scholarly journals Return to Play (RTP) and Performance in the Women’s National Basketball Association (WNBA) Following Anterior Cruciate Ligament (ACL) Reconstruction (194)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0030
Author(s):  
Joseph Tramer ◽  
Lafi Khalil ◽  
Alexander Ziedas ◽  
Muhammad Abbas ◽  
Nima Mehran ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Post Injury ◽  
Acl Injuries ◽  
Post Surgery ◽  
Before And After ◽  
Playing Time ◽  
Anterior Cruciate ◽  
And Performance

Objectives: The incidence of ACL injuries in WNBA athletes has been on the rise, despite the high rates of ACL injury there is a paucity of recent research examining the effect of ACL reconstruction on RTP and performance in these athletes. This cohort study seeks to quantify the effect of ACL reconstruction on RTP and performance on WNBA athletes. Methods: All ACL tears sustained in the WNBA from 1997-2018 were identified. BMI, age and position at the time of injury were collected for each player. RTP rates were calculated and performance data was collected for each player before and after injury to determine changes in playing time and statistical performance. Players who successfully RTP after ACL reconstruction were compared to a group of healthy controls who were matched by age, years of experience, position, height, and BMI. Statistics at one year and three years’ post-injury were compared to assess acute and longitudinal changes in performance relative to pre-injury baseline. Results: A total of fifty-nine WNBA players sustained an isolated ACL tear during the study period. Forty-one (69.5%) were able to RTP. There was no difference in demographic characteristics between forty-one players and matched controls. Following RTP athletes played an average of 7.5±12.8 fewer games, 5.1±9.2 fewer minutes per game, and scored 3.7±5.0 less points per game in their first year compared to the year prior to injury. (Table1) When compared to matched controls, WNBA players returning from ACL reconstruction demonstrated a significant decline in games played, games started, minutes per game, rebounds, assists, and blocks per game in their first season after RTP. These differences resolved by year three post-surgery (Table 2). Conclusions: There is a high RTP rate following ACL reconstruction in WNBA athletes. Players may experience a decrease in playing time and performance initially when returning to play, however these variables were found to return to baseline over time.

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 Gait Analysis and Knee Kinematics in Patients with Anterior Cruciate Ligament Rupture: Before and After Reconstruction

2020 ◽  
Vol 10 (10) ◽  
pp. 3378
Author(s):  
Dmitry Skvortsov ◽  
Sergey Kaurkin ◽  
Alexander Akhpashev ◽  
Aljona Altukhova ◽  
Alexander Troitskiy ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Gait Analysis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Surgical Reconstruction ◽  
Control Group ◽  
Cycle Duration ◽  
Post Surgery ◽  
Before And After ◽  
Anterior Cruciate

The objective of the study was to evaluate the clinical, functional, and biomechanical symptoms in patients with anterior cruciate ligament (ACL) rupture before and after ACL reconstruction. The study enrolled 20 patients and 20 healthy subjects as controls. Walking biomechanics was assessed at three time points: before surgery and three months and a year or more after surgical reconstruction. Impact loads on both sides differed significantly from the respective values before surgery (p<0.05). Walking cycle duration decreased with time after surgery. On both sides (affected and unaffected), hip movement amplitudes were significantly smaller than in control (p<0.05). They remained so in the follow-up periods after the reconstruction. Before ACL reconstruction, the amplitude of the main flexion of the knee was significantly reduced both on the affected and unaffected sides. The amplitude gradually increased after the reconstruction, and a year post-surgery, it reached, on the operated side, the same values as in the control group. Complete functional recovery of the knee joint was not achieved within a year after the ACL surgical reconstruction. The remaining changes, however, were not clinically pronounced and could only be detected by instrumental gait analysis. The compensatory processes developed bilaterally, in both the hip and knee joints.

Which Outcome Measures Should Be Used to Determine Readiness to Play After ACL Reconstruction?

