Patellar tendon repair in NFL athletes yielded worse return-to-play rates

“This study confirms what we had previously suspected in orthopedics, which is that even though the mechanism [of these injuries] seems less severe and they are less gruesome injuries, [these injuries] can actually lead to the most effect on an athlete’s career,” Harry T. Mai, MD, resident physician at Harbor-UCLA Medical Center, told Orthopedics Today.

Orthopedic injuries

Harry T. Mai
Harry T. Mai

Using team injury reports or other public records, Mai and his colleagues identified 559 National Football League (NFL) athletes who underwent procedures for ACL tears, Achilles tendon tears, patellar tendon tears, cervical disc herniation, lumbar disc herniation, sports hernia, knee articular cartilage repair, forearm fractures, tibial shaft fractures and ankle fractures. The Sports Orthopedic Outcomes Research Tool (SPORT) team at Northwestern University collected game and performance statistics during the regular season before and after surgery.

After an orthopedic procedure, results showed 79.4% of athletes returned to play. Procedures with significantly higher return-to-play rates included forearm open reduction and internal fixation (ORIF), sports hernia repair and tibia intramedullary (IM) nailing, while significantly lower rates of return to play was found with patellar tendon repair, ACL reconstruction and Achilles tendon repair.

According to Mai, although it is commonly believed that athletes who sustain an ACL tear can return to play and perform well, the results of this study showed significant declines in games played and performance at 1 year and 2 years to 3 years after surgery. This was also demonstrated in the patellar tendon repair. Similarly, researchers noted decreased performance in postoperative season one among athletes undergoing for ACL reconstruction, Achilles tendon repair and tibia IM nailing, although athletes were able to return to preoperative baseline levels of performance at 2 seasons to 3 seasons after surgery.

“You have a 70% return-to-play rate, sustained decreases in your performance 3 years after surgery, so this is the objective data that shows, despite what we all like to believe, that our favorite player is going to come back after ACL reconstruction and [perform] well. The majority of them do not do that,” Mai said.

Future injury prevention

Mai noted the objective data presented in this study could be used to help treat injuries in athletes in the future by creating models that could “potentially predict who is at risk for injury and who would need these types of surgeries.”

“As our database continues to grow, we can also use this data to provide consultation to any athletes or any person who has one of the injuries, set their expectation after surgery and provide objective, evidence-based, informed consent for these surgeries and show patients before surgery that these are the outcomes and this is the best possible scenario,” Mai said. – by Casey Tingle

Disclosure: Mai reports no relevant financial disclosures.

Autor / Fonte:Orthopedics Today, November 2016