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Gaudiani MA, Castle JP, Easton MK, Sprys-Tellner TJ, Wolterink TD, Haan JW, George GF, Wager SG, Lynch TS, Berger RJ. Return to Play, Performance, and Earnings Analysis After Lumbar Disc Herniation in National Hockey League Players. Global Spine J 2024:21925682241232338. [PMID: 38330937 DOI: 10.1177/21925682241232338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2024] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE Professional hockey players have a high incidence of lumbar disc herniations (LDH). The purpose of this study was to determine the impact of LDH on the performance and financial earnings of National Hockey League (NHL) players. METHODS NHL players who sustained a LDH were retrospectively reviewed utilizing an online database and a 2:1 matched control cohort. Player performance and game usage was compared at one- and three-season(s) pre- and post-injury season within the cohorts. Injured and matched players were divided into 3 groups based on the player's adjusted index season salary. RESULTS A total of 181 players were included, with 62 LDH players matched to 119 healthy controls. Return to play after LDH was 79%. The LDH cohort had fewer seasons played throughout their career compared to the matched group (12.5 ± 4.3 vs 14.2 ± 3.8; P = .031). At 1 season post-index, the LDH cohort had significantly fewer goals per 60 and points per 60 when compared to pre-index. At 3 seasons post-index, the LDH cohort exhibited a significant decline in time-on-ice per game played, goals per 60, and points per 60 compared to pre-index. CONCLUSION The majority of NHL players who sustained a LDH returned to play (79%) but had shorter careers overall and decreased performance outcomes when compared to matched cohorts at both 1 and 3 seasons post-injury.
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Affiliation(s)
| | - Joshua P Castle
- Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA
| | - Matthew K Easton
- Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA
| | | | | | - Jager W Haan
- Michigan State University College of Human Medicine, East Lansing, MI, USA
| | - Gary F George
- Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA
| | - Susan G Wager
- Wayne State University School of Medicine, Detroit, MI, USA
| | - T Sean Lynch
- Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA
| | - Ryan J Berger
- Department of Orthopaedic Surgery, Henry Ford Health, Detroit, MI, USA
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Reiter CR, Nelson CT, Satalich JR, O'Neill CN, Cyrus JW, O'Connell RS, Vap AR. Return to sport and active military duty after cervical disc arthroplasty: A systematic review. J Orthop 2023; 39:75-82. [PMID: 37113977 PMCID: PMC10126923 DOI: 10.1016/j.jor.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/03/2023] [Accepted: 04/11/2023] [Indexed: 04/29/2023] Open
Abstract
Introduction Cervical disc arthroplasty (CDA) has been established as an effective treatment for cervical disc degeneration or herniation in the general population. Return to sport (RTS) outcomes in athletes remain unclear. Objective The purpose of this review was to evaluate RTS following single-level, multi-level, or hybrid CDA, with additional return to activity context provided by return to duty (RTD) outcomes in active-duty military. Methods Medline, Embase, and Cochrane were searched through August 2022 for studies that reported RTS/RTD after CDA in athletic or active-duty populations. Data was extracted on the following topics: surgical failures/reoperations, surgical complications, RTS/RTD, and postoperative time to RTS/RTD. Results Thirteen papers covering 56 athletes and 323 active-duty members were included. Athletes were 59% male with a mean age of 39.8 years and active-duty members were 84% male with a mean age of 40.9 years. Only 1 of 151 cases required reoperation and only 6 instances of surgical complications were reported. Classified as return to general sporting activity, RTS was observed in 100% of patients (n = 51/51) after an average of 10.1 weeks to training and 30.5 weeks to competition. RTD was observed in 88% of patients (n = 268/304) after an average of 11.1 weeks. Average follow-up was 53.1 months for athletes and 13.4 months for the active-duty population. Conclusion CDA displays excellent RTS and RTD rates in physically demanding populations at rates superior or equivalent to alternative treatments. Surgeons should consider these findings when determining the optimal cervical disc treatment approach in active patients.
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Affiliation(s)
- Charles R. Reiter
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Chase T. Nelson
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - James R. Satalich
- Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Conor N. O'Neill
- Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - John W. Cyrus
- Health Sciences Library, Virginia Commonwealth University, Richmond, VA, USA
| | - Robert S. O'Connell
- Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
| | - Alexander R. Vap
- Department of Orthopaedic Surgery, Virginia Commonwealth University Health System, Richmond, VA, USA
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O'Connor SB, Holmberg KJ, Hammarstedt JE, Acosta JR, Monahan K, Sauber RD, Altman DT. Return-to-Play Outcomes of Athletes After Operative and Nonoperative Treatment of Lumbar Disc Herniation. Curr Rev Musculoskelet Med 2023; 16:192-200. [PMID: 36997833 DOI: 10.1007/s12178-023-09829-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 04/01/2023]
Abstract
PURPOSE OF REVIEW Lumbar disc herniation (LDH) is a common injury experienced by athletes and has important clinical considerations for athletes including the timing of return to sport. Lumbar disc herniation may result in loss of individual training and playing time for athletes. Current literature is inconclusive on whether surgical or conservative treatment of LDH is superior in athletes. Our aim was to review the literature to identify return-to-play (RTP) rates and performance outcomes following operative and nonoperative treatment of LDH in the athletic population. RECENT FINDINGS Athletes have unique measurements of successful treatment for LDH such as time to return to their sport and performance outcomes that are not as applicable as traditional metrics. It is suggested that surgical treatment may provide a quicker return to sport than nonoperative care in athletes. Additionally, conflicting findings have been seen in career length and performance status based on sport, often due to short and tumultuous career patterns. These differences may be seen based on the unique physical demands of each sport, different motivations to prolong sport, or other confounding factors that could not be controlled for or unrelated to LDH. Recent literature on RTP outcomes in athletes treated for LDH show variable results based on sport. Further research is needed to assist physicians and athletes in making the decision to undergo conservative or surgical treatment of LDH in the athletic population.
