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.

scholarly journals Performance After Concussion in National Hockey League Players

2021 ◽  
Vol 56 (4) ◽  
pp. 404-407
Author(s):  
Aidan L. Neustadtl ◽  
William K. Bukowski ◽  
Alan Neustadtl ◽  
David Milzman
Keyword(s):  
Outcome Measure ◽  
Cross Sectional Study ◽  
Ice Hockey ◽  
Return To Play ◽  
National Hockey League ◽  
Sectional Study ◽  
Cross Sectional ◽  
Hockey Players ◽  
Player Performance ◽  
Interesting Area

Context Concussions in ice hockey players are an interesting area of study due to the fast-paced and high-impact nature of the sport. Recently, researchers have focused on player performance after return from concussion to evaluate subclinical deficits that were previously missed. Objective To examine National Hockey League (NHL) player performance from 2013 to 2019 and compare performance before a concussion with performance immediately after recovering to assess the current NHL return-to-play protocol. Design Cross-sectional study. Setting The NHL Injury Viz and sports reporting websites. Patients or Other Participants Players in the NHL who sustained concussions from 2013 to 2019. Main Outcome Measure(s) Goals, assists, points, plus-minus, time on ice (TOI), and hits. Results When goals, assists, points, plus-minus, TOI, and hits were examined, only TOI was different after the players returned from injury, and this TOI difference was not substantively important. Conclusions After concussion, NHL player performance did not change.

Sports Hernia in National Hockey League Players

2012 ◽  
Vol 41 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Andre Jakoi ◽  
Craig O’Neill ◽  
Christopher Damsgaard ◽  
Keith Fehring ◽  
James Tom
Keyword(s):  
Statistical Significance ◽  
Return To Play ◽  
National Hockey League ◽  
Control Group ◽  
Sports Hernia ◽  
Level Of Evidence ◽  
Athletic Pubalgia ◽  
Hockey Players ◽  
Group A ◽  
Group B

Background: Athletic pubalgia is a complex injury that results in loss of play in competitive athletes, especially hockey players. The number of reported sports hernias has been increasing, and the importance of their management is vital. There are no studies reporting whether athletes can return to play at preinjury levels. Purpose: The focus of this study was to evaluate the productivity of professional hockey players before an established athletic pubalgia diagnosis contrasted with the productivity after sports hernia repair. Study Design: Cohort study; Level of evidence, 3. Methods: Professional National Hockey League (NHL) players who were reported to have a sports hernia and who underwent surgery from 2001 to 2008 were identified. Statistics were gathered on the players’ previous 2 full seasons and compared with the statistics 2 full seasons after surgery. Data concerning games played, goals, average time on ice, time of productivity, and assists were gathered. Players were divided into 3 groups: group A incorporated all players, group B were players with 6 or fewer seasons of play, and group C consisted of players with 7 or more seasons of play. A control group was chosen to compare player deterioration or improvement over a career; each player selected for the study had a corresponding control player with the same tenure in his career and position during the same years. Results: Forty-three hockey players were identified to have had sports hernia repairs from 2001 to 2008; ultimately, 80% would return to play 2 or more full seasons. Group A had statistically significant decreases in games played, goals scored, and assists. Versus the control group, the decreases in games played and assists were supported. Statistical analysis showed significant decreases in games played, goals scored, assists, and average time on ice the following 2 seasons in group C, which was also seen in comparison with the control group. Group B (16 players) showed only statistical significance in games played versus the control group. Conclusion: Players who undergo sports hernia surgeries return to play and often perform similar to their presurgery level. Players with over 7 full seasons return but with significant decreases in their overall performance levels. Less veteran players were able to return to play without any statistical decrease in performance and are likely the best candidates for repair once incurring injury.

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.

scholarly journals Prevalence of Os Styloideum in National Hockey League Players

2017 ◽  
Vol 9 (5) ◽  
pp. 469-473 ◽  
Author(s):  
Harry G. Greditzer ◽  
Ian D. Hutchinson ◽  
Christian S. Geannette ◽  
Robert N. Hotchkiss ◽  
Bryan T. Kelly ◽  
...  
Keyword(s):  
General Population ◽  
Bone Marrow Edema ◽  
Case Series ◽  
Ice Hockey ◽  
National Hockey League ◽  
Resonance Imaging ◽  
Level Of Evidence ◽  
Hockey Players ◽  
Bone Marrow Edema Pattern ◽  
Professional Hockey

