scholarly journals Professional Soccer Players’ Return to Play and Performance After Operative Repair of Achilles Tendon Rupture

2018 ◽  
Vol 6 (11) ◽  
pp. 232596711881077 ◽  
Author(s):  
David P. Trofa ◽  
Peter C. Noback ◽  
Jon-Michael E. Caldwell ◽  
J. Chance Miller ◽  
Justin K. Greisberg ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Soccer Players ◽  
Level Of Evidence ◽  
Professional Soccer ◽  
Playing Time ◽  
And Performance ◽  
The Impact

Background: The majority of Achilles tendon ruptures are sports related; however, no investigation has examined the impact of surgical repair for complete ruptures on professional soccer players. Purpose: To examine the return to play, playing time, and performance of professional soccer players following Achilles tendon repair. Study Design: Cohort study; Level of evidence, 3. Methods: Union of European Football Associations (UEFA) and Major League Soccer (MLS) athletes who sustained a primary complete Achilles tendon rupture and were treated surgically between 1988 and 2014 were identified via public injury reports. Demographic information and performance-related statistics for the identified athletes were recorded for the season before surgery and 2 seasons after surgery and were compared with information for matched controls. Statistical analyses were used to assess differences in recorded metrics. Results: A total of 24 athletes with Achilles ruptures met inclusion criteria, 17 (70.8%) of whom were able to return to play. On average, players had 8.3 years of professional-level experience prior to sustaining an Achilles rupture. Among athletes who returned to play, no differences were found in the number of games played or started, minutes played, or goals scored 1 year postoperatively compared with the year prior to injury. However, 2 years postoperatively, these athletes played 28.3% ( P = .028) fewer minutes compared with their preoperative season, despite starting and playing in an equivalent number of games. Matched controls had baseline playing time and performance statistics similar to those of players. However, controls played and started in significantly more games and played more minutes at 1 and 2 years compared with players ( P < .05). No differences were found in goals scored at any time point. Conclusion: This is the first investigation examining the effect of an Achilles repair on the career of professional soccer players. This is a difficult injury that most commonly occurs in veteran players and prevents 29.2% of players from returning to play despite surgical management. Additionally, athletes able to return to play were found to play fewer minutes 2 years postoperatively compared with their baseline as well as playing less at 1 and 2 years postoperatively compared with uninjured matched controls. The reduction in playing time following an Achilles repair has significant implications for professional players and teams.

scholarly journals Return to Play and Player Performance After Achilles Tendon Rupture in UEFA Professional Soccer Players: A Matched-Cohort Analysis of Players From 1999 to 2018

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110241
Author(s):  
Enrico M. Forlenza ◽  
Ophelie Z. Lavoie-Gagne ◽  
Yining Lu ◽  
Connor C. Diaz ◽  
Jorge Chahla ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Performance Metrics ◽  
Cohort Analysis ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Soccer Players ◽  
Professional Soccer ◽  
The Mean ◽  
Player Performance

Background: Achilles tendon rupture (ATR) is a potentially career-ending injury in professional athletes. Limited information exists regarding return to play (RTP) in professional soccer players after this injury. Purpose: To determine the RTP rate and time in professional soccer players after ATR and to evaluate player performance relative to matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: We evaluated 132 professional soccer players who suffered an ATR between 1999 and 2018. These athletes were matched 2:1 to uninjured controls by position, age, season of injury, seasons played, and height. We collected information on the date of injury, the date of RTP, and player performance metrics (minutes played, games played, goals scored, assists made, and points per game) from official team websites, public injury reports, and press releases. Changes in performance metrics for the 4 years after the season of injury were compared with metrics 1 season before injury. Univariate comparisons were performed using independent-sample, 2-group t tests and Wilcoxon rank-sum tests when normality of distributions was violated. Results: The mean age at ATR was 27.49 ± 4.06 years, and the mean time to RTP was 5.07 ± 2.61 months (18.19 ± 10.96 games). The RTP rate was 71% for the season after injury and 78% for return at any timepoint. Overall, 9% of the injured players experienced a rerupture during the study period. Compared with controls, the injured players played significantly less (-6.77 vs -1.81 games [ P < .001] and -560.17 vs -171.17 minutes [ P < .05]) and recorded fewer goals (-1.06 vs -0.29 [ P < .05]) and assists (-0.76 vs -0.02 [ P < .05]) during the season of their Achilles rupture. With the exception of midfielders, there were no significant differences in play time or performance metrics between injured and uninjured players at any postinjury timepoint. Conclusion: Soccer players who suffered an ATR had a 78% RTP rate, with a mean RTP time of 5 months. Injured players played less and demonstrated inferior performance during the season of injury. With the exception of midfielders, players displayed no significant differences in play time or performance during any of the 4 postinjury seasons.