2014 ◽  
Vol 23 (2) ◽  
pp. 158-164 ◽  
Author(s):  
Luke M. Mueller ◽  
Ben A. Bloomer ◽  
Chris J. Durall
Keyword(s):  
Acl Reconstruction ◽  
Outcome Measures ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Surgical Reconstruction ◽  
Clinical Scenario ◽  
Clinical Question ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Injured Knee

Clinical Scenario:Anterior cruciate ligament (ACL) injuries are associated with a lengthy recovery time, decreased performance, and an increased rate of reinjury. To improve performance of the injured knee, affected athletes often undergo surgical reconstruction and rehabilitation. Determining when an athlete is ready to safely return to play (RTP), however, can be challenging for clinicians. Although various outcome measures have been recommended, their ability to predict a safe RTP is questionable.Focused Clinical Question:Which outcome measures should be used to determine readiness to return to play after ACL reconstruction?

scholarly journals Return to Play Rates in NFL Wide Receivers and Running Backs After ACL Reconstruction: An Updated Analysis

2021 ◽  
Vol 9 (1) ◽  
pp. 232596712097474
Author(s):  
Aditya Manoharan ◽  
Dane Barton ◽  
Ansab Khwaja ◽  
L. Daniel Latt
Keyword(s):  
Acl Reconstruction ◽  
National Football League ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Control Group ◽  
Factors Affecting ◽  
Significant Difference ◽  
Before And After ◽  
Performance Statistics ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) ruptures are potentially career-threatening injuries to National Football League (NFL) skill position players. A 2006 study showed a return-to-play (RTP) rate of 79% for NFL running backs (RBs) and wide receivers (WRs). Since then, a number of factors affecting RTP, including style of play as well as rules regarding hits to the head, have changed how defensive players tackle offensive ball carriers. Purpose/Hypothesis: To determine whether the RTP rate for RBs and WRs in the NFL has changed since data were collected in the 2000s. Additionally, we evaluated player performance before and after ACL reconstruction (ACLR). We hypothesized that there will be a lower RTP rate than previously reported as well as a decrease in performance statistics after ACLR. Study Design: Descriptive epidemiology study. Methods: Publicly available NFL injury reports between the 2009-2010 and 2015-2016 seasons were utilized for RBs and WRs who underwent ACLR. Successful RTP was indicated by playing in at least 1 NFL game after reconstruction. Position-specific performance statistics from before and after reconstruction were gathered for these players, and the RTP players were compared against the players who did not RTP (dnRTP group). Pre- and postinjury performance measures were also compared against a matched control group of NFL RBs and WRs who had not sustained an ACL injury. Results: Overall, 61.8% of players (64.5% of RBs, 60% of WRs) returned to play at a mean of 13.6 months. Prior to injury, the RTP group had played in significantly more career games and had significantly more rushes and receptions per game than the dnRTP group; however, there was no significant difference in performance after ACLR. The WR RTP group had significantly decreased performance in all measured categories when compared with the control group. Conclusion: Our study found a lower RTP rate in RBs and WRs than previous studies conducted in the early 2000s. WRs who achieved RTP had decreased performance when compared with noninjured controls.

The Cost-Effectiveness of Anterior Cruciate Ligament Reconstruction in Competitive Athletes

2016 ◽  
Vol 45 (1) ◽  
pp. 23-33 ◽  
Author(s):  
Bruce A. Stewart ◽  
Amit M. Momaya ◽  
Marc D. Silverstein ◽  
David Lintner
Keyword(s):  
Cost Effectiveness ◽  
Physical Therapy ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Acl Injuries ◽  
Competitive Athletes ◽  
Anterior Cruciate ◽  
The Cost

Background: Competitive athletes value the ability to return to competitive play after the treatment of anterior cruciate ligament (ACL) injuries. ACL reconstruction has high success rates for return to play, but some studies indicate that patients may do well with nonoperative physical therapy treatment. Purpose: To evaluate the cost-effectiveness of the treatment of acute ACL tears with either initial surgical reconstruction or physical therapy in competitive athletes. Study Design: Economic and decision analysis; Level of evidence, 2. Methods: The incremental cost, incremental effectiveness, and incremental cost-effectiveness ratio (ICER) of ACL reconstruction compared with physical therapy were calculated from a cost-effectiveness analysis of ACL reconstruction compared with physical therapy for the initial management of acute ACL injuries in competitive athletes. The ACL reconstruction strategy and the physical therapy strategy were represented as Markov models. Costs and quality-adjusted life-years (QALYs) were evaluated over a 6-year time horizon and were analyzed from a societal perspective. Quality of life and probabilities of clinical outcomes were obtained from the peer-reviewed literature, and costs were compiled from a large academic hospital in the United States. One-way, 2-way, and probabilistic sensitivity analyses were used to assess the effect of uncertainty in variables on the ICER of ACL reconstruction. Results: The ICER of ACL reconstruction compared with physical therapy was $22,702 per QALY gained. The ICER was most sensitive to the quality of life of returning to play or not returning to play, costs, and duration of follow-up but relatively insensitive to the rates and costs of complications, probabilities of return to play for both operative and nonoperative treatments, and discount rate. Conclusion: ACL reconstruction is a cost-effective strategy for competitive athletes with an ACL injury.

