scholarly journals Association of Prior Anterior Cruciate Ligament Tear With Decreased Career Longevity in Women’s National Basketball Association

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110092
Author(s):  
Joseph S. Tramer ◽  
Lafi S. Khalil ◽  
Toufic R. Jildeh ◽  
Mohammad Sattar ◽  
Alexander Ziedas ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
National Basketball Association ◽  
Healthy Controls ◽  
Acl Tear ◽  
History Of ◽  
Anterior Cruciate ◽  
And Performance

Background: The incidence of anterior cruciate ligament (ACL) injuries in women’s basketball exceeds that of men. There is a paucity of data regarding career performance in Women’s National Basketball Association (WNBA) athletes with a history of ACL reconstruction. Purpose: To determine whether WNBA athletes with a history of ACL injury prior to professional play have reduced career game utilization, defined as games played and started and minutes per game (MPG), as well as statistical performance, defined by player efficiency rating (PER). Study Design: Cohort study; Level of evidence, 3. Methods: Included were 42 WNBA players from 1997 to 2018 who had a history of ACL reconstruction before entering professional leagues. Body mass index (BMI), age, and position were collected for each player. Career data and performance statistics were likewise collected for each player’s entire WNBA career. A control group of WNBA players with no history of ACL injury were matched by position, BMI, and age at the time of WNBA debut. Statistics compared game utilization and performance to assess the impact of ACL reconstruction. Results: Athletes who sustained an ACL tear before entering the league played in fewer games per season in their first 3 professional seasons compared with healthy controls (24.2 ± 8.4 vs 28.2 ± 6.1; P = .02). Among athletes with a history of ACL reconstruction, 11 (26.2%) played only a single WNBA season, while no control athletes played in just 1 season. Additionally, athletes who had a previous ACL tear started significantly fewer games per season (9.0 ± 9.4 vs 14.0 ± 9.0; P < .01) and played fewer MPG (15.5 ± 7.2 vs 20.7 ± 5.5; P < .01) during their WNBA career. Athletes with a history of ACL tear had significantly shorter WNBA careers (4.8 ± 4.1 vs 8.1 ± 3.3 seasons; P < .001). Total professional play duration (WNBA + overseas) was significantly reduced in players with an ACL tear compared with controls ( P < .05). PER was not significantly different between cohorts at any time point. Conclusion: WNBA athletes with a history of an ACL tear before professional play had decreased career game utilization and workload throughout their career despite having similar PER compared with healthy controls.

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.

Plyometrics Did Not Improve Jump-Landing Biomechanics in Individuals With a History of Anterior Cruciate Ligament Reconstruction: A Randomized Controlled Trial

2021 ◽  
pp. 1-8
Author(s):  
Hyunjae Jeon ◽  
Sean Krysak ◽  
Steven J. Pfeiffer ◽  
Abbey C. Thomas
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Body Mass ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Jump Landing ◽  
History Of ◽  
Anterior Cruciate

Second anterior cruciate ligament (ACL) injury has similar biomechanical risk factors as primary injury. Standard of care rehabilitation does not adequately mitigate these biomechanical risks. This study examined the effectiveness of a 4-week plyometric intervention on biomechanical risk factors of second ACL injury versus no intervention in patients with a history of ACL reconstruction. Thirty adults post-ACL reconstruction received 12 sessions of plyometric (age: 19.9 ± 1.62 years; body mass index: 23.9 ± 2.6 kg/m2; months postoperative: 35.7 ± 24.2) or no (age: 21.3 ± 3.5 years; body mass index: 27.7 ± 4.8 kg/m2; months postoperative: 45.3 ± 25.4) exercise intervention. Hip and knee biomechanics were quantified during a jump-landing task before and after the intervention. Individual response to the intervention was evaluated via minimal detectable change. Hip flexion angle had the greatest response to plyometric training. Overall, focused plyometric intervention did not adequately mitigate biomechanical risk factors of second ACL injury; thus, development of interventions capable of modifying biomechanics known to contribute to ACL injury risk remains necessary.