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Affiliation(s)
| | - Kyle J Holmberg
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Jon E Hammarstedt
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Jonathan R Acosta
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Kevin Monahan
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Ryan D Sauber
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
| | - Daniel T Altman
- Department of Orthopaedic Surgery, Allegheny General Hospital, Pittsburgh, PA, USA
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Collins AP, Ali S, Zaruta D, Perry N, Riemenschneider J, Service BC. Validity of Video-Based Analysis for Analyzing Shoulder Injuries in the National Basketball Association. Orthop J Sports Med 2023; 11:23259671231157768. [PMID: 36896095 PMCID: PMC9989390 DOI: 10.1177/23259671231157768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/09/2022] [Indexed: 03/11/2023] Open
Abstract
Background Shoulder injuries are very common in athletes playing in the National Basketball Association (NBA). With increasing injury video uploads available online, we may be able to identify and systematically describe the mechanism of these injuries in these athletes. Purpose To (1) determine the validity of video-based analysis to evaluate mechanisms of shoulder injuries in NBA players during the 2010-2020 seasons and (2) report on commonly sustained injuries, circumstances associated with injury, and number of games missed owing to injury. Study Design Cross-sectional study; Level of evidence, 3. Methods An injury report data set was queried for shoulder injuries among NBA players between the 2010-2011 season and the 2019-2020 season, and results were cross-referenced using YouTube.com to identify high-quality videos of the injuries. Out of 532 shoulder injuries in this time frame, video evidence from 39 (7.3%) were evaluated for mechanism of injury and other corresponding situational data. From the remaining shoulder injuries, a randomly selected control cohort of 50 injuries occurring in the same interval was assessed for descriptive injury data, incidence of recurrence, necessity for surgery, and number of games missed, to compare with corresponding data from injuries in the videographic evidence cohort. Results In the videographic evidence cohort, the most common mechanism of injury was lateral contact to the shoulder (41%; P < .001), which was associated with an injury to the acromioclavicular joint (30.8%; P < .001). Injuries occurred more often when the team was on offense (58.9%; P < .001) versus defense. Players who required surgery missed 33 more games on average than players who did not require surgery (P < .001). For the injured players, a 33% incidence of reinjury was identified in the 12 months after their initial injury. As compared with the control cohort, no significant differences were noted in injury laterality, recurrence rates, necessity for surgical management, time in the season, or number of games missed. Conclusion Despite its low yield of 7.3%, video-based analysis may be a useful tool to determine the mechanism of shoulder injuries in the NBA, given the similarities of injury characteristics as compared with the control group.
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Affiliation(s)
- Andrew P Collins
- College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Sabah Ali
- College of Medicine, University of Central Florida, Orlando, Florida, USA
| | - Douglas Zaruta
- Orlando Health Jewett Orthopedic Institute, Orlando, Florida, USA
| | - Nichole Perry
- Orlando Health Jewett Orthopedic Institute, Orlando, Florida, USA
| | | | - Benjamin C Service
- College of Medicine, University of Central Florida, Orlando, Florida, USA.,Orlando Health Jewett Orthopedic Institute, Orlando, Florida, USA.,College of Medicine, Florida State University, Tallahassee, Florida, USA
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Abstract
PURPOSE OF REVIEW Treatment of overhead athletes requires a systematic approach that will make an accurate diagnosis, deliver effective treatment, and make timely and safe return to sport. RECENT FINDINGS New data has shown success rates and return to play effectiveness after different types of cervical and lumbar surgery. Cervical foraminotomy has been shown to have the highest rate and fastest return to play, but with the highest incidence of need for revision surgery. Cervical artificial disc replacement has shown promising results in the general population and is being done more commonly in elite athletes, but has an unknown risk for failure. Cervical fusion is a well-established and effective treatment, but has the longest healing time and risk for adjacent level pathology. In the lumbar spine, discectomy has a long and proven track record, fusion is rarely performed but can be effective, and artificial disc replacement is extremely rare in an elite athlete. An effective and comprehensive approach can diagnose, treat, and return overhead athletes to competitive play.
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Lian J, Sewani F, Dayan I, Voleti PB, Gonzalez D, Levy IM, Musahl V, Allen A. Systematic Review of Injuries in the Men's and Women's National Basketball Association. Am J Sports Med 2022; 50:1416-1429. [PMID: 34213367 DOI: 10.1177/03635465211014506] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Numerous studies have reported the incidence and outcomes of injuries in the men's and women's National Basketball Association (NBA and WNBA, respectively). PURPOSE To synthesize published data regarding the incidence and outcomes of all injuries in the NBA and WNBA in a comprehensive review. STUDY DESIGN Systematic review; Level of evidence, 4. METHODS Following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we searched 3 electronic databases (PubMed, MEDLINE, Embase) for studies of all levels of evidence since 1990 pertaining to injuries sustained by active players in the NBA and WNBA. Studies were excluded if the cohort of interest included ≤3 active players. RESULTS The initial search of the 3 databases yielded 1253 unique studies, of which 49 met final inclusion criteria for this review. Only 4 studies included athletes in the WNBA. Based on the mean annual incidence, the 5 most common orthopaedic sports injuries sustained in the NBA were concussions (9.5-14.9 per year), fractures of the hand (3.5-5.5 per year), lower extremity stress fractures (4.8 per year), meniscal tears (2.3-3.3 per year), and anterior cruciate ligament tears (1.5-2.6 per year). Cartilage defects treated using microfracture, Achilles tendon ruptures, and anterior cruciate ligament injuries were 3 injuries that led to significant reductions in performance measurements after injury. CONCLUSION With advances in sports technology and statistical analysis, there is rapidly growing interest in injuries among professional basketball athletes. High-quality prospective studies are needed to understand the prevalence and effect of injuries on player performance and career length. This information can inform preventative and treatment measures taken by health care providers to protect players and guide safe return to play at a high level.
