Return to play, performance, and value of National Basketball Association players following Achilles tendon rupture.

Background: Achilles tendon ruptures are devastating injuries for National Basketball Association (NBA) players: prior studies have demonstrated decreased performance following return-to-play, but none have evaluated the effect of injury on rate-adjusted contextual statistics to assess the true change in performance. Additionally, there exists a paucity of data on the independent impact on defensive performance following return.Hypothesis: Compared to both control-matched peers and preoperative careers, we hypothesize that player production based on rate-adjusted contextual statistics will significantly decline following Achilles tendon rupture.Study design: Retrospective Cohort StudyMethods: Publicly available NBA injury data on Achilles tendon rupture were reviewed from the 1996 -1997 to the 2016-2017 seasons. Controls were matched based on height, position, age, and rate-adjusted statistics. Extracted data included Value over Replacement Player Rating, Box Plus-Minus, Win Shares, offensive rating, defensive rating, and time to return-to-play, and was collected for the season before and two seasons following injury.Results: Twenty-five NBA players with surgically treated complete Achilles ruptures met inclusion and exclusion criteria. The return-to-play rate from Achilles tendon ruptures from 1996-1997 to 2016-2017 was 80%, with a mean recovery period of 311.0 ± 100.9 days. After 2 years, performance significantly declined for Value over Replacement Player Rating, Box Plus-Minus, and offensive rating compared to controls and cases. However, there was no significant effect on defensive rating (P = 0.38). After two seasons, returning players had a Value over Replacement Player Rating that was 24.1% below pre-injury levels, contributed 1.4 fewer points per 100 possessions by Box Plus-Minus, and yielded 2.4 fewer wins by Win Shares.Conclusions: Achilles tendon rupture results in significant decreases in offensive production and career longevity. The injury does not have a significant impact on defensive production.Clinical relevance: Achilles tendon ruptures significantly affect basketball players ability to return-to-play, and their in-game performance.Level of evidence: 3.

Return to Play After Multiligament Knee Injuries in National Football League Athletes.

BACKGROUND:: Return to play (RTP) of National Football League (NFL) athletes after isolated anterior cruciate ligament (ACL) tears has been reported. However, no studies have reported on RTP of NFL athletes after multiligament knee injuries. HYPOTHESES:: NFL athletes with multiligament knee injuries have lower RTP rates and longer recoveries than athletes with isolated ACL tears. Second, athletes with ACL and medial collateral ligament (MCL) injuries will have higher RTP rates and shorter time to RTP than athletes with an ACL tear and posterolateral corner involvement. STUDY DESIGN:: Retrospective cohort study. LEVEL OF EVIDENCE:: Level 4. METHODS:: Publicly available NFL injury data were reviewed for all multiligament knee injuries incurred between 2000 and 2016 with RTP information. Athletes were excluded if RTP was limited for reasons unrelated to the injury. Extracted data included type of injury, RTP, time to RTP (days), number and percentage of games played, and performance. RESULTS:: A total of 50 NFL athletes with multiligament knee injuries met inclusion and exclusion criteria. The overall RTP rate was 64.0%. Athletes with ACL/MCL tears had an RTP rate of 70.8%, whereas athletes with ACL and posterior collateral ligament/lateral collateral ligament (PCL/LCL) tears had an RTP rate of 55.6% ( P = 0.26). Mean time to RTP for all 50 athletes was 388.71 ± 198.52 days. The mean time to RTP for athletes with ACL/MCL injuries was 305.1 ± 58.9 days, compared with 459.2 ± 245.1 days ( P = 0.004) and 609.3 ± 183.1 days ( P < 0.0001) for those with combined ACL and PCL/LCL injuries and frank knee dislocations, respectively. Athletes with ACL/MCL injuries were more likely to return to prior performance level (43.5%) than those with ACL and PCL/LCL injuries (18.5%) ( P < 0.001). CONCLUSION:: The RTP rate for athletes with multiligament knee injuries is significantly less than the RTP rate for athletes with isolated ACL tears. In addition, athletes with ACL and MCL tears have a higher RTP rate, a significantly shorter time to RTP, and a greater likelihood of returning to prior performance than athletes with ACL and PCL/LCL tears. CLINICAL RELEVANCE:: Multiligament knee injuries significantly affect the ability of a football player to return to sport. ACL and MCL tears are associated with better RTP prognosis compared with ACL and PCL/LCL tears.

Epidemiology and Impact on Performance of Lower Extremity Stress Injuries in Professional Basketball Players.

BACKGROUND: Professional basketball players in the National Basketball Association (NBA) subject their lower extremities to significant repetitive loading during both regular-season and off-season training. Little is known about the incidence of lower extremity bony stress injuries and their impact on return to play and performance in these athletes. HYPOTHESIS: Stress injuries of the lower extremity will have significant impact on performance. STUDY DESIGN: Case series. LEVEL OF EVIDENCE: Level 4. METHODS: All bony stress injuries from 2005 to 2015 were identified from the NBA. Number of games missed due to injury and performance statistics were collected from 2 years prior to injury to 2 years after the injury. A linear regression analysis was performed to determine the impact of injury for players who returned to sport. RESULTS: A total of 76 lower extremity bony stress injuries involving 75 NBA players (mean age, 25.4 ± 4.1 years) were identified. Fifty-five percent (42/76) involved the foot, and most injuries occurred during the regular season (82.9%, 63/76), with half occurring within the first 6 weeks. Among players who sustained a fifth metatarsal stress fracture, 42.9% were unable to return to professional play. Players who sustained stress injuries had reduced play performance, specifically related to number of games played ( P = 0.014) and number of steals per game ( P = 0.004). Players who had surgery had significantly better performance at 2 years than those who were managed nonoperatively, independent of the type of injury (ß = 4.561; 95% CI, 1.255-7.868). CONCLUSION: Lower extremity bony stress injuries may significantly affect both short- and long-term player performance and career length. Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics compared with those treated using conservative methods. CLINICAL RELEVANCE: Stress injuries result in decreased player performance, and surgical intervention results in improved performance metrics.

Performance following a first professional concussion among National Basketball Association players.

OBJECTIVES: Basketball is a physical game played on a hardwood floor among high-jumping athletes at risk for injury. It is currently unknown how sport-related concussion (SRC) affects player performance after injury among professional basketball players. The objective of this study was to explore the impact of SRC on basketball performance among National Basketball Association (NBA) players. METHODS: A retrospective, archival cohort study was performed that compared NBA player performance following concussion to pre-concussive performance. A comprehensive NBA injury database, compiled from publically available sources, was queried for NBA players who suffered concussion from 2005-06 to 2014-15 (10 seasons). Intra-and inter-player analyses were performed against a matched control group of players who missed playing time for personal reasons. RESULTS: Following application of inclusion/exclusion criteria and a matching process, 51 concussed players and 51 control players were included in analysis. There were no statistically significant decrements in baseline to post-concussion performance metrics in intra-player or player vs. controls after 5 return games. CONCLUSIONS: Our findings suggest that at the NBA level, an athlete's performance in the initial 5 games following injury does not suffer from the after-effects of concussive injury. These results may be useful in counseling professional athletes following a concussion.