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      Professional Soccer Players’ Return to Play and Performance After Operative Repair of Achilles Tendon Rupture

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          Abstract

          Background:

          The majority of Achilles tendon ruptures are sports related; however, no investigation has examined the impact of surgical repair for complete ruptures on professional soccer players.

          Purpose:

          To examine the return to play, playing time, and performance of professional soccer players following Achilles tendon repair.

          Study Design:

          Cohort study; Level of evidence, 3.

          Methods:

          Union of European Football Associations (UEFA) and Major League Soccer (MLS) athletes who sustained a primary complete Achilles tendon rupture and were treated surgically between 1988 and 2014 were identified via public injury reports. Demographic information and performance-related statistics for the identified athletes were recorded for the season before surgery and 2 seasons after surgery and were compared with information for matched controls. Statistical analyses were used to assess differences in recorded metrics.

          Results:

          A total of 24 athletes with Achilles ruptures met inclusion criteria, 17 (70.8%) of whom were able to return to play. On average, players had 8.3 years of professional-level experience prior to sustaining an Achilles rupture. Among athletes who returned to play, no differences were found in the number of games played or started, minutes played, or goals scored 1 year postoperatively compared with the year prior to injury. However, 2 years postoperatively, these athletes played 28.3% ( P = .028) fewer minutes compared with their preoperative season, despite starting and playing in an equivalent number of games. Matched controls had baseline playing time and performance statistics similar to those of players. However, controls played and started in significantly more games and played more minutes at 1 and 2 years compared with players ( P < .05). No differences were found in goals scored at any time point.

          Conclusion:

          This is the first investigation examining the effect of an Achilles repair on the career of professional soccer players. This is a difficult injury that most commonly occurs in veteran players and prevents 29.2% of players from returning to play despite surgical management. Additionally, athletes able to return to play were found to play fewer minutes 2 years postoperatively compared with their baseline as well as playing less at 1 and 2 years postoperatively compared with uninjured matched controls. The reduction in playing time following an Achilles repair has significant implications for professional players and teams.

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          Most cited references25

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          Hamstring injuries have increased by 4% annually in men's professional football, since 2001: a 13-year longitudinal analysis of the UEFA Elite Club injury study.

          There are limited data on hamstring injury rates over time in football.
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            • Article: not found

            Prevalence of Ulnar Collateral Ligament Surgery in Professional Baseball Players.

            While the high rate of ulnar collateral ligament (UCL) injuries in professional baseball is widely discussed in the media and medical literature, the actual prevalence of UCL reconstruction has not been documented.
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              Performance outcomes after repair of complete achilles tendon ruptures in national basketball association players.

              A complete rupture of the Achilles tendon is a devastating injury. Variables affecting return to competition and performance changes for National Basketball Association (NBA) players are not readily evident. Players in the NBA who ruptured their Achilles tendons and who underwent surgical repair would have more experience in the league, and the performance of those who were able to return to competition would be decreased when compared with their performance before injury and with their control-matched peers. Cohort study; Level of evidence, 3. Data for 18 basketball players with Achilles tendon repair over a 23-year period (1988-2011) were obtained from injury reports, press releases, and player profiles. Variables included age, body mass index (BMI), player position, and number of years playing in the league. Individual season statistics were obtained, and the NBA player efficiency rating (PER) was calculated for 2 seasons before and after injury. Controls were matched by playing position, number of seasons played, and performance statistics. Univariate and multivariate analyses were performed to assess the effect of each factor. At the time of injury, the average age was 29.7 years, average BMI was 25.6, and average playing experience was 7.6 years. Seven players never returned to play an NBA game, whereas 11 players returned to play 1 season, with 8 of those players returning for ≥2 seasons. Players who returned missed an average of 55.9 games. The PER was reduced by 4.57 (P = .003) in the first season and by 4.38 (P = .010) in the second season. When compared with controls, players demonstrated a significant decline in the PER the first season (P = .038) and second season (P = .081) after their return. The NBA players who returned to play after repair of complete Achilles tendon ruptures showed a significant decrease in playing time and performance. Thirty-nine percent of players never returned to play.
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                Author and article information

                Journal
                Orthop J Sports Med
                Orthop J Sports Med
                OJS
                spojs
                Orthopaedic Journal of Sports Medicine
                SAGE Publications (Sage CA: Los Angeles, CA )
                2325-9671
                28 November 2018
                November 2018
                : 6
                : 11
                : 2325967118810772
                Affiliations
                []Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, New York, New York, USA.
                [2-2325967118810772] Investigation performed at Columbia University Medical Center, New York, New York, USA
                Author notes
                [*] [* ]David P. Trofa, MD, Department of Orthopaedics, New York Presbyterian, Columbia University Medical Center, 622 West 168th St, PH 11-1130, New York, NY 10032, USA (email: davidtrofa@ 123456gmail.com ).
                Article
                10.1177_2325967118810772
                10.1177/2325967118810772
                6280612
                30534574
                7bcc0842-751b-46f4-8aa5-066e1d51829b
                © The Author(s) 2018

                This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License ( http://www.creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access pages ( https://us.sagepub.com/en-us/nam/open-access-at-sage).

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                soccer,achilles tendon,achilles repair,return to play,union of european football associations,major league soccer

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