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.

Professional soccer players; Return to play and performance after Achilles tendon ruptures

2017 ◽  
Vol 23 ◽  
pp. 121
Author(s):  
D. Trofa ◽  
P. Noback ◽  
C. Ahmad ◽  
J. Greisberg ◽  
J. Turner Vosseller
Keyword(s):  
Achilles Tendon ◽  
Return To Play ◽  
Soccer Players ◽  
Professional Soccer ◽  
Tendon Ruptures ◽  
And Performance

Epidemiology of Achilles Tendon Rupture in Italian First Division Football (Soccer) Players and Their Performance After Return to Play

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Alberto Grassi ◽  
Silvio Caravelli ◽  
Mario Fuiano ◽  
Pieter D'Hooghe ◽  
Matteo Filippini ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Soccer Players

scholarly journals Professional Athletes’ Return to Play and Performance after Achilles Tendon Ruptures

2017 ◽  
Vol 2 (2) ◽  
pp. 2473011416S0000
Author(s):  
Johnathan Miller ◽  
Denzel Woode ◽  
Eugene Jang ◽  
David Trofa ◽  
Justin Greisberg ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Inclusion Criteria ◽  
Post Injury ◽  
Tendon Ruptures ◽  
Performance Statistics ◽  
And Performance

Category: Sports Introduction/Purpose: The majority of Achilles tendon ruptures are sports-related. A significant decrease in return to play, playing time, and performance has been shown in National Basketball Association (NBA) players who sustained a complete Achilles tendon rupture requiring surgical repair. However, no study to date has examined and compared the impact on performance and return to play across multiple professional sports. Methods: Publicly available records yielded a list of NBA, National Football League (NFL), Major League Baseball (MLB), and National Hockey League (NHL) athletes who suffered Achilles tendon ruptures requiring surgical repair from 1989-2013. Demographic information and performance-related statistics were recorded from public sports statistics websites. The primary outcome of this study was the proportion of games played post- vs. pre-injury. Secondary markers of longevity were minutes played for NBA, games started for NFL, and innings played in field for MLB. Inclusion criteria included individuals in the NBA, NFL, MLB, and NHL with professional experience for at least 2 years before and after sustaining a primary Achilles tendon rupture requiring surgical repair. A matched control was selected for all returning players by identifying athletes with similar playing position, number of seasons played, and career performance statistics. The study was powered to detect a 15% difference in games played between ruptures and controls. Results: Of 100 athletes initially screened for the study, 43 met the inclusion criteria. Others were excluded for not completing at least 2 seasons pre- (n=16) or post-injury (n=32), or having a confounding injury (n=9). Athletes on average played 75.4% (p < 0.001) and 81.9% (p=0.002) of the games played the season prior to injury at 1 and 2 years post-injury, respectively. Other markers of longevity were also significantly decreased in athletes at 1 and 2 years post-injury (p < 0.001). Athletes also performed worse, with post-injury performances equivalent to 74.8% of pre-injury performance at 1 year (p=0.001) and 77.7% at 2 years (p < 0.001). Compared to controls, athletes with Achilles injuries played fewer games (p < 0.001) and had decreased longevity (p=0.025), and performance statistics (p < 0.001) at 1 year, but not 2 years after injury. Conclusion: An Achilles rupture is a devastating injury with many athletes unable to return to play. Further, athletes who managed to play for 2 years after injury play significantly fewer games, and experience significant decreases in secondary measures of longevity and performance metrics. Compared to controls, however, only the 1-year post-injury longevity and performance statistics were significantly worse. This implies a bimodal distribution of successful return to play: a significant portion of athletes undergoing repair never return to their prior level of competition, but those that do can often perform at a level commensurate with non-injured controls after 2 years.

