Statistics ◽  
Anterior Cruciate

Background: Excellent outcomes have been reported for anterior cruciate ligament (ACL) reconstruction (ACLR) in professional athletes in a number of different sports. However, no study has directly compared these outcomes between sports. Purpose: To determine if differences in performance-based outcomes exist after ACLR between professional athletes of each sport. Study Design: Cohort study; Level of evidence, 3. Methods: National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) athletes undergoing primary ACLR for an acute rupture were identified through an established protocol of injury reports and public archives. Sport-specific performance statistics were collected before and after surgery for each athlete. Return to play (RTP) was defined as a successful return to the active roster for at least 1 regular-season game after ACLR. Results: Of 344 professional athletes who met the inclusion criteria, a total of 298 (86.6%) returned to play. NHL players had a significantly higher rate of RTP (95.8% vs 83.4%, respectively; P = .04) and a shorter recovery time (258 ± 110 days vs 367 ± 268 days, respectively; P < .001) than athletes in all the other sports. NFL athletes experienced significantly shorter careers postoperatively than players in all the other sports (2.1 vs 3.2 years, respectively; P < .001). All athletes played fewer games ( P ≤ .02) 1 season postoperatively, while those in the NFL had the lowest rate of active players 2 and 3 seasons postoperatively (60%; P = .002). NBA and NFL players showed decreased performance at season 1 after ACLR ( P ≤ .001). NFL players continued to have lower performance at seasons 2 and 3 ( P = .002), while NBA players recovered to baseline performance. Conclusion: The data indicate that NFL athletes fare the worst after ACLR with the lowest survival rate, shortest postoperative career length, and sustained decreases in performance. NHL athletes fare the best with the highest rates of RTP, highest survival rates, longest postoperative career lengths, and no significant changes in performance. The unique physical demand that each sport requires is likely one of the explanations for these differences in outcomes.

scholarly journals Risk Factors for Reoperation and Performance-Based Outcomes After Operative Fixation of Foot Fractures in the Professional Athlete: A Cross-Sport Analysis

2017 ◽  
Vol 10 (1) ◽  
pp. 70-74 ◽  
Author(s):  
Sameer K. Singh ◽  
Kevin E. Larkin ◽  
Anish R. Kadakia ◽  
Wellington K. Hsu
Keyword(s):  
Operative Treatment ◽  
Performance Outcomes ◽  
Return To Play ◽  
Professional Athletes ◽  
Performance Levels ◽  
Postoperative Performance ◽  
Foot Fracture ◽  
Operative Fixation ◽  
Foot Fractures ◽  
The Impact

Background: Professional athletes are predisposed to fractures of the foot due to large stresses placed on the lower extremity. These players are concerned with efficiently returning to play at a high level. Return-to-play rates after operative treatment have been previously reported, yet performance outcomes after such treatment are generally unknown in this population. Hypothesis: Overall, professional athletes sustaining a foot fracture would return to play at high rates with little impact on postoperative performance or league participation. However, National Football League (NFL) athletes would have a significantly greater decline in performance due to the high-impact nature of the sport. Study Design: Case series. Level of Evidence: Level 4. Methods: Athletes in the National Basketball League (NBA), NFL, Major League Baseball (MLB), and National Hockey League (NHL) undergoing operative fixation of a foot fracture were identified through a well-established protocol confirmed by multiple sources of the public record. Return-to-play rate and time to return were collected for each sport. League participation and game performance data were collected before and after surgery. Statistical analysis was performed, with significance accepted as P ≤ 0.05. Results: A total of 77 players undergoing 84 procedures met the inclusion criteria. Overall, 98.7% (76/77) of players were able to return to play, with a median time to return across all sports of 137 days. Players returned to preoperative performance levels within 1 season of surgery. Six players (7.8%) sustained refracture requiring reoperation, all of whom were in the NBA. Percentage of games started during the season after primary operative treatment was a predictive factor for reinjury (99% vs 40%, P = 0.001). Conclusion: Athletes returned to play at a high rate after foot fracture fixation, with excellent postoperative performance levels, regardless of sport and fracture location. NBA athletes sustaining fifth metatarsal and navicular fractures are at greater risk of reinjury compared with other athletes. Returning to high levels of athletic participation soon after surgery may predispose athletes to refracture and subsequent reoperation. Clinical Relevance: Players, coaches, and team physicians should be aware of the impact of foot fractures on career performance and longevity to best guide therapy.