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Affiliation(s)
- Jayson Lian
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Faraz Sewani
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Isaac Dayan
- Albert Einstein College of Medicine, Bronx, New York, USA
| | - Pramod B Voleti
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - David Gonzalez
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - I Martin Levy
- Department of Orthopaedic Surgery, Montefiore Medical Center, Bronx, New York, USA
| | - Volker Musahl
- Department of Orthopaedic Surgery, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Answorth Allen
- Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, New York, USA
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Makhni MC, Curriero FC, Yeung CM, Leung E, Kvit A, Mroz T, Ahmad CS, Lehman RA. Epidemiology of Spine-Related Neurologic Injuries in Professional Baseball Players. Spine (Phila Pa 1976) 2022; 47:E265-E271. [PMID: 34265806 DOI: 10.1097/brs.0000000000004166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A retrospective case series study. OBJECTIVE To analyze the epidemiology of diagnoses of degenerative cervical and lumbar spinal conditions among Major League Baseball (MLB) and Minor League Baseball (MiLB) players. SUMMARY OF BACKGROUND DATA Repetitive high-energy forces in professional baseball players may predispose them to degenerative cervical and lumbar spinal conditions. There is a lack of data concerning the epidemiology of these injuries in professional baseball. METHODS Deidentified data on spine injuries were collected from all MLB and MiLB teams from 2011 to 2016 from the MLB-commissioned Health and Injury Tracking System database. Rates of diagnoses of common degenerative spinal conditions as well as their impact on days missed due to injury, necessitation of surgery, and player participation and career-ending status were assessed. Injury rates were reported as injuries per 1000 athlete-exposures in concordance with prior studies. RESULTS Over 2011 to 2016, 4246 days of play were missed due to 172 spine-related injuries. 73.3% were related to the lumbar spine and 26.7% to the cervical spine. There were similar rates of surgery required for these injuries (18.3% of lumbar injuries vs. 13.0% of cervical injuries, P = 0.2164). Mean age of players with cervical injuries was higher compared with the lumbar group (27.5 vs. 25.4, P = 0.0119). Average number of days missed due to lumbar injuries was significantly higher than those due to cervical injuries (34.1 vs. 21.6 d, P = 0.0468). Spine injury rates for pitchers were significantly higher than those of other position players (0.086 per 1000 athlete-exposures vs. 0.037, P < 0.0001). CONCLUSION Neurologic diagnoses relating to the cervical and lumbar spine lead to substantial disability among MLB and MiLB players as well as days missed from play. Pitchers have over double the rates of injury compared with other position players. Lumbar conditions were associated with significantly higher numbers of days missed from play.Level of Evidence: 4.
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Affiliation(s)
- Melvin C Makhni
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Frank C Curriero
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Caleb M Yeung
- Department of Orthopaedic Surgery, Brigham and Women's Hospital, Boston, MA
| | - Eric Leung
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY
| | - Anton Kvit
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Tom Mroz
- Department of Orthopedic Surgery, Cleveland Clinic, Cleveland, OH
| | - Christopher S Ahmad
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY
| | - Ronald A Lehman
- Department of Orthopedic Surgery, Columbia University Medical Center, New York, NY
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Kajy M, Higginbotham DO, Ball G, Vaidya R. "Fantasy Points" associated with Professional Athlete Performance after Lumbar Discectomy or Microdiscectomy. Spartan Med Res J 2022; 7:30766. [PMID: 35291710 PMCID: PMC8873437 DOI: 10.51894/001c.30766] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 12/13/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The treatment of Lumbar Disc Herniation (LDH) in elite athletes is a debated topic that lacks consensus in the literature due to varying outcome reporting methods. The objective of this study was to quantify the overall performance of a sample of professional athletes before and after receiving a lumbar discectomy or microdiscectomy in a cohort of players in the National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL) and Major League Baseball (MLB). METHODS The authors identified publicly accessible data from a cohort of different types of professional players who received either a lumbar discectomy or a microdiscectomy. These records were identified through newspaper archives, injury reports, player profiles and press releases between 1993 through 2015. Fantasy and Wins Above Replacement (WAR) scores were calculated for each player. RESULTS A total of 38 professional players met study inclusion criteria. NFL players had the lowest return-to-play (RTP) at nine of 14 (64%). The RTP for NBA, NHL and MLB players were comparable with 6/7 (86%) vs 8/9 (89%) vs 7/8 (88%). NFL players had the lowest average career length after surgery at 34.8 months, while NBA players had the longest average career length at 48 months. MLB players on average required the longest time to return to presurgical level of performance (24 months) and required the longest average recovery time at 12 months. CONCLUSIONS Based on these results, the average performance of most elite athletes are likely to decrease after undergoing a lumbar discectomy. Although it appears that performance peaks in the initial years after the operation for some players, there was an overall long-term decline in this sample of elite athletes. Study limitations included small sample size, lack of controlling for possible confounding variables (e.g., age, etc.) and use of variable reporting sources. Additional studies with larger sample sizes and age-matched controls are needed to examine the effects of lumbar discectomy more comprehensively in elite athletes.