scholarly journals Return to Play and Performance After Achilles Tendon Rupture in Women’s National Basketball Association Players

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0020
Author(s):  
Vincent Federico ◽  
Samy Gabriel ◽  
Christopher W. Reb
Keyword(s):  
Achilles Tendon ◽  
Effect Size ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
National Basketball Association ◽  
Return To Play ◽  
Post Injury ◽  
Tendon Ruptures ◽  
Performance Statistics ◽  
And Performance

Category: Sports; Trauma Introduction/Purpose: For the professional athlete, an Achilles tendon rupture is a devastating and potentially career ending injury. Basketball players with Achilles tendon injuries have among the lowest reported return to play rates for orthopaedic injuries. Among National Basketball Association (NBA) players, Achilles rupture has been shown to result in difficulty with returning to competition and significantly decreased productivity exhibiting a large effect size (0.95). Comparable data regarding Women’s National Basketball Association (WNBA) players is lacking. This study evaluated the impact of Achilles tendon rupture on return to play and post-injury performance among WNBA players in order to test the null hypothesis of equal negative impact as observed in the NBA. Methods: This was an IRB exempt retrospective matched cohort study. Public records indicated 12 WNBA players incurred Achilles tendon ruptures between the 2006 and 2018 seasons. Demographic data and performance statistics were collected for pre and post-injury seasons. A control cohort was matched for age, height, weight, years of experience in WNBA, position, and pre-injury player efficiency rating (PER). Individual pre versus post injury and injury cohort versus control cohort performance statistics were compared using paired and independent samples t-tests, respectively. Injury effect size on performance was calculated. The primary outcome was difference in PER. Secondary outcomes included differences in itemized performance statistics. A priori sample size based on effect size of 0.95 indicated that 12 players per cohort were needed for 80% power to detect a difference in PER at alpha of 0.05. Results: 7 (58%) players returned to WNBA play by mean 9.5 months. There was no significant difference in pre injury PER from seasons matched for years of WNBA experience between cohorts (13.7 vs 11.9; P = 0.6). Mean PER significantly decreased in the first year (13.66 vs 9.00; P = .04; Cohen’s d = .99) and approached a significance difference in the second year (14.56 vs 9.95; P = 05; Cohen’s d = 1.02) in the injured cohort only. Minutes per game (MPG) significantly decreased only year 1 post-injury (25.84 vs 19.54; P = .04; Cohen’s d = 6.56). Points per game (PPG), field goals attempted per game (FGA), and free throws attempted per game (FTA) significantly decreased in both years post-injury (all p < 0.05). Conclusion:: WNBA players incurred Achilles tendon ruptures at a rate of 2% annually. This was associated with a moderate rate of return to play and significantly reduced production (PER, MPG, PPG, FGA, and FTA) in the first year. The second season following injury found players returning closer to pre-injury performance, with persistent significant reduction in PPG, FGA, and FTA. Effect sizes were uniformly large. These data were consistent with NBA results, supporting the null hypothesis. Providers may use this data to counsel high and elite level female basketball players on return to play and performance expectations following Achilles tendon ruptures.