scholarly journals Return to Play in Athletes After Thumb Ulnar Collateral Ligament Repair With Suture Tape Augmentation

2020 ◽  
Vol 8 (7) ◽  
pp. 232596712093506
Author(s):  
Daniel B. Gibbs ◽  
Steven S. Shin
Keyword(s):  
High School ◽  
Ulnar Collateral Ligament ◽  
Return To Play ◽  
Professional Athletes ◽  
Basketball Players ◽  
Baseball Players ◽  
Professional Basketball ◽  
Competitive Athletes ◽  
Suture Tape

Background: Thumb ulnar collateral ligament (UCL) tears are common in competitive athletes. These tears often occur as a result of a radially directed force on an extended thumb. To date, no literature exists on the use of suture tape augmentation for repair of the thumb UCL in a competitive athlete cohort. Hypothesis: Using suture tape augmentation for the thumb UCL will allow for a safe and expedient return to play in competitive athletes. Study Design: Case series; Level of evidence, 4. Methods: A retrospective chart review was completed to identify all patients who underwent operative primary thumb UCL repair between 2014 and 2018. All procedures were performed at a single institution by the senior author. Inclusion criteria were acute complete tears of the thumb metacarpophalangeal joint UCL, treated with primary repair via suture tape augmentation in competitive high school, collegiate, or professional athletes. Exclusion criteria included recreational athletes, patients who underwent reconstruction (rather than repair), and patients with insufficient follow-up to establish return to play. Charts of patients identified through the retrospective review were further evaluated to determine patient- and injury-related variables. Return to play was defined as return to game competition and stratified as to whether this was at the same level of competition or any level of competition. Results: A total of 18 thumbs in 17 competitive high school, collegiate, and professional athletes were included in this study. One of the professional basketball players sustained injury to both thumbs approximately 10 months apart. The study group comprised 4 collegiate baseball players, 6 professional baseball players, 3 professional basketball players, 1 professional hockey player, 1 amateur-level hockey player, 1 high school basketball player, and 1 high school volleyball player. Mean follow-up was 27.9 months, and no complications were noted. Athletes who sustained an in-season injury (n = 13; 72.2%) returned to play at any level at a mean ± SD of 30.9 ± 10.1 days and at the same level at 36.3 ± 11.2 days. Athletes who sustained an out-of-season injury (n = 5; 27.8%) returned to play at any level at 101.4 ± 86.6 days and at the same level at 114.6 ± 87.0 days. Conclusion: The findings presented here offer evidence for return to play in competitive high school, collegiate, and professional athletes with a thumb UCL tear treated with repair and suture tape augmentation. All athletes returned to the same level of play. Those attempting to return in-season returned to the same level of play at a mean of just under 5 weeks. Augmenting the repair with anchored suture may prevent prolonged immobilization, expedite thumb motion, and improve postoperative recovery.

Effect of Concussions on the Performance of Running Backs and Wide Receivers in the National Football League

2019 ◽  
Vol 47 (11) ◽  
pp. 2717-2722 ◽  
Author(s):  
Toufic R. Jildeh ◽  
Kelechi R. Okoroha ◽  
Kevin A. Taylor ◽  
Patrick Buckley ◽  
Samir Mehta ◽  
...  
Keyword(s):  
National Football League ◽  
Individual Performance ◽  
High Rate ◽  
Return To Play ◽  
Control Group ◽  
Football Players ◽  
Professional Football ◽  
Significant Difference ◽  
Before And After ◽  
Player Performance

Background: Concussion injuries are common in professional football players; however, their effect on player performance remains unclear. Purpose: To quantify the effect of concussions on the performance of running backs and wide receivers in professional football players. Study Design: Cohort study; Level of evidence, 3. Methods: Concussion data from the National Football League were collected for a period of 4 seasons (2012-2015) for running backs and wide receivers. Age, experience, position, time to return to play, yearly total yards, and touchdowns were recorded. A power rating (total yards divided by 10 plus touchdowns multiplied by 6) was calculated for each player’s injury season as well as for the 3 seasons before and after their respective injury. A control group of running backs and wide receivers without an identified concussion injury who competed in the 2012 season was assembled for comparison. Player performance up to 3 seasons before and after the injury season was examined to assess acute and longitudinal changes in player performance. Results: A total of 38 eligible running backs and wide receivers sustained a concussion during the study period. Thirty-four (89%) players were able to return to competition in the same season, missing an average of 1.5 ± 0.9 games; the remaining 4 players returned in the subsequent season. Power ratings for concussed players were similar to those of controls throughout the study period. Concussed players did not suffer an individual performance decline upon returning within the same season. Furthermore, no significant difference in change of power rating was observed in concussed players in the acute (±1 year from injury; −1.2 ± 4.8 vs –1.1 ± 3.9, P = .199) or chronic (±3 years from injury; –3.6 ± 8.0 vs –3.0 ± 4.5, P = .219) setting compared with controls. All concussed players successfully returned to competition in either the index or next season. Conclusion: A high rate of National Football League running backs and wide receivers are able to return to play after a concussion injury. These players were found to perform at a similar level in both the acute and long-term period after concussion.