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Affiliation(s)
| | | | - Guy Ball
- Orthopaedic Surgery, McLaren Oakland
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Abstract
Although the safety of contact sports has improved over the years, participation in any sport always carries a risk of injury. When cervical or lumbar spine injuries do occur, prompt diagnosis is essential, and athletes must be held out of the sport if indicated to prevent further harm and allow for recovery. This article highlights some of the most common cervical spine pathologies (stinger/burners, strain, stenosis/cord neuropraxia, disc herniation, and fracture/instability) and lumbar spine pathologies (strain, disc degeneration, disc herniation, fracture, spondylolysis/spondylolisthesis, and scoliosis) encountered in sports and reviews the associated return to play guidelines and expectations for each condition.
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Sedrak P, Shahbaz M, Gohal C, Madden K, Aleem I, Khan M. Return to Play After Symptomatic Lumbar Disc Herniation in Elite Athletes: A Systematic Review and Meta-analysis of Operative Versus Nonoperative Treatment. Sports Health 2021; 13:446-453. [PMID: 33563131 PMCID: PMC8404721 DOI: 10.1177/1941738121991782] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Context: The prevalence of symptomatic lumbar disc herniation (LDH) in athletes can be as high as 75%. For elite athletes diagnosed with LDH, return to play (RTP) is a major concern, and thus comparing surgical with nonoperative care is essential to guide practitioners and athletes, not just in terms of recovery rates but also speed of recovery. Objective: The purpose of this systematic review is to provide an update on RTP outcomes for elite athletes after lumbar discectomy versus nonoperative treatment of LDHs. Data Sources: A search of the literature was conducted using 3 online databases (MEDLINE, EMBASE, and PubMed) to identify pertinent studies. Study Selection: Yielded studies were screened according to the inclusion criteria. Study Design: Systematic review with meta-analysis. Level of Evidence: Level 4. Data Extraction: Relevant data were extracted. A meta-analysis was performed comparing RTP rate for all comparative studies. Results: Twenty studies met the inclusion criteria and were included in this review. Overall, 663 out of 799 patients (83.0%) returned to play in the surgical group and 251 out of 308 patients (81.5%) returned to play in the nonoperative group. No statistically significant difference for RTP rate was found (odds ratio, 1.39; 95% CI, 0.58-3.34; P = 0.46; I2, 71%). The mean time to RTP for patients undergoing lumbar discectomy was 5.19 months (range 1.00-8.70 months), and 4.11 months (range 3.60-5.70 months) for those treated conservatively. Conclusion: There was no significant difference in RTP rate between athletes treated with operative or nonoperative management of LDHs, nor did operative management have a faster time to RTP. Athletes should consider the lack of difference in RTP rate in addition to the potential risks associated with spinal surgery when choosing a treatment option. Future randomized controlled trials are needed on this topic to allow for high-powered conclusions.
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Affiliation(s)
- Phelopater Sedrak
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mustafa Shahbaz
- Faculty of Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Chetan Gohal
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Kim Madden
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Ilyas Aleem
- Division of Spine Surgery, Department of Orthopaedic Surgery and Neurosurgery, University of Michigan, Ann Arbor, Michigan
| | - Moin Khan
- Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, Ontario, Canada
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Allahabadi S, Su F, Lansdown DA. Systematic Review of Orthopaedic and Sports Medicine Injuries and Treatment Outcomes in Women's National Basketball Association and National Basketball Association Players. Orthop J Sports Med 2021; 9:2325967120982076. [PMID: 33623799 PMCID: PMC7878958 DOI: 10.1177/2325967120982076] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 08/31/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Athletes in the Women’s National Basketball Association (WNBA) and National Basketball Association (NBA) are subject to high injury rates given the physical demands of the sport. Comprehensive data regarding injury patterns and rates in these athletes are limited. Purpose: To summarize available data on orthopaedic and sports medicine–related injuries through 2020 in professional female and male basketball players. Study Design: Systematic review; Level of evidence, 4. Methods: A search was conducted using PubMed and Embase through April 5, 2020, to identify injury studies regarding WNBA and NBA players. Studies were included if the injury or surgery was considered a direct consequence of game play including musculoskeletal/orthopaedic, concussion, ophthalmologic, and craniomaxillofacial injuries. Systematic reviews, screening studies, or studies without sufficient WNBA or NBA player subgroup analysis were excluded. Results: A total of 49 studies met inclusion criteria, 43 (87.8%) of which detailed musculoskeletal injuries. The lower extremity represented 63.3% of studies. A majority (59.2%) of studies were level 4 evidence. The source of data was primarily comprehensive online search (n = 33; 67.3%), followed by official databases (n = 11; 22.4%). Only 3 studies concerned WNBA athletes compared with 47 that concerned NBA athletes. The lowest return-to-play rates were cited for Achilles tendon repairs (61.0%-79.5%). Variability in return-to-play rates existed among studies even with similar seasons studied. Conclusion: The majority of literature available on orthopaedic and sports medicine–related injuries of NBA and WNBA athletes is on the lower extremity. The injuries that had the greatest effect on return to play and performance were Achilles tendon ruptures and knee cartilage injuries treated using microfracture. The reported outcomes are limited by heterogeneity and overlapping injury studies. There are limited available data on WNBA injuries specifically.