Eighty-two per cent of male professional football (soccer) players return to play at the previous level two seasons after Achilles tendon rupture treated with surgical repair

2019 ◽  
Vol 54 (8) ◽  
pp. 480-486 ◽  
Author(s):  
Alberto Grassi ◽  
Guendalina Rossi ◽  
Pieter D'Hooghe ◽  
Randeep Aujla ◽  
Massimiliano Mosca ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Surgical Repair ◽  
Achilles Tendon Rupture ◽  
Return To Play ◽  
Soccer Players ◽  
Football Players ◽  
The Public ◽  
Return To Competition

ObjectiveTo evaluate the time to return to playing following acute Achilles tendon rupture (ATR) and surgical repair in professional male football (soccer) players.MethodsProfessional male football (soccer) players who sustained an ATR and underwent surgical repair were identified through internet-based injury reports from January 2008 to August 2018. Only League 1 and 2 players with injuries who had at least 1 year of follow-up from the search date were included. Injury history and time to return to play were retrieved from the public platform transfermarkt.com. For athletes who competed for at least two seasons after returning to play, re-ruptures and number of matches played were reported.Results118 athletes (mean age 27.2±7.2 years) were included. 113 (96%) returned to unrestricted practice after a mean of 199±53 days, with faster recovery in players involved in national teams. Return to competition was after a mean of 274±114 days. In the 76 athletes with at least two seasons of follow-up, 14 (18%) did not compete at the pre-injury level during the two seasons following the index injury. Six players (8%) sustained a re-rupture within the first two seasons after return to play; four re-ruptures were in footballers who returned to play <180 days after injury. Age >30 years and re-ruptures had higher odds ratios of not returning to the same level of play.Conclusions96% of professional male football players who underwent surgery to repair an ATR returned to unrestricted practice and then competition after an average time of 7 and 9 months, respectively. However, 18% did not return to the same level of play within the two seasons following their return, with a higher risk in those experiencing a re-rupture.

scholarly journals Operative Outcome of Side-Locking Loop Suture Technique Accompanied by Autologous Semitendinosus Tendon Grafting for Chronic Rupture of Achilles Tendon

2021 ◽  
Vol 6 (2) ◽  
pp. 247301142110035
Author(s):  
Keisuke Tsukada ◽  
Youichi Yasui ◽  
Maya Kubo ◽  
Shinya Miki ◽  
Kentaro Matsui ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Scale Score ◽  
Tendon Rupture ◽  
Plantar Flexion ◽  
Achilles Tendon Rupture ◽  
Case Series ◽  
Semitendinosus Tendon ◽  
Level Of Evidence ◽  
Operative Outcomes

Background: The purpose of this retrospective study was to clarify the operative outcomes of the side-locking loop suture (SLLS) technique accompanied by autologous semitendinosus tendon grafting for chronic Achilles tendon rupture. Methods: A chart review was conducted of consecutive patients treated with the SLLS technique at our department from 2012 to 2017. Postoperatively, a below-knee splint was applied for 2 weeks in 20 degrees of plantar flexion and then active range of motion exercise was started. Partial weightbearing exercise was allowed at 4 weeks according to patient tolerance, and full weightbearing without crutches was allowed at 8 weeks. The American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale score and the Achilles tendon rupture score (ATRS) were used to evaluate clinical outcomes preoperatively and at the final follow-up. Results: Ten patients (6 men, 4 women) were included in the analysis. Mean AOFAS ankle-hindfoot scale score increased significantly from 64.2 ± 5.6 points preoperatively to 95.0 ± 5.3 points at the final follow-up ( P < .001). The mean ATRS also increased significantly from 29.8 ± 4.4 points to 86.2 ± 7.7 points, respectively ( P < .001). Mean time between surgery and ability to perform 20 continuous double-leg heel raises of the operated foot was 13.5 ± 3.4 (range 10-18) weeks. One patient complained of postoperative hypoesthesia in the foot, which had spontaneously resolved by 3 months after surgery. Conclusion: The SLLS technique accompanied by autologous semitendinosus tendon grafting provided successful operative outcomes for patients with chronic Achilles tendon rupture regardless of the size of the defect, and thus long-term orthotic use was not needed after surgery. Level of Evidence: Level IV, retrospective case series.

scholarly journals Effect of Achilles Tendon Rupture on Player Performance and Longevity in Women’s National Basketball Association Players