Professional Athletes’ Return to Play and Performance After Operative Repair of an Achilles Tendon Rupture

2017 ◽  
Vol 45 (12) ◽  
pp. 2864-2871 ◽  
Author(s):  
David P. Trofa ◽  
J. Chance Miller ◽  
Eugene S. Jang ◽  
Denzel R. Woode ◽  
Justin K. Greisberg ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
National Football League ◽  
Achilles Tendon Rupture ◽  
Tendon Repair ◽  
The United States ◽  
Return To Play ◽  
Professional Athletes ◽  
Level Of Evidence ◽  
And Performance

Background: Most Achilles tendon ruptures are sports related. However, few studies have examined and compared the effect of surgical repair for complete ruptures on return to play (RTP), play time, and performance across multiple sports. Purpose: To examine RTP and performance among professional athletes after Achilles tendon repair and compare pre- versus postoperative functional outcomes of professional athletes from different major leagues in the United States. Study Design: Cohort study; Level of evidence, 3. Methods: National Basketball Association (NBA), National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who sustained a primary complete Achilles tendon rupture treated surgically between 1989 and 2013 were identified via public injury reports and press releases. Demographic information and performance-related statistics were recorded for 2 seasons before and after surgery and compared with matched controls. Statistical analyses were used to assess differences in recorded metrics. Results: Of 86 athletes screened, 62 met inclusion criteria including 25 NBA, 32 NFL, and 5 MLB players. Nineteen (30.6%) professional athletes with an isolated Achilles tendon rupture treated surgically were unable to return to play. Among athletes who successfully returned to play, game participation averaged 75.4% ( P < .001) and 81.9% ( P = .002) of the total games played the season before injury at 1 and 2 years postoperatively, respectively. Play time was significantly decreased and athletes performed significantly worse compared with preoperative levels at 1 and 2 years after injury ( P < .001). When players were compared with matched controls, an Achilles tendon rupture resulted in fewer games played ( P < .001), decreased play time ( P = .025), and worse performance statistics ( P < .001) at 1 year but not 2 years postoperatively ( P > .05). When individual sports were compared, NBA players were most significantly affected, experiencing significant decreases in games played, play time, and performance. Conclusion: An Achilles tendon rupture is a devastating injury that prevents RTP for 30.6% of professional players. Athletes who do return play in fewer games, have less play time, and perform at a lower level than their preinjury status. However, these functional deficits are seen only at 1 year after surgery compared with matched controls, such that players who return to play can expect to perform at a level commensurate with uninjured controls 2 years postoperatively.

scholarly journals Platelet-rich plasma (PRP) Shortens Return to Play in National Football League (NFL) Players with Acute Hamstring Injuries

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0042
Author(s):  
Justin W. Arner ◽  
Tracye J. Lawyer ◽  
Craig Stephen Mauro ◽  
James P. Bradley
Keyword(s):  
Operative Treatment ◽  
National Football League ◽  
Platelet Rich Plasma ◽  
Financial Impact ◽  
Return To Play ◽  
Professional Athletes ◽  
Hamstring Injury ◽  
Hamstring Injuries ◽  
Injection Treatment ◽  
Musculoskeletal Radiologist