scholarly journals Psychological and Social Components of Recovery Following Anterior Cruciate Ligament Reconstruction in Young Athletes: A Narrative Review

2021 ◽  
Vol 18 (17) ◽  
pp. 9267
Author(s):  
Emil Vutescu ◽  
Sebastian Orman ◽  
Edgar Garcia-Lopez ◽  
Justin Lau ◽  
Andrew Gage ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Narrative Review ◽  
Acl Rupture ◽  
Return To Play ◽  
Young Athletes ◽  
Acl Injuries ◽  
Anterior Cruciate

Anterior cruciate ligament (ACL) rupture is a common injury in young athletes. To restore knee stability and function, patients often undergo ACL reconstruction (ACLR). Historically, there has been a focus in this population on the epidemiology of ACL injury, the technical aspects of ACL reconstruction, and post-operative functional outcomes. Although increasingly recognized as an important aspect in recovery, there remains limited literature examining the psychological aspects of post-operative rehabilitation and return to play following youth ACL reconstruction. Despite technical surgical successes and well-designed rehabilitation programs, many athletes never reach their preinjury athletic performance level and some may never return to their primary sport. This suggests that other factors may influence recovery, and indeed this has been documented in the adult literature. In addition to restoration of functional strength and stability, psychological and social factors play an important role in the recovery and overall outcome of ACL injuries in the pediatric population. Factors such as psychological readiness to return-to-play (RTP), motivation, mood disturbance, locus of control, recovery expectations, fear of reinjury, and self-esteem are correlated to the RTP potential of the young athlete. A better understanding of these concepts may help to maximize young patients’ outcomes after ACL reconstruction. The purpose of this article is to perform a narrative review of the current literature addressing psychosocial factors associated with recovery after ACL injury and subsequent reconstruction in young athletes. Our goal is to provide a resource for clinicians treating youth ACL injuries to help identify patients with maladaptive psychological responses after injury and encourage a multidisciplinary approach when treating young athletes with an ACL rupture.

scholarly journals Effect of Workload After ACL Reconstruction on Rerupture Rates in NBA Players

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096446
Author(s):  
Lafi S. Khalil ◽  
Robert N. Matar ◽  
Tahsin Rahman ◽  
Sreten Franovic ◽  
Muhammad J. Abbas ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Control Group ◽  
Primary Group ◽  
Level Of Evidence ◽  
Performance Statistics ◽  
Anterior Cruciate ◽  
And Performance ◽  
Game Performance

Background: Rupture of the anterior cruciate ligament (ACL) is a common and potentially career-altering injury sustained by players in the National Basketball Association (NBA). Strategies have been employed by the league to prevent reinjury of players after ACL reconstruction (ACLR), including minute restrictions and rest games; however, it remains unknown whether workload metrics after ACLR influence the risk for reinjury and revision surgery. Purpose: To evaluate whether workload changes after return to play (RTP) from primary ACLR influences the risk of rerupture in NBA players. Study Design: Case-control study; Level of evidence, 3. Methods: We identified NBA players from 1975 to 2018 who underwent primary ACLR as well as those who required revision ACLR. Primary outcomes included workload measures such as games played, games started, and minutes per game. Secondary outcomes included in-game performance statistics. Statistical analysis was used to compare relative workload and performance 3 years before and 3 years after undergoing primary ACLR. Workload was also compared between the control group of NBA players who underwent primary ACLR and those who required revision ACLR. Results: A total of 68 players who underwent primary ACLR were included, 8 of whom subsequently required revision ACLR. In their first season upon RTP, control players (primary ACLR) demonstrated a significant reduction in all workload metrics relative to the season before injury ( P < .001), while the revision group demonstrated an unchanged to increased workload. In a comparison between the primary and revision groups during the first season after RTP, the primary group demonstrated significantly fewer games started (mean ± SD, 22.2 ± 3.0 vs 35.8 ± 8.3; P = .039) and minutes per game (20.5 ± 1.1 vs 27.0 ± 3.1; P = .048) than revision players. The primary ACLR group demonstrated reduced cumulative workload trends for the first 3 years after RTP relative to 3 years before injury, which was not demonstrated in the revision ACLR group, albeit statistically insignificant. Conclusion: Our study found that after ACLR, a reduction in workload parameters relative to preinjury baseline was associated with players who did not sustain rerupture. Further study is required to determine if workload measures following RTP from primary ACLR should be individualized relative to preinjury baseline.

