scholarly journals Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098164
Author(s):  
Steven F. DeFroda ◽  
Devan D. Patel ◽  
John Milner ◽  
Daniel S. Yang ◽  
Brett D. Owens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Case Series ◽  
National Basketball Association ◽  
High Rate ◽  
Return To Play ◽  
Lower Percentage ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury in National Basketball Association (NBA) players can have a significant impact on player longevity and performance. Current literature reports a high rate of return to play, but there are limited data on performance after ACL reconstruction (ACLR). Purpose/Hypothesis: To determine return to play and player performance in the first and second seasons after ACLR in NBA players. We hypothesized that players would return at a high rate. However, we also hypothesized that performance in the first season after ACLR would be worse as compared with the preinjury performance, with a return to baseline by postoperative year 2. Study Design: Case series; Level of evidence, 4. Methods: An online database of NBA athlete injuries between 2010 and 2019 was queried using the term ACL reconstruction. For the included players, the following data were recorded: name; age at injury; position; height, weight, and body mass index; handedness; NBA experience; dates of injury, surgery, and return; knee affected; and postoperative seasons played. Regular season statistics for 1 preinjury season and 2 postoperative seasons were compiled and included games started and played, minutes played, and player efficiency rating. Kaplan-Meier survivorship plots were computed for athlete return-to-play and retirement endpoints. Results: A total of 26 athletes underwent ACLR; of these, 84% (95% CI, 63.9%-95.5%) returned to play at a mean 372.5 days (95% CI, 323.5-421.5 days) after surgery. Career length after injury was a mean of 3.36 seasons (95% CI, 2.27-4.45 seasons). Factors that contributed to an increased probability of return to play included younger age at injury (odds ratio, 0.71 [95% CI, 0.47-0.92]; P = .0337) and fewer years of experience in the NBA before injury (odds ratio, 0.70 [95% CI, 0.45-0.93]; P = .0335). Postoperatively, athletes played a significantly lower percentage of total games in the first season (48.4%; P = .0004) and second season (62.1%; P = .0067) as compared with the preinjury season (78.5%). Player efficiency rating in the first season was 19.3% less than that in the preinjury season ( P = .0056). Performance in the second postoperative season was not significantly different versus preinjury. Conclusion: NBA players have a high rate of RTP after ACLR. However, it may take longer than a single season for elite NBA athletes to return to their full preinjury performance. Younger players and those with less NBA experience returned at higher rates.

Playing Performance After Anterior Cruciate Ligament Reconstruction Among Australian Football League Players From 1999 to 2013

2019 ◽  
Vol 47 (7) ◽  
pp. 1550-1556
Author(s):  
Courtney C.H. Lai ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Average Level ◽  
Australian Football League ◽  
Australian Football ◽  
Anterior Cruciate

Background: Achieving preinjury levels of athletic performance has been challenging for elite athletes after anterior cruciate ligament (ACL) reconstruction. Although a recent study found that 77% of Australian Football League (AFL) players who underwent ACL reconstruction from 1999 to 2013 returned to play at the highest level, the study did not indicate how consistently or well they were able to play. Purpose: To identify the number of AFL players who returned to play consistently over 2 seasons after ACL reconstruction, compare their playing performance in these seasons with preinjury performance, and evaluate factors associated with returning to preinjury levels of performance. Study Design: Case series; Level of evidence, 4. Methods: Analysis included 104 AFL players who underwent ACL reconstruction between 1999 and 2013. All had played at least 10 AFL matches in 1 season before ACL injury. Ranking points, as devised by AFL statisticians, were used to measure individual playing performance. Results: Of the 104 players who played at least 10 matches in 1 season before ACL injury, 53 (51%) returned to play at least 10 matches in 2 seasons after surgery. Of these 53 players, 36 (68%) returned to their preinjury levels of performance. The 17 remaining players who did not return to their preinjury performance still performed comparably to the AFL average level after surgery. Players <25 years old (odds ratio = 2.9, P = .01) or <90 kg (odds ratio = 2.7, P = .03) had greater odds of returning to their preinjury levels of performance. Conclusion: Returning to play on a consistent basis was a substantial challenge for AFL players after ACL reconstruction. However, among players who did return to play consistently over 2 seasons, their postsurgery average performance was comparable with the AFL average level of performance, and two-thirds returned to their preinjury levels of performance. Younger and lighter players were more likely to return to their preinjury levels of performance, possibly given the nature of AFL club playing list management decisions.