scholarly journals High Risk of New Knee Injuries in Female Soccer Players After Primary Anterior Cruciate Ligament Reconstruction at 5- to 10-Year Follow-up

2021 ◽  
pp. 036354652110444
Author(s):  
Anne Fältström ◽  
Joanna Kvist ◽  
Martin Hägglund
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Knee Injury ◽  
Cruciate Ligament ◽  
Knee Injuries ◽  
Acl Injury ◽  
Soccer Players ◽  
Healthy Controls ◽  
Anterior Cruciate

Background: A new anterior cruciate ligament (ACL) injury after ACL reconstruction is a feared outcome. Purpose: To study the risk of new knee injuries in female soccer players 5 to 10 years after primary unilateral ACL reconstruction and to compare players who returned to soccer with (1) players who did not return and (2) knee-healthy soccer players (controls). Study Design: Cohort study; Level of evidence, 2. Methods: Demographic, soccer-specific, and surgical data were recorded at baseline for 317 female soccer players (mean ± SD age, 20.1 ± 2.7 years) 1.6 ± 0.7 years after ACL reconstruction and for 119 matched controls (mean age, 19.5 ± 2.5 years). Data on new knee injuries and soccer-playing status were collected 5 to 10 years after ACL reconstruction via a questionnaire. Results: Among players with ACL reconstruction, 222 (70%) responded at a mean 6.5 ± 1.0 years after primary ACL reconstruction. We compared 3 cohorts: (1) among 163 players with ACL reconstruction who returned to soccer, 68 (42%) sustained 44 reruptures and 29 contralateral ruptures; (2) among 59 players with ACL reconstruction who did not return to soccer, 11 (19%) sustained 9 reruptures and 2 contralateral ruptures; and (3) among 113 knee-healthy controls, 12 (11%) sustained 13 ACL injuries. Players who returned had a >2-fold higher risk of a new ACL injury than players who did not return (risk ratio, 2.24; 95% CI, 1.27-3.93; P = .005) and a 4-fold higher risk than controls (risk ratio, 3.93; 95% CI, 2.23-6.91; P <.001). A new ACL, meniscal, or cartilage injury was the most frequent new knee injury. Among players who returned to soccer, 68% reported a new knee injury, and they had a 2- to 5-times higher risk of any new knee injury and knee surgery than players who did not return and controls. Conclusion: Two-thirds of female soccer players with ACL reconstruction who returned to soccer sustained a new knee injury within 5 to 10 years; 42% had a new ACL injury. Their risk of a new knee injury and knee surgery was 2 to 5 times greater than that for players who did not return and for knee-healthy controls. New injury may have negative consequences for long-term knee health and should be a critical consideration in the decision to return to play.

scholarly journals Recurrent Anterior Cruciate Ligament Tears in the National Football League: A Case-Control Study

2019 ◽  
Vol 7 (12) ◽  
pp. 232596711989141 ◽  
Author(s):  
Casey R. Stuhlman ◽  
Christopher J. Owens ◽  
Eric M. Samuelson ◽  
Ryan P. Vermillion ◽  
Mark D. Shermansky ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
National Football League ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
American Football ◽  
Matched Cohort ◽  
Control Cohort ◽  
History Of ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injuries are common in American football players. The risk of subsequent ACL reinjury to either the ipsilateral or the contralateral knee in National Football League (NFL) draftees with a history of successful ACL reconstruction before entering the NFL remains unknown. Hypothesis: NFL athletes with a history of successful ACL reconstruction before being drafted will likely demonstrate increased risk of subsequent ACL injury when compared with a control cohort consisting of players of similar positions and draft class. Study Design: Cohort study; Level of evidence, 3. Methods: Detailed orthopaedic evaluations of NFL Combine participants from 2006 to 2012 were obtained to identify players entering the NFL draft with a history of successful ACL reconstruction. A control cohort was created in a 2:1 ratio, consisting of players matched by position and draft class. Results: Of the 2016 players invited to the NFL Combine during the study period, 100 met the inclusion criteria. A total of 26 subsequent ACL reinjuries (12 ipsilateral, 14 contralateral) occurred in 25 players (25%) while playing in the NFL, with injuries occurring at a mean of 22.1 months after the NFL draft. In comparison, 18 of the 200 (9%) carefully matched cohort players without history of prior ACL injury sustained a new ACL injury during this time period ( P < .001). Conclusion: NFL athletes with a history of successful ACL reconstruction before being drafted into the NFL have a significantly higher rate of subsequent ACL reinjury while playing in the NFL when compared with a carefully matched cohort of players without a history of prior ACL injury.