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.

scholarly journals Anterolateral ligament of the knee: back to the future in anterior cruciate ligament reconstruction

2015 ◽  
Vol 7 (2) ◽  
Author(s):  
Davide Edoardo Bonasia ◽  
Andrea D'Amelio ◽  
Pietro Pellegrino ◽  
Federica Rosso ◽  
Roberto Rossi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Double Bundle ◽  
Anterolateral Ligament ◽  
Rotational Instability ◽  
Small Subset ◽  
Acl Injuries ◽  
Anterior Cruciate ◽  
Double Bundle Acl Reconstruction

Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament. The goal of this review is to summarize the existing knowledge regarding the anterolateral ligament of the knee, including anatomy, histology, biomechanics and imaging. In addition, the most common anterolateral reconstruction/tenodesis techniques are described together with their respective clinical outcomes.

Low Rates of Return to Preinjury Sport After Bilateral Anterior Cruciate Ligament Reconstruction

2018 ◽  
Vol 47 (2) ◽  
pp. 334-338 ◽  
Author(s):  
Kate E. Webster ◽  
Julian A. Feller ◽  
Alexander J. Kimp ◽  
Timothy S. Whitehead
Keyword(s):  
Quality Of Life ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Rates Of Return ◽  
Acl Injuries ◽  
Reconstruction Surgery ◽  
Anterior Cruciate

Background: Patients with bilateral anterior cruciate ligament (ACL) injuries tend to report worse results in terms of knee function and quality of life as compared with those with unilateral injury. There are limited data regarding return to preinjury sport in this group. Purpose: To report return-to-sport rates for patients who had bilateral ACL reconstruction and to compare outcomes according to age and sex. Study Design: Case series; Level of evidence, 4. Methods: A total of 107 patients (62 male, 45 female) who underwent primary ACL reconstruction surgery to both knees completed a detailed sports activity survey at a mean 5-year follow-up (range, 2.5-10 years). Follow-up also included the International Knee Documentation Committee subjective form, Marx Activity Scale, and Knee injury and Osteoarthritis Outcome Score–Quality of Life subscale. Rates of return to preinjury levels of sport were calculated for the whole cohort, and for further analysis, the group was divided according to age (<25 vs ≥25 years), sex, and time between the reconstruction procedures (<3 vs ≥3 years). Results: The rate of return to preinjury sport after bilateral ACL reconstruction was 40% (95% CI, 31%-50%), as compared with an 83% (95% CI, 74%-88%) return rate after the first reconstruction procedure. Although not statistically significant, return rates were higher for male versus female patients (47% vs 31%) and older versus younger patients (45% vs 31%). Of those who returned to their preinjury levels of sport after the second reconstruction, 72% thought that they could perform as well as before their ACL injuries. In contrast, only 20% thought that they could perform as well if they returned to a lower level. Fear of reinjury was the most common reason cited for failure to return to sport after the second reconstruction. Patient-reported outcome scores were higher for those who returned to their preinjury levels of sport but did not differ for sex and age. Conclusion: Return-to-sport rates drop markedly after a second (contralateral) ACL reconstruction, with less than half of the investigated cohort returning to its preinjury level of sport. Return-to-sport outcomes are less than ideal for patients who have ACL reconstruction surgery to both knees.

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