scholarly journals Return to Play and Performance in the Women’s National Basketball Association After Anterior Cruciate Ligament Reconstruction

2020 ◽  
Vol 8 (9) ◽  
pp. 232596712094707 ◽  
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Alexander Ziedas ◽  
Nima Mehran ◽  
Kelechi R. Okoroha
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
National Basketball Association ◽  
Return To Play ◽  
Level Of Evidence ◽  
Women's National Basketball Association ◽  
Playing Time ◽  
Anterior Cruciate ◽  
And Performance

Background: The incidence of anterior cruciate ligament (ACL) injuries in Women’s National Basketball Association (WNBA) athletes continues to increase. There is a paucity of data regarding return-to-play (RTP) rates and performance after ACL reconstruction in these athletes. Purpose: To quantify RTP rates and performance after ACL reconstruction in WNBA athletes. Study Design: Cohort study; Level of evidence, 3. Methods: All ACL tears sustained in the WNBA from 1997 through 2018 were identified. Body mass index (BMI), age, and position at the time of injury were collected for each player. RTP rates were calculated, and performance data were collected for each player before and after injury to determine changes in playing time and statistical performance. Players who successfully returned to play after ACL reconstruction were compared with a group of healthy controls who were matched by age, years of experience, position, height, and BMI. Statistics at 1 and 3 years after injury were compared to assess acute and longitudinal changes in performance relative to preinjury baseline. Results: A total of 59 WNBA players sustained ACL tears during the study period, and 41 (69.5%) were able to successfully RTP. Players played a mean of 7.5 ± 12.8 fewer games, played 5.0 ± 9.2 fewer minutes per game, and scored 3.7 ± 5.0 fewer points per game in their first year after RTP compared with the year before injury. Athletes with ACL reconstruction demonstrated significantly decreased performance measures regarding games played, games started, minutes, rebounds, assists, and blocks per game in their first season after RTP compared with control athletes in the same indexed year; however, these differences resolved by year 3 after surgery. Conclusion: WNBA athletes have a high RTP rate after ACL reconstruction. Players may experience an initial decrease in playing time and performance when returning to play; however, these variables were found to return to baseline over time.

scholarly journals Economic and Performance Impact of Anterior Cruciate Ligament Injury in National Basketball Association Players

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110266
Author(s):  
Nicholas J. Vaudreuil ◽  
Carola F. van Eck ◽  
Stephen J. Lombardo ◽  
F. Daniel Kharrazi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Economic Impact ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Economic Loss ◽  
National Basketball Association ◽  
Return To Play ◽  
Ligament Injury ◽  
Significant Drop ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears are one of the most devastating injuries seen in the National Basketball Association (NBA). No previous studies have examined the economic impact of ACL tears in the NBA. Purpose/Hypothesis: The purpose of this study was to examine the economic impact of ACL tears on NBA players and teams by calculating the costs of recovery (COR) and classifying players based on preinjury success level (All-Star or equivalent, starter, or reserve) and salary (in US$ million: <1.5, 1.5-4, or >4 per season). It was hypothesized that players with a lower preinjury salary or primarily a reserve role would have decreased costs, lower rates of return to play (RTP), and shorter careers. Study Design: Descriptive epidemiology study. Methods: We reviewed the publicly available records of NBA players treated with ACL reconstruction from 2000 to 2015. Data collected included player demographics, player salaries, statistical performance using player efficiency rating (PER), and specifics regarding time missed and RTP rate. Results: A total of 35 players met the study inclusion criteria. The cumulative economic loss from ACL injuries in the NBA from 2000 to 2015 was $99 million. The average COR was $2.9 million per player. RTP rate was 91% overall, with 70% retention at 3 years. Players that made a salary of less than $1.5 million per season before the injury had a significant drop in PER (difference of –7), RTP rate of 63%, and only 37% retention at 3 years. Conversely, recovering All-Star players also had a significant drop in PER (–6.2), and no players repeated as All-Stars in the season after ACL reconstruction (0%), although they did have a 100% RTP rate and an average career length of 5.6 seasons postinjury. Conclusion: While the RTP rate in NBA athletes remained high, ACL reconstruction can result in decreased statistical performance and/or inability to return to prior levels of play. Players who made less than $1.5 million preinjury or played primarily in a reserve role were associated with lower RTP and retention in the NBA at 3 years.