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Affiliation(s)
- Sachin Allahabadi
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Favian Su
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
| | - Drew A Lansdown
- Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA
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12
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Pagani NR, Leibman MI, Guss MS. Return to play and performance after surgical repair of distal biceps tendon ruptures in National Football League athletes. J Shoulder Elbow Surg 2021; 30:346-351. [PMID: 32650082 DOI: 10.1016/j.jse.2020.06.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 06/11/2020] [Accepted: 06/22/2020] [Indexed: 02/01/2023]
Abstract
BACKGROUND The purpose of this study was to determine whether surgical repair of distal biceps tendon ruptures in professional football players would lead to a decrease in postinjury performance when compared to preinjury performance and control-matched peers. We also sought to define return to sport, postinjury career length, and games played per season in National Football League players following surgical repair of distal biceps tendon ruptures. METHODS Data for National Football League players who underwent surgical repair of distal biceps tendon ruptures during a 20-year time period were collected. A total of 25 cases in 22 players were included in the analysis. Matched controls based on player position, age, experience, and performance statistics were identified. Performance scores for cases and controls were calculated using a standardized scoring system specific to player position. RESULTS Of the 25 cases, 21 (84%) were able to return to sport in the National Football League. The overall 1-year survival rate of return to play in players undergoing surgical repair of distal biceps tendon ruptures was 76% and overall 2-year survival was 56%. Players who underwent surgical repair of distal biceps tendon ruptures had significantly shorter postinjury career lengths and played fewer games per season postinjury than matched controls. There was no significant difference by position in postinjury performance scores when compared to matched controls. CONCLUSION National Football League players undergoing surgical repair of distal biceps tendon ruptures have a high rate of return to sport, though many retire within the next few seasons following surgery. Players who do return to competition can be expected to perform at a level comparable to their peers.
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Affiliation(s)
- Nicholas R Pagani
- Department of Orthopaedic Surgery, Tufts Medical Center, Boston, MA, USA
| | - Matthew I Leibman
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Tufts University School of Medicine, Hand Surgery, PC, Newton, MA, USA
| | - Michael S Guss
- Department of Orthopaedic Surgery, Newton-Wellesley Hospital, Tufts University School of Medicine, Hand Surgery, PC, Newton, MA, USA.
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13
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Sheu C, Ferkel RD. Athletic Performance in the National Basketball Association After Arthroscopic Debridement of Osteochondral Lesions of the Talus. Orthop J Sports Med 2021; 9:2325967120970205. [PMID: 33457433 PMCID: PMC7802091 DOI: 10.1177/2325967120970205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 07/01/2020] [Indexed: 11/15/2022] Open
Abstract
Background: Use of marrow-stimulating techniques to treat osteochondral lesions of the
talus (OLTs) in National Basketball Association (NBA) players is
controversial. Hypothesis: NBA players will be able to return to preinjury playing status after
treatment of OLTs by arthroscopic debridement alone without
marrow-stimulating techniques. Study Design: Cohort study; Level of evidence, 3. Methods: Between the 2000 and 2015 seasons, 10 NBA players were treated with
arthroscopic debridement of an OLT. The following performance outcomes were
compared pre- and postoperatively: seasons played, games played, games
started, minutes per game, points per game, field goals, 3-point shots,
rebounds, assists, double doubles, triple doubles, steals, blocks,
turnovers, personal fouls, assists per turnovers, steals per turnovers, NBA
rating, scoring efficiency, and shooting efficiency. In addition, the
players were compared with a matched control group using mixed effects
regression and Fisher least significant difference modeling. Results: All 10 players returned to play in the NBA after arthroscopic debridement
without microfracture or drilling of an OLT. When compared with preoperative
performance, postoperative mean points scored, assists made, and steals made
increased by 2.86 (P = .042), 0.61 (P =
.049), and 0.15 (P = .027), respectively. Only field goal
percentage decreased postoperatively when compared with matched controls;
however, this normalized by the end of the second season after surgery.
There was no statistically significant change in any of the other
performance factors when compared with matched controls. All patients
returned to basketball during the same season (n = 1) or the following
season (n = 9) if the operation was performed off-season. The mean length of
career after surgery was 4.1 years, with 5 players still playing in the
league at the time of this study. Conclusion: After arthroscopic debridement of an OLT without drilling or microfracture,
there was a high rate of return to the NBA, with improved points scored,
assists, and steals made after surgery when compared with preoperative
performance. There was no statistically significant change in any
performance factors when compared with uninjured matched controls. Lesion
size did not affect player career length. These data should be used to
manage patients’ and teams’ expectations regarding players’ ability to
return to elite levels of athletic performance after surgery of an OLT.