Background: Os styloideum describes an accessory carpal ossicle between the trapezoid, the capitate, and the second and third metacarpals. Injuries to this tissue have been described as part of the carpal boss syndrome. While the etiology of os styloideum remains uncertain, it may represent a physiologic response to altered loading forces in the wrist, similar to the development of cam-type deformity in the hips of ice hockey players or the Bennett lesion in the shoulders of baseball pitchers. Hypothesis: Professional hockey players will have a higher prevalence of os styloideum compared with the general population. Study Design: Case series. Level of Evidence: Level 4. Methods: A retrospective review of 16 professional hockey players from 4 different National Hockey League (NHL) teams who underwent unilateral imaging of the wrist was performed. Seventeen wrists were reviewed for the presence of os styloideum. Results: Thirteen of 16 players (81%) had an os styloideum, representing an increased prevalence compared with the general population. Previous clinical and cadaveric studies estimated a general prevalence of up to 19% ( P < 0.001). For the 10 players who had their leading wrist scanned, 9 had an os styloideum (90%). Ten of 11 (91%) players demonstrated a bone marrow edema pattern within the metacarpal and the os styloideum on magnetic resonance imaging. There was no significant association between the presence of an os styloideum and the player’s position, leading wrist, or years in the league. Conclusion: There appears to be an increased prevalence of os styloideum among NHL players, and team physicians should consider this finding while formulating a differential diagnosis for dorsal wrist pain. Clinical Relevance: This study identified NHL players as having an increased prevalence of os styloideum compared with the general population. By doing so, these findings represent an opportunity to enhance our understanding of the etiology, clinical significance, and treatment of os styloideum.

scholarly journals Cost Analysis of Failed Shoulder Stabilization

2015 ◽  
Vol 5 (1) ◽  
pp. 14-19
Author(s):  
Jonathan A Godin ◽  
Jack G Skendzel ◽  
Jon K Sekiya
Keyword(s):  
Cost Analysis ◽  
Failure Rate ◽  
Shoulder Instability ◽  
Open Repair ◽  
Surgical Techniques ◽  
Arthroscopic Repair ◽  
High Rate ◽  
Return To Play ◽  
Shoulder Stabilization ◽  
Open Stabilization

ABSTRACT Background Shoulder instability is a common problem, especially in the young, active population. Revision stabilization has a high rate of recurrent instability, low rates of return to play, and low clinical outcome scores. The challenge for surgeons is identifying the best surgery for each patient. To our knowledge, no studies have been published examining the cost of failed shoulder stabilization. Hypothesis The high cost of index and revision stabilization procedures in a cohort of patients with recurrent shoulder instability can be reduced through judicious preoperative planning and the use of more aggressive surgical techniques during the index operation. Methods We retrospectively reviewed the medical records and billing information of 18 consecutive patients treated at our institution for failed shoulder instability repairs during a 36-month period. Using the billing records for each case, a cost analysis was conducted from a societal perspective. Results The actual costs of index stabilization and revision stabilization procedures for our cohort of 18 patients amounted to $1,447,690. The costs of revision surgeries conducted for this cohort by a single surgeon at our institution amounted to $673,248. The hypothetical costs of primary arthroscopic stabilization and open stabilization for a cohort of 18 patients leading to permanent repair was $395,415 and $585,639 respectively. The incremental difference between actual costs and hypothetical costs of primary osteoarticular (OA) allograft stabilization for patients with bony defects is $278,394. For patients with significant bone defects, an open repair with failure rate of 44.9%, or an arthroscopic repair with failure rate of 62.8%, is cost neutral to a primary open repair with OA allograft. In addition, an open repair with failure rate of 13.0%, or an arthroscopic repair with failure rate of 41.3%, is cost neutral to a primary definitive repair. Conclusion Failed shoulder stabilization bears high costs to society, even without considering the psychological costs to patients. We must identify and refine diagnostic and prognostic factors to better determine the appropriate treatment modality for patients with primary shoulder instability. Godin JA, Skendzel JG, Sekiya JK. Cost Analysis of Failed Shoulder Stabilization. The Duke Orthop J 2015;5(1):14-19.

Return to play after treatment of shoulder labral tears in professional hockey players

2016 ◽  
Vol 44 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Ashwin Rangavajjula ◽  
Adam Hyatt ◽  
Eli Raneses ◽  
Jim McCrossin ◽  
Steven Cohen ◽  
...  
Keyword(s):  
Return To Play ◽  
Labral Tears ◽  
Hockey Players ◽  
Professional Hockey

scholarly journals Shoulder instability, performance, and return to play in National Hockey League players

2020 ◽  
Vol 4 (4) ◽  
pp. 786-791
Author(s):  
Hasani W. Swindell ◽  
Kyle L. McCormick ◽  
Liana J. Tedesco ◽  
Carl L. Herndon ◽  
Christopher S. Ahmad ◽  
...  
Keyword(s):  
Shoulder Instability ◽  
Return To Play ◽  
National Hockey League

scholarly journals High Ankle Sprains in Professional Ice Hockey Players: Prognosis and Correlation Between Magnetic Resonance Imaging Patterns of Injury and Return to Play

2019 ◽  
Vol 7 (9) ◽  
pp. 232596711987157 ◽  
Author(s):  
Brent Mollon ◽  
David Wasserstein ◽  
Gráinne M. Murphy ◽  
Lawrence M. White ◽  
John Theodoropoulos
Keyword(s):  
Return To Play ◽  
Ankle Sprains ◽  
Resonance Imaging ◽  
Ligamentous Injury ◽  
Tibiofibular Ligament ◽  
Partial Tears ◽  
Hockey Players ◽  
Professional Hockey ◽  
High Ankle Sprain ◽  
Patterns Of Injury