Fifteen-Year Audit of Anterior Cruciate Ligament Reconstructions in the Australian Football League From 1999 to 2013: Return to Play and Subsequent ACL Injury

2018 ◽  
Vol 46 (14) ◽  
pp. 3353-3360 ◽  
Author(s):  
Courtney C.H. Lai ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Rates Of Return ◽  
Australian Football League ◽  
Australian Football ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury has been a major cause of missed game time among Australian Football League (AFL) players. Return to play after ACL reconstruction is not always achieved, even among elite athletes. The rate of subsequent ACL injury in the AFL from 1990 to 2000 was high as compared with that of other elite sports. Purpose: To determine the rates of return to play and subsequent ACL injury after ACL reconstruction among AFL players from 1999 to 2013 and to explore factors associated with differing rates of return to play and subsequent ACL injury. Study Design: Case series; Level of evidence, 4. Methods: A total of 158 AFL players who underwent ACL reconstruction were identified from a prospectively maintained registry of AFL player injuries. Further data were gathered from official playing statistics, surgical records, and structured phone interviews. Results: The rate of return to play after an initial ACL injury was 77% (121 of 158 players). Greater preinjury playing experience and earlier selection in the AFL draft were associated with higher rates of return to play. The rate of subsequent ACL injury to either knee was 30% (48 of 158 players) and was especially high among players aged <21 years (23 of 46 players, 50%). After subsequent ACL injury, 34 of 48 players (71%) returned to play. In primary ACL reconstruction, the use of Ligament Augmentation and Reconstruction System grafts resulted in a faster return to play ( P = .001) but had a higher risk of subsequent revision reconstruction (risk ratio = 2.8, P = .048). Family history of ACL injury was associated with an increased risk of subsequent contralateral ACL injury (risk ratio = 3.8, P = .002). Conclusion: Most AFL players who underwent ACL reconstruction returned to play at least 1 AFL match. The high rate of subsequent ACL injury among AFL players demonstrates the highly demanding nature of Australian football, particularly at the elite level. The risk factors for subsequent ACL injury should be considered carefully when treatment and rehabilitation decisions are made for these high-demand athletes.

scholarly journals Factors Associated With Psychological Readiness to Return to Sports With Cutting, Pivoting, and Jump-Landings After Primary ACL Reconstruction

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096448
Author(s):  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Shunsuke Ohji ◽  
Takehiro Ohmi ◽  
Hideyuki Koga ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Regression Analysis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Return To Sports ◽  
Factors Associated ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction ◽  
Jump Landings

Background: High psychological readiness is an important element for returning to sports after anterior cruciate ligament (ACL) reconstruction. Identifying factors that contribute to psychological readiness is essential for planning interventions to return to play. No studies have used multivariate analysis to clarify factors associated with psychological readiness to return to specific sports. Hypothesis: To identify factors that contribute to an athlete’s psychological readiness to return after ACL reconstruction to sports that require cutting, pivoting, and jump-landings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants were athletes who before injury had participated in sports with limited contact that required cutting, pivoting, and jump-landings (basketball, soccer, futsal, volleyball, badminton, tennis, and frisbee) and hoped to return to the same sport after reconstruction. Psychological readiness was measured using the Anterior Cruciate Ligament–Return to Sport After Injury Scale (ACL-RSI) in athletes more than 6 months after primary ACL reconstruction. To clarify factors associated with the ACL-RSI, univariate regression analysis and multivariate regression analysis were performed using the following independent variables: age, sex, body mass index, time from injury to reconstruction, time from reconstruction to testing, meniscal surgery, modified Tegner activity scale before injury, kinesiophobia, limb symmetry index of knee strength, limb symmetry indices of single-leg hop (SLH) distances, and subjective running ability. Results: Higher subjective running ability, a lower kinesiophobia score, and greater limb symmetry in the lateral SLH were positively associated with psychological readiness. Conclusion: The psychological readiness of athletes aiming to return after ACL reconstruction to limited-contact sports that require cutting, pivoting, and jump-landings was affected by subjective running ability, kinesiophobia, and asymmetry of lateral SLH distance. This information may be useful in planning appropriate interventions and thereby increasing the likelihood of an athlete’s returning to such sports.

scholarly journals Combined Intra- and Extra-Articular Technique in Revision Anterior Cruciate Ligament Reconstruction

Joints ◽  
2017 ◽  
Vol 05 (03) ◽  
pp. 156-163 ◽  
Author(s):  
Jessica Zanovello ◽  
Federica Rosso ◽  
Alessandro Bistolfi ◽  
Roberto Rossi ◽  
Filippo Castoldi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Case Series ◽  
Return To Sport ◽  
Surgical Removal ◽  
Level Of Evidence ◽  
Anterior Cruciate ◽  
Over The Top