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Affiliation(s)
| | - Richard D Ferkel
- Southern California Orthopedic Institute, Van Nuys, California, USA
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Early outcomes of transforaminal percutaneous endoscopic lumbar discectomy for high school athletes with herniated nucleus pulposus of the lumbar spine. J Pediatr Orthop B 2020; 29:599-606. [PMID: 32301825 DOI: 10.1097/bpb.0000000000000726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There are no reports in the literature on the clinical outcomes of percutaneous endoscopic lumbar discectomy (PELD) for high school athletes suffering from herniated nucleus pulposus (HNP) of the lumbar spine. PELD is a minimally invasive surgical procedure that can be performed under local anesthesia via an 8-mm skin incision. This study examined the outcomes of transforaminal PELD in high school athletes suffering from HNP. Subjects were 18 patients [14 males and four females; mean age 17 (15-18) years] who underwent PELD at our institutions. The events in which the patients competed were baseball (n = 6), softball (n = 2), rugby (n = 2), basketball (n = 2), table tennis (n = 2), American football (n = 1), wrestling (n = 1), track and field (n = 1), and dance (n = 1). All patients underwent PELD under local anesthesia. Back pain was assessed using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and a visual analog scale (VAS) before and after surgery. Time to return to competitive sport, complications, and rate of recurrence of herniation were examined. All factors assessed by the JOABPEQ were significantly improved after surgery. VAS score was also improved after surgery. Time to return to competitive sport was 7 weeks on average. The rate of return to play was 94.4%. There were no complications, such as dural tear, exiting nerve root injury, or hematoma. One patient had recurrence of HNP. PELD is a promising minimally invasive and effective procedure for high school athletes with HNP.
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Abstract
OBJECTIVE To investigate the prevalence and outcomes of surgery for lumbar disc herniation in professional football players. DESIGN Retrospective case series. SETTING Sports rehabilitation center. PARTICIPANTS A period of 10 seasons of the Italian Football First League (Serie A) was retrospectively investigated. Thirty-three teams (for a total of 1960 players) took turns in the 10 seasons, and 42 team doctors were requested to provide information about the number of players who underwent surgery for lumbar disc herniation. INTERVENTION Survey distributed to team doctors. MAIN OUTCOME MEASURES Prevalence and match incidence of the lumbar discectomy, proportion of players returning to competition after surgery, recovery time and preintervention and postintervention number of appearances in official matches were analyzed. RESULTS Eleven players underwent the surgical intervention during the considered period. The prevalence of the surgical treatment was 0.6%, whereas the match incidence was 0.09 cases/1000 match hours. All players returned to competitions 6.0 (3.5-7.7) months after surgery, with no significant difference between different roles. The number of appearances in official matches was comparable during the seasons before and after surgery. CONCLUSIONS The lumbar discectomy must be considered a rare surgical procedure performed in professional football players. All players returned to competitions after surgery. The postintervention number of appearances in official matches was comparable with the preintervention one.
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Shah K, Bharuka A, Gadiya A, Nene A. Assessment of Outcomes of Spine Surgery in Indian Athletes Involved in High-End Contact Sports. Asian Spine J 2020; 15:192-199. [PMID: 32521952 PMCID: PMC8055450 DOI: 10.31616/asj.2019.0376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 02/25/2020] [Indexed: 11/23/2022] Open
Abstract
STUDY DESIGN This study was a retrospective analysis. PURPOSE This study aimed to analyze the functional outcome following spinal surgery in elite athletes using return-to-play criteria. OVERVIEW OF LITERATURE Spinal ailments are relatively common in athletes and are bound to increase due to the ever-growing popularity of contact sports. An elite athlete is highly motivated to make a rapid recovery and return to full participation in sports. Although the criteria for diagnosis and surgical treatment of various spinal disorders in athletes have been well defined in the literature, there is no clear definition about the factors determining the return to play in athletes. METHODS This study was a retrospective analysis of the data of 10 elite athletes who underwent spinal surgery for symptomatic degenerative disorder of the spine. Eight patients underwent lumbar spine surgery (two patients of microdiscectomy and six patients of fusion), and the remaining two patients underwent cervical spine surgery (one each anterior cervical discectomy and fusion and anterior cervical disc replacement). Outcome measures were investigated using return-to-training and return-to-sports criteria, as indicated by the length of time between surgery and return to competitive sports as parameters. RESULTS Of the 10 patients, eight were males and two were females. The average age of the patients at the time of surgery was 32.4 years (range, 25-41 years). All patients returned to active participation of their sports. The average time for return to training was 7.3 weeks (range, 3-12 weeks). The average time for return to sports was 45.6 weeks (range, 36-72 weeks), and the average follow-up period was 59 months (range, 27-120 months). CONCLUSIONS Spine surgery in an elite athlete involved in contact sports is safe and effective. Currently, there is a lack of standardized guidelines for return to sports after spine injuries. An athlete needs to be symptom-free, with full range of motion and full strength before returning to sports.
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Affiliation(s)
- Kunal Shah
- Department of Spine Surgery, Pain and Spine Clinic, Mumbai, India
| | - Anuj Bharuka
- Department of Spine Surgery, Lilavati Hospital and Research Center, Mumbai, India
| | - Akshay Gadiya
- Department of Spine Surgery, Lilavati Hospital and Research Center, Mumbai, India
| | - Abhay Nene
- Department of Spine Surgery, Lilavati Hospital and Research Center, Mumbai, India
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Ramamurti P, Stake S, Fassihi SC, Pandarinath R, Doerre T. No change in performance metrics in major league baseball players sustaining wrist fractures after being struck by an errant pitch. J Orthop 2020; 22:213-219. [PMID: 32425420 DOI: 10.1016/j.jor.2020.04.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 04/28/2020] [Indexed: 11/18/2022] Open
Abstract
Objective This study aimed to determine the effect of wrist fractures on performance metrics in Major League Baseball Players after they were hit by an errant pitch. Methods Players who sustained wrist fractures after being struck by a pitch were identified and changes in performance metrics were calculated. Results In both the short- and medium-term analysis, there were no significant differences in all pre- and post-injury offensive statistics following return to play. Conclusion Wrist fractures sustained after being struck by an errant pitch do not significantly impact professional baseball player performance if the player is able to return to sport.