Objectives: Hamstring injuries are common in professional athletes and subsequent delays in healing are common, costly, and even career ending. The efficacy of platelet-rich plasma (PRP) for augmentation of non-operative treatment of partial musculotendinous hamstring injuries has not yet been established. Methods: NFL players from a single team who sustained acute grade 2 hamstring injuries as diagnosed on MRI by a musculoskeletal radiologist from 2009 to 2017 were retrospectively reviewed. Average days, practices, and games missed were recorded. Players that did and did not receive PRP injections were compared. Those who received PRP did so within 24 to 48 hours after injury. Results: Ninety-four NFL players had MRI evidence of a hamstring injury, while 61 athletes sustained grade 2 injuries. Thirty-one were treated with PRP injections and 30 were not. Average time missed in those treated with PRP injections was 22.4 days, 18.5 practices, and 1.7 games. In those who did not receive PRP injections, time missed was 25.8 days (p = 0.81), 22.2 practices (p = 0.68), and 2.7 games (p < 0.05). Conclusion: PRP injection treatment for acute grade 2 hamstring injuries in NFL players allows for faster return to play with a 1 game overall difference. Due to the possible large financial impact of return to play 1 game sooner, PRP injections for treatment of grade 2 hamstring injuries may be advantageous in professional athletes. Additional evaluation of PRP treatment of acute hamstring injuries in a larger cohort is necessary.

Outcomes of NCAA Defensive Football Players Following Achilles Tendon Repair

2020 ◽  
Vol 41 (4) ◽  
pp. 398-402 ◽  
Author(s):  
Patrick M. Wise ◽  
Jesse L. King ◽  
Christopher M. Stauch ◽  
Kempland C. Walley ◽  
Michael C. Aynardi ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
National Football League ◽  
National Collegiate Athletic Association ◽  
Tendon Repair ◽  
High Rate ◽  
Performance Criteria ◽  
Return To Play ◽  
Football Players ◽  
Level Of Evidence ◽  
Significant Drop

Background: The incidence of Achilles ruptures has been on the rise in National Collegiate Athletic Association (NCAA) football players, but the career impact of this injury is not fully understood. In this study, we analyzed a large series of Achilles tendon injuries in NCAA Football Bowl Subdivision (FBS) defensive football players who required repair in order to determine their return to play, performance, and career outcomes afterward. Methods: FBS defensive football players who required Achilles repair from 2010 to 2016 were identified. The return to play of the eligible underclassmen athletes was then determined and the preinjury and postoperative performances of players who met criteria were compared with matched controls. The number of underclassmen who went on to participate in the National Football League (NFL) Combine or play in at least 1 NFL game was also determined and compared with controls. Results: Fifty-seven total Achilles ruptures were identified, 40 of which occurred in underclassmen, who returned at a rate of 92.5%. Of the players who met performance criteria, only defensive backs differed from matched controls in terms of solo tackling ( P = .025) and total tackling (P = .038), while still increasing compared with preoperative performance. Only 5.0% of underclassmen performed at NFL Combine and only 7.5% competed in at least 1 NFL game (20.0% and 21.3%, respectively, for matched controls). Conclusion: Defensive FBS players returned at a high rate following Achilles rupture and did not seem to experience a significant drop-off in performance upon return. An Achilles rupture did appear to impact their chances of playing professionally in the future, however. Level of Evidence: Level III, retrospective comparative study.

Characteristics and Outcomes of Arthroscopic Femoroacetabular Impingement Surgery in the National Football League

2017 ◽  
Vol 46 (1) ◽  
pp. 144-148 ◽  
Author(s):  
Benedict U. Nwachukwu ◽  
Asheesh Bedi ◽  
Ajay Premkumar ◽  
Pete Draovitch ◽  
Bryan T. Kelly
Keyword(s):  
Femoroacetabular Impingement ◽  
National Football League ◽  
Arthroscopic Surgery ◽  
High Rate ◽  
Return To Play ◽  
Labral Repair ◽  
Control Group ◽  
Football Players ◽  
Level Of Evidence ◽  
Significant Difference