scholarly journals Do Pediatric Patients With Anterior Cruciate Ligament Tears Have a Higher Rate of Familial Anterior Cruciate Ligament Injury?

2020 ◽  
Vol 8 (10) ◽  
pp. 232596712095966
Author(s):  
Joshua T. Bram ◽  
Nicolas Pascual-Leone ◽  
Neeraj M. Patel ◽  
Christopher J. DeFrancesco ◽  
Nakul S. Talathi ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Family History ◽  
Pediatric Patients ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Ligament Injury ◽  
Acl Tear ◽  
First Degree Relatives ◽  
History Of ◽  
Anterior Cruciate

Background: Several studies have examined the anterior cruciate ligament (ACL) injury history among relatives of patients undergoing ACL reconstruction (ACLR), but they have primarily analyzed adults with variable results. Hypothesis: We hypothesized that he rate of familial ACL injuries among pediatric patients with ACL tears would be greater than that among pediatric patients with uninjured knees. Study Design: Cohort study; Level of evidence, 3. Methods: Pediatric patients (≤18 years of age) who underwent ACLR between January 2009 and May 2016 were contacted to complete a questionnaire on subsequent complications and family history of ACL tears. A control cohort was recruited from children with uninjured knees seen in the concussion clinic of our institution. Binary logistic regression was used to determine the factors predictive of having a familial ACL tear history or complications. Results: Overall, 450 pediatric patients with primary ACL tears were included. Age at the time of surgery was 14.9 ± 2.2 years with a follow-up of 4.3 ± 2.1 years. When compared with 267 control patients, those with an ACL tear reported a higher rate of first-degree relatives with an ACL injury history (25.1% vs 12.0%; P < .001). In multivariate analysis, children with ACL injury had nearly 3 times (odds ratio [OR], 2.7) higher odds of having a first-degree relative with an ACL tear (95% CI, 1.7-4.2; P < .001). Patients were stratified by the number of first-degree relatives with ACL tears: no relatives, 1 relative, or ≥2 relatives. Children with ≥2 first-degree relatives were more likely to sustain a postoperative graft failure (OR, 5.1; 95% CI 1.7-15.2; P = .003) or a complication requiring surgical intervention (OR, 7.5; 95% CI, 2.6-22.0; P < .001). Conclusion: A family history of ACL injury is more likely in pediatric patients with ACL tears than in uninjured children. Further, patients undergoing primary ACLR as well as a strong family history of ACL tears are more likely to sustain a postoperative graft rupture or complication requiring surgery.

Decreased Postural Control in Patients Undergoing Anterior Cruciate Ligament Reconstruction Compared to Healthy Controls

2020 ◽  
Vol 29 (7) ◽  
pp. 920-925 ◽  
Author(s):  
Jonathon R. Staples ◽  
Kevin A. Schafer ◽  
Matthew V. Smith ◽  
John Motley ◽  
Mark Halstead ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Postural Stability ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Time To Failure ◽  
Healthy Controls ◽  
Anterior Cruciate ◽  
Dynamic Postural Stability