Purpose The aim of the study was to evaluate the “over the top” (OTT) nonanatomical technique for revision of anterior cruciate ligament (ACL) reconstruction. Methods Twenty-four patients with a mean age of 31.9 ± 11.2 years underwent revision of ACL reconstruction using OTT technique. International Knee Documentation Committee (IKDC) score, Knee Injury and Osteoarthritis Outcome Score (KOOS), Lysholm score, Tegner score, Subjective Patient Outcome for Return to Sport (SPORTS) score, Anterior Cruciate Ligament-Return to Sport After Injury (ACL-RSI) scale, and KT-1000 evaluation were recorded at a mean follow-up of 30.7 ± 18.9 months. Results Postoperatively, the IKDC objective total score significantly improved (p = 0.0046). The KOOS, Lysholm, and Tegner scores also improved, but the results were not statistically significant (62.4 vs. 72.6, 6.5 vs. 75.8, and 4.1 vs. 6.0, respectively). The subjective IKDC evaluation score improved from an average of 51.1 points to 63.7 points at the last follow-up (p = 0.0027). The RTP prevalence was 81.8%, with 44.4% of the patients returning to the same preinjury level. According to the SPORTS score, 16.6% of patients played sport without limitations in activity and performance. The average ACL-RSI score was 52.1 ± 27.0. No major complications were reported. A total of 21.5% of patients underwent surgical removal of staples. The failure prevalence was 14.3% and the cumulative survivorship, calculated using the Kaplan–Meier method, was equal to 70% at 60 months of follow-up. Conclusion The OTT technique in the revision ACL reconstruction provided improvement in objective and subjective scores, good RTP prevalence, and acceptable rate of complication and failure. One of the advantages was the possibility to avoid the femoral tunnel. Level of Evidence Level IV, therapeutic case series.

scholarly journals Impact of Anterior Cruciate Ligament Reconstruction on NCAA FBS Football Players: Return to Play and Performance Vary by Position

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711984105 ◽  
Author(s):  
Patrick Martin Wise ◽  
Robert A. Gallo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
National Collegiate Athletic Association ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Football Players ◽  
Significant Performance ◽  
Anterior Cruciate ◽  
The Impact

Background: Anterior cruciate ligament (ACL) injuries are devastating for college football players. Although the change in functional performance of National Collegiate Athletic Association (NCAA) football players after reconstruction has been shown to be negligible, studies have failed to analyze the statistical performance of these players upon their return. Purpose/Hypothesis: The purpose of this study was to quantify the impact of ACL reconstruction on the statistical performance of collegiate football players. We hypothesized that statistical performance would vary by position and that running backs, wide receivers, and defensive backs, compared with preinjury and controls, would experience the largest decline in performance after returning from ACL reconstruction. Study Design: Descriptive epidemiology study. Methods: NCAA Football Bowl Subdivision (FBS) football players who experienced ACL tears between the years 2010 and 2015 were identified. The rates of return to play after surgery were determined for each position. Preinjury and postoperative performance statistics of each running back, receiver, defensive lineman, linebacker, and defensive back who met inclusion criteria were compared. A t-test analysis was used to compare the performance changes experienced by these players versus the performance changes of matched controls. Results: A total of 349 players were identified. Only 63.64% of eligible offensive linemen returned to play. Upon return, running backs experienced significant performance decreases compared with controls in carries (mean ± SD, –2.4 ± 2.7 vs 2.8 ± 1.6; P = .003), yards (–12.3 ± 15.5 vs 13.8 ± 7.8; P = .006), and receptions (–0.22 ± 0.32 vs 0.32 ± 0.23; P = .011) per game. Receivers displayed significant performance decreases compared with controls in number of touchdowns (–0.019 ± 0.110 vs 0.18 ± 0.06; P = .004), receptions (–0.11 ± 0.79 vs 1.2 ± 0.4; P = .004), and yards (–3.2 ± 10.6 vs 18.6 ± 5.4; P = .0009) per game. Linebackers demonstrated less improvement than controls in tackles for loss (0.007 ± 0.115 vs 0.31 ± 0.11; P = .0003) and sacks (0.001 ± 0.061 vs 0.10 ± 0.06; P = .026). Conclusion: Although offensive linemen were the least likely to return to play, running backs and receivers returned to play at a lower level of performance. The performance of defensive players was less affected by ACL reconstruction.