Background: Hockey players sustain a greater incidence of ankle syndesmosis injuries than other athletes. These injuries have a higher morbidity and more unpredictable recovery than lateral ankle sprains. Magnetic resonance imaging (MRI) has been used to establish the diagnosis but has not been evaluated for its ability to predict return to play. Hypothesis: We hypothesized that patterns of injury defined on MRI could be used to predict return to play in a cohort of professional hockey players with syndesmosis sprains. Study Design: Cohort study; Level of evidence, 3. Methods: A prospectively collected National Hockey League (NHL) database was analyzed from the 2006-2007 to 2011-2012 seasons to assess return to play after an injury. A separate retrospective review of ankle MRI scans from professional hockey players with a documented high ankle sprain sustained between 2007 and 2012 was performed. Injuries were classified on MRI as complete or partial tears of the anterior-inferior tibiofibular ligament (AITFL), posterior-inferior tibiofibular ligament (PITFL), anterior talofibular ligament (ATFL), posterior talofibular ligament (PTFL), calcaneofibular ligament (CFL), and deltoid ligament. Fractures, bone contusions, and osteochondral lesions were also recorded. Results: A total of 105 NHL athletes sustained high ankle sprains over the 5 seasons studied. Of these athletes, 85 were unable to play and missed a median of 8 games (range, 0-65 games). A retrospective MRI evaluation of 21 scans identified complete AITFL tears in 13 (62%) and high-grade partial tears in 5 (24%) cases. In contrast, the PITFL was partially torn in 9 (43%) and normal in 12 (57%) cases. Bone contusions were seen in 71% of cases and lacked a consistent pattern. The most commonly associated ligamentous injury was of the ATFL, which was injured in 52% of cases (11/21; 3 complete and 8 partial). There was no difference in the mean number of days lost when players were stratified by patterns of injury (incomplete/complete AITFL tear ± additional ligamentous injury, bone contusion, syndesmosis width). Conclusion: A high ankle sprain resulted in significant variations in time of recovery among professional hockey players. A torn AITFL and bone bruising were the most common patterns of injury. Although MRI can be used to confirm the diagnosis of a syndesmosis injury, it did not predict return to play in this population.

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.

scholarly journals Concussions in the National Basketball Association: Analysis of Incidence, Return to Play, and Performance From 1999 to 2018

2019 ◽  
Vol 7 (6) ◽  
pp. 232596711985419 ◽  
Author(s):  
Bhavik H. Patel ◽  
Kelechi R. Okoroha ◽  
Toufic R. Jildeh ◽  
Yining Lu ◽  
Alexander J. Idarraga ◽  
...  
Keyword(s):  
National Basketball Association ◽  
High Rate ◽  
Return To Play ◽  
Control Group ◽  
Time Interval ◽  
Before And After ◽  
Sports Leagues ◽  
And Performance ◽  
Player Performance ◽  
First Time

Background: The effect of concussions on professional athletes has been investigated in many sports. However, few studies have evaluated concussions in National Basketball Association (NBA) players. Hypothesis: We hypothesized that concussion incidence has increased, yet the return-to-play (RTP) rate will remain high following the institution of the NBA concussion policy (NBACP). We also hypothesized that the incidence of repeat concussions will be similar to first occurrences and that player performance and game availability will not be significantly affected by sustaining a concussion. Study Design: Descriptive epidemiology study. Methods: Publicly available records were searched to identify all concussions from NBA seasons 1999-2000 to 2017-2018. Player demographics and information regarding career history were tabulated. Incidence of concussion and RTP timing were evaluated before and after institution of the NBACP (2011). Minutes per game and game score per minute were evaluated pre- versus postconcussion. Player availability and performance were also compared with an age-, body mass index–, position-, and experience-matched control group of players who did not sustain a concussion. Results: A total of 189 concussions were reported in the NBA from 1999 to 2018, with a mean ± SD incidence of 9.7 ± 7.3 concussions per season. Following implementation of the NBACP, incidence significantly increased from 5.7 ± 2.8 to 16.7 ± 7.5 concussions per season ( P = .007). All players returned to play following first-time concussion after missing 7.7 ± 8.6 days and 3.5 ± 4.1 games. RTP time was not significantly different after implementation of the NBACP (games missed, P = .24; days missed, P = .27), and there was no difference in concussion-free time interval ( P = .29). Game score per minute and minutes per game were not significantly affected by sustaining a concussion (both P > .05). Conclusion: Concussion incidence in NBA players is approximately 17 instances per season since the 2011 institution of a league-wide concussion policy. The number of reported concussions significantly increased following the policy, in line with trends seen in other professional sports leagues. Players have retained a high rate of RTP after 3 to 4 missed games. Player performance and availability are not affected by sustaining a concussion following successful RTP.

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