Background: Previous studies have reported that hip abnormalities may account for 10% of injuries in professional football players. The effect of femoroacetabular impingement (FAI) and arthroscopic FAI surgery in National Football League (NFL) athletes has not been well studied. Purpose: To investigate the effect of arthroscopic FAI surgery on return to play (RTP) and RTP performance in NFL players. Study Design: Cohort study; Level of evidence, 3. Methods: NFL athletes undergoing arthroscopic FAI surgery at a single institution between 2006 and 2014 were identified. Medical records were reviewed for demographic, clinical, and operative variables. RTP and RTP performance were assessed based on a review of publicly available NFL player statistics. RTP and RTP performance data included time to RTP; games played before and after the injury; yearly total yards and touchdowns for offensive players; and yearly total tackles, sacks, and interceptions for defensive players. The offensive power rating (OPR = [total yards/10] + [total touchdowns × 6]) and defensive power rating (DPR = total tackles + [total sacks × 2] + [total interceptions × 2]) were calculated. Paired t tests comparing preinjury and postinjury seasons were performed. A matched cohort of NFL players was created to compare trends for OPR, DPR, and career longevity. Results: Forty-eight hips in 40 NFL players (mean age, 25.6 years) with symptomatic FAI were included; 8 players underwent staged bilateral hip arthroscopic procedures. The majority of players were offensive (n = 24; 60.0%), with offensive lineman (n = 11; 27.5%) being the most common of all positions. Of the 48 included hips, all had labral tears, and 41 (85.4%) underwent labral repair. Forty-two of the 48 hips (87.5%) underwent cam decompression, and 10 (20.8%) underwent rim decompression. Of the 40 included players, 37 (92.5%) achieved RTP to professional competition after their hip arthroscopic surgery at a mean of 6.0 months. Before the injury, included patients played in a mean of 11.0 games compared with 9.5 games in their postoperative season ( P = .26). The mean OPR and DPR demonstrated a nonsignificant decline in the postoperative season (preinjury OPR, 40.2; postinjury OPR, 32.3; P = .34) (preinjury DPR, 49.6; postinjury DPR, 36.4; P = .10). A similar decline in the OPR and DPR across seasons was observed in the control group. NFL athletes played, on average, 3.3 ± 1.5 seasons after undergoing hip arthroscopic surgery; this was not significantly different from the controls (2.5 ± 1.5 seasons; P = .47). There was no significant difference in mean annual salaries based on contracts negotiated before the injury and the first negotiated contract after surgery ($3.3 million vs $3.6 million, respectively; P = .58). Conclusion: There was a very high rate of RTP in the NFL after arthroscopic FAI surgery; this rate is higher than what has been previously reported for other orthopaedic procedures in NFL athletes. Additionally, these NFL athletes achieved RTP at a faster time frame (6 months) than previously reported for other procedures. These findings have important implications for counseling elite football players about the expected outcome of arthroscopic FAI surgery.

scholarly journals Shoulder Instability, Performance and Return to Play in National Hockey League Athletes

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0038
Author(s):  
Kyle McCormick ◽  
Liana Tedesco ◽  
Carl Herndon ◽  
Christopher Ahmad ◽  
William Levine ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Performance Outcomes ◽  
High Rate ◽  
Return To Play ◽  
National Hockey League ◽  
Shoulder Injuries ◽  
Hockey Players ◽  
Professional Hockey ◽  
One Year ◽  
Player Performance

Objectives: Hockey players are at risk for various injury due to the aggressive nature of gameplay with the rate of shoulder injuries ranges from 8.6% to 21.9%. Although performance and return to play outcomes following shoulder instability events have been analyzed in other contact sports, there is a paucity of information on the effects amongst professional hockey players. Our study investigates the incidence of shoulder instability events in the National Hockey League (NHL) and the subsequent effect on return-to-play (RTP) and player performance. We hypothesized that NHL players sustaining a shoulder instability event returned to play at a high rate without significant changes in player performance after injury. Methods: A total of 67 confirmed in-season shoulder instability events were identified in the NHL between 2003 - 2017. Demographic characteristics and performance statistics one year prior to injury and one year following injury were collected and analyzed. Overall RTP was determined and differences in performance following injury were compared to experience-matched, era-matched, position-matched and age-matched controls. A separate analysis was performed comparing differences in performance as a function of operative and nonoperative treatment. Results: An average of 4.19 shoulder dislocations occurred per season in the NHL with an overall incidence rate of 0.020 instability events per 1000 game exposures (CI 0.017-0.027) with no significant differences between forwards and defensemen (p = 0.871). Overall, 33.8% of players suffered season ending injuries but 98.5% of all players were able to return to play with an average of 26.3±20.8 regular season games missed. Compared to controls, players suffering a shoulder instability event experienced an increase in both average time on ice and shooting percentage upon returning to gameplay (p = 0.002, p <0.001, respectively) yet there were no significant differences in seasons played, goals, assists and points per game; offensive, defensive and overall point shares compared to controls. In terms of treatment, 47.8% of all players were treated operatively with half of these players treated with surgery after suffering season-ending injuries. Compared to operative treatment, conservatively managed players experienced a significant decrease in points per game after injury (p = 0.034), however there were no significant differences in number of seasons played, goals per game, assists per game, offensive, defensive and overall point shares between treatment groups. Conclusion: Regardless of treatment, professional hockey players experience a high rate of return to play with acceptable performance outcomes following in-game shoulder instability events. Surgical management can be beneficial as an increase in points per game was seen in those treated operatively compared to players managed nonoperatively.

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