SLR - January 2018 - Lenny Nguyen
Reference: David P. Trofa, J. Chance Miller, Eugene S. Jang, Denzel R. Woode, Justin K. Greisberg, and J. Turner Vosseller. Professional Athletes’ Return to Play and Performance After Operative Repair of an Achilles Tendon Rupture. Am J Sports Med. 2017 Oct; 45(12): 2864–2871.Scientific Literature Review
Reviewed By: Lenny Nguyen, DPM
Residency Program: NYU Langone Hospital Systems, Brooklyn, NY
Podiatric Relevance: An Achilles tendon rupture is a devastating injury that can significantly affect the return to activity of patients. While there is much debate on the best treatment for Achilles ruptures, athletes are often treated with surgical repair to ensure the quickest return to play. The purpose of this study was to compare functional outcomes before and after operative repair of an Achilles tendon rupture in professional athletes.
Methods: Data was collected on athletes from the National Basketball Association (NBA), National Football League (NFL), Major League Baseball (MLB) and National Hockey League (NHL) who had a surgical repair of the Achilles tendon after a complete rupture between 1989 and 2013. Inclusion criteria included athletes who participated in at least one game for two consecutive seasons before injury, no other confounding injuries and at least two years of professional play. Performance-related statistics and demographics were recorded for two seasons before and after surgery and matched with controls selected for all athletes.
Results: Eighty-six athletes were identified as sustaining an Achilles tendon rupture, while 62 of them met the inclusion criteria. Playtime was significantly reduced by an average of 72.1 percent at one year postoperatively and 67.1 percent at two years postoperatively for all athletes. Performance statistics were reduced as well at one and two years postoperatively to 74.8 percent and 77.7 percent, respectively, compared to their preinjury status. Compared to their matched controls, the injured athletes had reduced playtime, played fewer games and performed at a lower level at one year postoperatively. Two years after the operation, no significant difference was found between the control and injured athletes.
Conclusions: After two years of operative repair of an Achilles tendon rupture, 30.6 percent of the athletes were unable to return to play. This study indicated athletes who undergo a operative repair of a ruptured Achilles tendon and are able to make it through their first season after injury may be able to play as much and perform on par as uninjured controls. This study can help podiatric physicians guide and manage expectations of their injured athletic patients.