2021 ◽  
Vol 9 (3) ◽  
pp. 232596712198998
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Patrick Buckley ◽  
Alexander Ziedas ◽  
Patricia A. Kolowich ◽  
...  
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
Achilles Tendon Rupture ◽  
National Basketball Association ◽  
Return To Play ◽  
Control Group ◽  
Healthy Controls ◽  
Career Longevity ◽  
Women's National Basketball Association ◽  
Player Performance

Background:Women’s National Basketball Association (WNBA) players have a greater incidence of lower extremity injury compared with male players, yet no data exist on functional outcomes after Achilles tendon rupture (ATR).Purpose:To evaluate the effect of Achilles tendon repair on game utilization, player performance, and career longevity in WNBA athletes.Study Design:Cohort study; Level of evidence, 3.Methods:WNBA players from 1997 to 2019 with a history of ATR (n = 12) were matched 1:2 to a healthy control group. Player characteristics, game utilization, and in-game performance data were collected for each athlete, from which the player efficiency rating (PER) was calculated. Statistical analysis was performed comparing postinjury data to preinjury baseline as well as cumulative career data. Changes at each time point relative to the preinjury baseline were also compared between groups.Results:Of the 12 players with ATR, 10 (83.3%) returned to play at the WNBA level at a mean (±SD) of 12.5 ± 3.3 months. Four players participated in only 1 WNBA season after injury. There were no differences in characteristics between the 10 players who returned to play after injury and the control group. After return to play, the WNBA players demonstrated a significant decrease in game utilization compared with preinjury, playing in 6.0 ± 6.9 fewer games, starting in 12.7 ± 15.4 fewer games, and playing 10.2 ± 9.1 fewer minutes per game ( P < .05 for all). After the index date of injury, the players with Achilles repair played 2.1 ± 1.2 more years in the WNBA, while control players played 5.35 ± 3.2 years ( P < .01) Additionally, the players with Achilles repair had a significant decrease in PER in the year after injury compared with preinjury (7.1 ± 5.3 vs 11.0 ± 4.4; P = .02). The reduction in game utilization and decrease in PER in these players was maintained when compared with the matched controls ( P < .05 for both).Conclusion:The majority of WNBA players who sustained ATR were able to return to sport after their injury; however, their career longevity was shorter than that of healthy controls. There was a significant decrease in game utilization and performance in the year after return to play compared with healthy controls.

Return to Play Following Achilles Tendon Rupture in NFL Players Based on Position

2021 ◽  
pp. 193864002110403
Author(s):  
Dane Barton ◽  
Aditya Manoharan ◽  
Ansab Khwaja ◽  
Jacob Sorenson ◽  
Michel Taylor
Keyword(s):  
Achilles Tendon ◽  
Tendon Rupture ◽  
National Football League ◽  
Achilles Tendon Rupture ◽  
Epidemiologic Study ◽  
Return To Play ◽  
Control Group ◽  
Study Cohort ◽  
History Of ◽  
Level 3

Background: The purpose of this study was to determine the return-to-play (RTP) rate and postinjury performance after Achilles tendon (AT) ruptures in National Football League (NFL) skill position players. Methods: The study included NFL skill positions with an AT rupture between the 2009-2010 and 2015-2016 seasons. Performance data were collected and compared against a matched control group. RTP was defined as playing in at least 1 game after repair. Results: RTP rate was 57% for the study cohort. The tight ends (TEs) had the highest RTP rate at 71% while the wide receivers (WRs) had the lowest RTP rate at 38%. Compared with the control group, WRs with successful RTP had significantly less receptions per game ( P = .01). For defensive players with RTP there were significant decreases in postrepair performance in tackles, passes defended, and fumbles forced/recovered compared with the control group. Conclusion: A total of 57% of players achieved RTP with WRs and running backs (RBs) having the lowest RTP rates and TEs and linebackers (LBs) having the highest RTP rates. RBs, defensive backs (DBs), and LBs with successful RTP had decreased performance in all categories. This updated information may be helpful for athletes, physicians, scouts, and coaches in evaluating players with a history of AT rupture. Levels of Evidence: Analytic, level 3, retrospective cohort study, Epidemiologic study

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