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Affiliation(s)
- Pradip Ramamurti
- George Washington School of Medicine and Health Sciences, 2300 I St NW, Washington, DC, 20052, USA
| | - Seth Stake
- Department of Orthopedic Surgery, George Washington University, 2300 M St, Washington DC, 20037, USA
| | - Safa C Fassihi
- Department of Orthopedic Surgery, George Washington University, 2300 M St, Washington DC, 20037, USA
| | - Rajeev Pandarinath
- Department of Orthopedic Surgery, George Washington University, 2300 M St, Washington DC, 20037, USA
| | - Teresa Doerre
- Department of Orthopedic Surgery, George Washington University, 2300 M St, Washington DC, 20037, USA
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Salehi PP, Heiser A, Torabi SJ, Azizzadeh B, Lee J, Lee YH. Facial Fractures and the National Basketball Association: Epidemiology and Outcomes. Laryngoscope 2020; 130:E824-E832. [DOI: 10.1002/lary.28690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/09/2020] [Accepted: 03/25/2020] [Indexed: 12/31/2022]
Affiliation(s)
- Parsa P. Salehi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Alyssa Heiser
- Department of Otolaryngology–Head and Neck Surgery The University of Vermont Medical Center Burlington Vermont U.S.A
| | - Sina J. Torabi
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
| | - Babak Azizzadeh
- Center for Advanced Facial Plastic Surgery Beverly Hills California U.S.A
- Division of Head and Neck Surgery, Department of Otolaryngology–Head and Neck Surgery David Geffen School of Medicine at the University of California Los Angeles California Los Angeles U.S.A
| | - Jonathan Lee
- Department of Surgery, Division of Plastic Surgery Baystate Medical Center Springfield Massachusetts U.S.A
| | - Yan H. Lee
- Department of Surgery, Otolaryngology–Head and Neck Surgery Yale University School of Medicine New Haven Connecticut U.S.A
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Ball JR, Harris CB, Lee J, Vives MJ. Lumbar Spine Injuries in Sports: Review of the Literature and Current Treatment Recommendations. SPORTS MEDICINE-OPEN 2019; 5:26. [PMID: 31236714 PMCID: PMC6591346 DOI: 10.1186/s40798-019-0199-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/07/2019] [Indexed: 11/22/2022]
Abstract
Low back pain is one of the most prevalent complaints of athletes at all levels of competition. The purpose of this literature review is to provide an overview of sport-specific injuries and treatment outcomes that can be used by healthcare providers to better recognize injury patterns and treatment options for different groups of athletes. To our knowledge, no prior comprehensive review of lumbar spine injuries in sports is currently available in the literature, and it is essential that healthcare providers understand the sport-specific injury patterns and treatment guidelines for athletes presenting with low back pain following an athletic injury. Injury mechanisms were found to vary significantly by sport, although some broad recommendations can be made with regards to optimal treatment for these injuries and return to play. Additionally, it was found that certain treatments were more beneficial and resulted in higher rates of return to play depending on the specific sport of the injured athlete. Healthcare providers need to be aware of the different injury patterns seen in specific sports in order to properly evaluate and treat these injuries. Furthermore, an individualized treatment plan needs to be selected in a sport-specific context in order to meet the needs of the athlete in the short and long term.
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Affiliation(s)
- Jacob R Ball
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
| | - Colin B Harris
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA.
| | - Jonathan Lee
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
| | - Michael J Vives
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen St., ACC D1610, Newark, NJ, 07103, USA
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Performance Outcomes After Hook of Hamate Fractures in Major League Baseball Players. J Sport Rehabil 2018; 27:577-580. [DOI: 10.1123/jsr.2017-0071] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Lewis M. It's a Hard-Knock Life: Game Load, Fatigue, and Injury Risk in the National Basketball Association. J Athl Train 2018; 53:503-509. [PMID: 29771139 DOI: 10.4085/1062-6050-243-17] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT National Basketball Association (NBA) athletes experience a high rate of injuries. Injury prevention requires identifying observable and controllable risk factors. OBJECTIVE To examine the relationship among game load, fatigue, and injuries in NBA athletes. DESIGN Cross-sectional study. SETTING Game statistics and injury reports over 3 NBA seasons (2012-2015). PATIENTS OR OTHER PARTICIPANTS Data represented 627 players (height = 200.7 ± 8.9 cm, mass = 100.6 ± 12.1 kg, NBA experience = 4.8 ± 4.2 years, pre-NBA experience = 3.2 ± 1.9 years), 73 209 games, and 1663 injury events. MAIN OUTCOME MEASURE(S) An injury event was defined as a player missing or leaving a game due to injury. Logistic multilevel regression was used to predict injuries from time-lagged fatigue and game load with between-subjects differences explained by demographic variables. RESULTS The odds of injury increased by 2.87% ( P < .001) for each 96 minutes played and decreased by 15.96% ( P < .001) for each day of rest. Increases in game load increased injury odds by 8.23% ( P < .001) for every additional 3 rebounds and 9.87% ( P < .001) for every additional 3 field-goal attempts. When fatigue and game load were held constant, injury odds increased by 3.03% ( P = .04) for each year of NBA experience and 10.59% ( P = .02) for a 6-cm decrease in height. I observed variability in the intercepts ( P < .001) and the slopes for minutes, rest, field-goal attempts, and rebounds (all P < .001). CONCLUSIONS Injuries were associated with greater fatigue and game load, more years of NBA experience, and being shorter than average. Both baseline injury risk and the magnitude of the load-injury and fatigue-injury associations varied across individuals. Researchers should explore the nature of these relationships.
