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. 2020 Nov 30;8(11):2325967120966041.
doi: 10.1177/2325967120966041. eCollection 2020 Nov.

Effect of Achilles Tendon Rupture on Player Performance and Longevity in National Basketball Association Players

Lafi S Khalil  1 , Toufic R Jildeh  1 , Joseph S Tramer  1 , Muhammad J Abbas  2 , Luke Hessburg  2 , Nima Mehran  3 , Kelechi R Okoroha  1
Affiliations

Effect of Achilles Tendon Rupture on Player Performance and Longevity in National Basketball Association Players

Lafi S Khalil et al. Orthop J Sports Med. .

Abstract

Background: National Basketball Association (NBA) players who return to sport (RTS) after Achilles tendon rupture have been reported to have poor outcomes.

Purpose: To evaluate the effect of Achilles tendon ruptures on player performance and career longevity in NBA athletes.

Study design: Cohort study; Level of evidence, 3.

Methods: NBA players who sustained Achilles tendon ruptures between 1970 and 2019 were identified using publicly available resources and were matched 1:1 to a healthy control group by age, position, height, and body mass index. Demographic characteristics, player utilization (games and minutes), and performance efficiency rating (PER) were documented for all athletes. The season of Achilles tendon rupture was set as the index year, and statistical analysis compared postindex versus preindex data both acutely and in the long term. Percentages relative to preoperative values were calculated to compare the injured and control groups in a standardized fashion.

Results: Of 47 players, 34 (72.3%) with Achilles tendon ruptures returned to play at the NBA level after surgical intervention. A total of 7 players were excluded from the study. No differences were found in demographic characteristics or PER (2 years before injury) between the remaining 27 players and matched controls. The injured players had significantly shorter careers compared with control players (3.1 ± 2.3 vs 5.8 ± 3.5 seasons, respectively; P < .05). Injured players demonstrated significant declines in games per season (GPS), minutes per game (MPG), and PER at 1 year and 3 years after RTS compared with preindex baseline (P < .05). Injured players, compared with control players, had reduced relative percentages of games started (GS) (50% vs 125%, respectively), MPG (83% vs 103%), and PER (80% vs 96%) at 1 year after return (P < .05), but reductions at extended 3-year follow-up were seen only in GPS (71% vs 91%) and GS (39% vs 99%) (P < .05).

Conclusion: Our study found that 72.3% of NBA players returned to play after Achilles tendon repair, but they had shorter careers compared with uninjured controls. Players returning from Achilles tendon repairs had decreased game utilization and performance at all time points relative to their individual preindex baseline. However, for the injured players when compared with controls, game utilization but not performance was found to be decreased at 3-year follow-up.

Keywords: Achilles tendon; Achilles tendon rupture; Basketball; NBA; general sports trauma; performance.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: T.R.J. has received educational support from DePuy Synthes and hospitality payments from Zimmer Biomet. N.M. has received educational support from Arthrex and Smith & Nephew and grant support from Arthrex and Linvatec. K.R.O. has received educational support from Arthrex and Smith & Nephew and hospitality payments from Medical Device Business Services, Stryker, Wright Medical, and Zimmer Biomet. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
Relative percentage of utilization and performance (A) 1 season and (B) 3 seasons after return to sport from Achilles tendon repair. The preindex baseline is represented by the dotted horizontal line (100%) across all variables. Relative percentages below this line indicate that the postindex variable was less than baseline. *P < .05: significant differences between Achilles tendon repair and control groups. GPS, games per season; GS, games started; MPG, minutes per game; PER, player efficiency rating.
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