Use Caution When Assessing Preoperative Leg-Length Discrepancy in Pediatric Patients With Anterior Cruciate Ligament Injuries

2020 ◽  
Vol 48 (12) ◽  
pp. 2948-2953
Author(s):  
Madison R. Heath ◽  
Alexandra H. Aitchison ◽  
Lindsay M. Schlichte ◽  
Christine Goodbody ◽  
Frank A. Cordasco ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Intraclass Correlation ◽  
Case Series ◽  
Surgical Reconstruction ◽  
Radiographic Examination ◽  
Leg Length ◽  
Level Of Evidence ◽  
Anterior Cruciate

Background: Pre- and postoperative standing hip-to-ankle radiographs are critical for monitoring potential postoperative growth arrest and resultant deformities after pediatric anterior cruciate ligament (ACL) reconstruction. Purpose: To determine the prevalence of apparent preoperative leg-length discrepancies (LLDs) that resolve at the first postoperative radiographic examination in patients undergoing ACL reconstruction in order to understand what proportion of the noted preoperative deformities may have been inaccurate. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of prospectively collected preoperative and first postoperative full-length hip-to-ankle radiographs was performed in a cohort of skeletally immature patients who had an acute ACL injury and underwent subsequent surgical reconstruction. Leg length measurements for both the injured and the uninjured legs were obtained for comparison. Results: A total of 112 patients (mean age, 12.7 ± 1.7 years) were included (79 boys and 33 girls). Leg-length measurement interrater reliability among 3 raters for 25 randomly chosen images was nearly perfect (intraclass correlation coefficient, 0.996; 95% CI, 0.994-0.998). At baseline, there was no apparent preoperative LLD (<5 mm) in 48% (n = 54) of participants, while 37% (n = 41) displayed a small apparent LLD (5 to <10 mm), 12% (n = 13) displayed a moderate apparent LLD (10 to <15 mm), and 4% (n = 4) displayed a large apparent LLD (≥15 mm). Of the patients with an apparent preoperative LLD, 66% (n = 38) of them tore their ACL on the leg measuring shorter. At first postoperative radiographs, 48% (n = 28) of patients with an apparent preoperative LLD showed resolution to no LLD: 46% (n = 19) of patients with a small apparent preoperative LLD, 54% (n = 7) of patients with a moderate apparent LLD, and 50% (n = 2) of patients with a large apparent LLD. Conclusion: A high percentage of patients (48%) with apparent preoperative LLDs showed resolution to no LLDs by their first postoperative imaging, indicating that preoperative hip-to-ankle radiographs display some false LLDs in patients with recent ACL tears who are unable to fully extend their injured leg and bear weight.

scholarly journals Anterior Cruciate Ligament Reconstruction Graft Options

2018 ◽  
Vol 6 (6_suppl3) ◽  
pp. 2325967118S0004
Author(s):  
Gustavo Vinagre ◽  
João Saraiva
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Ligament Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Knee Stability ◽  
Advantages And Disadvantages ◽  
Anterior Cruciate ◽  
Sports Traumatology ◽  
The Ideal

Introduction: The Anterior Cruciate Ligament (ACL) tear is one of the most feared injuries since it can be crucial in the athlete’s career. The ACL reconstruction is one of the most frequent surgical procedures in Sports and the goal is to restore knee stability and avoid further injuries on the meniscus and cartilage, representing a constant topic of debate in Sports Traumatology. There are different graft options for ACL reconstruction that have been described over the years, addressed by different studies with controversy and different outcomes. The decision of the ideal graft for an ACL reconstruction is very complex, but should be consensual among all those involved in the injury process, and should be taken according to patient´s anatomy, physical demand and intrinsic graft specifications, that are key to know and understand. Objectives: Review and summarize the different graft options available for ACL reconstruction in order to make an optimal and individualized choice for each athlete to maximize the return to play and back to Sports at pre-injury levels. Methods: A literature review was performed on PubMed / Medline electronic databases with the words “ACL graft” by relevance. The articles with graft comparisons specifications were selected. Results: The results of our review were summarized with the advantages and disadvantages of the following grafts: Bone-Tendon-Bone (BTB) autograft; hamstrings autograft, quadriceps autograft and allografts. Conclusion: Taking into account the scientific knowledge available and despite the differences in each graft, the choice of the ideal graft that should be used in the ACL reconstruction should be individualized for each athlete, according to intrinsic graft specifications and extrinsic particularities of each sport and athlete.

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