Context: Patients with anterior cruciate ligament (ACL) tears are likely to have deficient dynamic postural stability compared with healthy sex- and age-matched controls. Objectives: To test the hypothesis that patients undergoing ACL reconstruction have decreased dynamic postural stability compared with matched healthy controls. Design: Prospective case-control study. Setting: Orthopedic sports medicine and physical therapy clinics. Patients or Other Participants: Patients aged 20 years and younger with an ACL tear scheduled for reconstruction were enrolled prospectively. Controls were recruited from local high schools and colleges via flyers. Interventions: Patients underwent double-stance dynamic postural stability testing prior to surgery, recording time to failure and dynamic motion analysis (DMA) scores. Patients were then matched with healthy controls. Main Outcome Measures: Demographics, time to failure, and DMA scores were compared between groups. Results: A total of 19 females and 12 males with ACL tears were matched with controls. Individuals with ACL tears were more active (Marx activity score: 15.7 [1.0] vs 10.8 [4.9], P < .001); had shorter times until test failure (84.4 [15.8] vs 99.5 [14.5] s, P < .001); and had higher (worse) DMA scores (627 [147] vs 481 [132], P < .001), indicating less dynamic postural stability. Six patients with ACL deficiency (1 male and 5 females) demonstrated lower (better) DMA scores than their controls, and another 7 (4 males and 3 females) were within 20% of controls. Conclusions: Patients undergoing ACL reconstruction had worse global dynamic postural stability compared with well-matched controls. This may represent the effect of the ACL injury or preexisting deficits that contributed to the injury itself. These differences should be studied further to evaluate their relevance to ACL injury risk, rehabilitation, and return to play.

scholarly journals Driving Tendency is Associated with Increased Risk of Anterior Cruciate Ligament Tears in National Basketball Association Players (103)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0025
Author(s):  
Kevin Thomas ◽  
Blake Schultz ◽  
Mark Cinque ◽  
Joshua Harris ◽  
Geoffrey Abrams
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Long Range ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
T Test ◽  
National Basketball Association ◽  
Increased Risk ◽  
Significant Difference ◽  
Anterior Cruciate

Objectives: Previous work has shown a high return to sport (RTS) after Anterior Cruciate Ligament Reconstruction (ACLR) in National Basketball Association (NBA) players. Data on performance outcomes after RTS are less clear, with some demonstrating no difference compared to controls and others showing decreased performance. Two fundamentals of basketball are driving the ball to the basket and long-range shooting. Driving involves lateral movement, whereas long-range shooting features vertical movement. The biomechanics of these two scoring approaches may affect risk of ACL injury and post-ACLR performance. The objective of this study was to investigate whether NBA players with higher drive tendency and/or higher tendency to shoot 3-point shots are more likely to tear their Anterior Cruciate Ligament (ACL) relative to controls and if they experience decreased statistical performance after returning to play. Methods: Season-level performance statistics and ACL injuries were aggregated from the 1980-2017 NBA seasons. Fifty players with isolated ACL tears during their NBA careers who had game performance data before and after injury were identified. Three-point shooting tendency was measured using the 3-point attempt rate (3PAr) statistic for each player-season. A statistical model was created to evaluate player’s tendency to drive the ball to the basket. The driving tendencies of players who underwent ACL reconstruction was compared with that of other players using an independent sample t-test. The rate of ACL tears among those with high driving tendency was compared with that of other players using an independent sample t-test. To investigate whether driving tendency and three-point shooting tendency are associated with RTS outcomes, objective case-control matching was performed. The last full season before each case player’s ACL injury was matched with similar seasons of two control players without history of ACL injury (figure 1). Total career points and playing minutes after RTS were compared between cases and controls using paired z-tests. Changes in driving tendency and three-point shooting tendency before injury vs after injury were compared between cases and controls using paired z-tests. Results: Players with career-average driving tendencies more than 1 standard deviation above the mean were more likely to tear their ACL than other players (0.0521 vs 0.0275, p = 0.0258) (figure 2). This represents a relative risk of 1.896. Players who experienced an ACL tear also had higher average drive tendencies than other players (p = 0.0468). There was not a significant difference between career-average 3-point attempt rate of ACLR players relative to others. There was no significant difference in total post-injury career points or career minutes between cases and controls. There was also no significant change in driving or 3-point shooting tendency after RTS compared to controls. ACL-injured players with higher driving tendency did not fall further below the performance of their controls after they returned. Conclusions: NBA players with increased drive tendency are more likely to tear their ACL. However, players who are able to return after ACL reconstruction do not underperform statistically compared to controls and do not alter their style of play compared to the normal changes seen with age.

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.

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.

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