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Affiliation(s)
- Melanie Lewis
- Department of Psychology, University of Oklahoma, Norman
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Begly JP, Guss MS, Wolfson TS, Mahure SA, Rokito AS, Jazrawi LM. Performance outcomes after medial ulnar collateral ligament reconstruction in Major League Baseball positional players. J Shoulder Elbow Surg 2018; 27:282-290. [PMID: 29332665 DOI: 10.1016/j.jse.2017.09.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Revised: 08/26/2017] [Accepted: 09/09/2017] [Indexed: 02/01/2023]
Abstract
BACKGROUND We sought to determine whether professional baseball positional players who underwent medial ulnar collateral ligament (MUCL) reconstruction demonstrate decreases in performance on return to competition compared with preoperative performance metrics and their control-matched peers. METHODS Data for 35 Major League Baseball positional players who underwent MUCL reconstruction during 31 seasons were obtained. Twenty-six players met inclusion criteria. Individual statistics for the 2 seasons immediately before injury and the 2 seasons after injury included wins above replacement (WAR), on-base plus slugging (OPS), and isolated power (ISO). Twenty-six controls matched by player position, age, plate appearances, and performance statistics were identified. RESULTS Of the 35 athletes who underwent surgery, 7 did not return to their preinjury level of competition (return to play rate of 80%). In comparing preinjury with postinjury statistics, players exhibited a significant decrease in plate appearances, at-bats, and WAR 2 seasons after injury but did not demonstrate declines in WAR 1 season after injury. Compared with matched controls, athletes who underwent MUCL reconstruction did not demonstrate significant decline in statistical performance, including OPS, WAR, and ISO, after return to play from surgery. Of all positional players, catchers undergoing surgery demonstrated lowest rates of return to play (56%) along with statistically significant decreases in home run rate, runs batted in, and ISO. CONCLUSION Major League Baseball positional players undergoing MUCL reconstruction can reasonably expect to return to their preinjury level of competition and performance after surgery compared with their peers. Positional players return to play at a rate comparable to that of pitchers; catchers may experience more difficultly in returning to preinjury levels of play.
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Affiliation(s)
- John P Begly
- New York University Hospital for Joint Diseases, New York, NY, USA
| | - Michael S Guss
- New York University Hospital for Joint Diseases, New York, NY, USA
| | | | | | - Andrew S Rokito
- New York University Hospital for Joint Diseases, New York, NY, USA
| | - Laith M Jazrawi
- New York University Hospital for Joint Diseases, New York, NY, USA
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Rugg C, Kadoor A, Feeley BT, Pandya NK. The Effects of Playing Multiple High School Sports on National Basketball Association Players' Propensity for Injury and Athletic Performance. Am J Sports Med 2018; 46:402-408. [PMID: 29135275 DOI: 10.1177/0363546517738736] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Athletes who specialize in their sport at an early age may be at risk for burnout, overuse injury, and reduced attainment of elite status. Timing of sport specialization has not been studied in elite basketball athletes. HYPOTHESIS National Basketball Association (NBA) players who played multiple sports during adolescence would be less likely to experience injury and would have higher participation rates in terms of games played and career length compared with single-sport athletes. STUDY DESIGN Descriptive epidemiology study. METHODS First-round draft picks from 2008 to 2015 in the NBA were included in the study. From publically available records from the internet, the following data were collected for each athlete: participation in high school sports, major injuries sustained in the NBA, percentage of games played in the NBA, and whether the athlete was still active in the NBA. Athletes who participated in sports in addition to basketball during high school were defined as multisport athletes and were compared with athletes who participated only in basketball in high school. RESULTS Two hundred thirty-seven athletes were included in the study, of which 36 (15%) were multisport athletes and 201 (85%) were single-sport athletes in high school. The multisport cohort played in a statistically significantly greater percentage of total games (78.4% vs 72.8%; P < .001). Participants in the multisport cohort were less likely to sustain a major injury during their career (25% vs 43%, P = .03). Finally, a greater percentage of the multisport athletes were active in the league at time of data acquisition, indicating increased longevity in the NBA (94% vs 81.1%; P = .03). CONCLUSION While a minority of professional basketball athletes participated in multiple sports in high school, those who were multisport athletes participated in more games, experienced fewer major injuries, and had longer careers than those who participated in a single sport. Further research is needed to determine the reasons behind these differences.
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Affiliation(s)
- Caitlin Rugg
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
| | - Adarsh Kadoor
- University of California San Diego, San Diego, California, USA
| | - Brian T Feeley
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
| | - Nirav K Pandya
- Department of Orthopaedic Surgery, University of California San Francisco, San Francisco, California, USA
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The Difference in Clinical Outcomes After Anterior Cervical Fusion, Disk Replacement, and Foraminotomy in Professional Athletes. Clin Spine Surg 2018; 31:E80-E84. [PMID: 28719454 DOI: 10.1097/bsd.0000000000000570] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective case series. OBJECT To compare postoperative outcomes of professional athletes treated for cervical disk herniation after anterior cervical discectomy and fusion (ACDF) and posterior foraminotomy (PF), or total disk replacement (TDR). SUMMARY OF BACKGROUND DATA ACDF, PF, and TDR have all led to excellent outcomes in the general population but the unique demands in the professional athlete necessitate specific study. METHODS Athletes of 4 major American professional sports leagues-National Football League, Major League Baseball, National Hockey League and National Basketball Association-diagnosed with cervical disk herniation and managed operatively were identified. Athletes were grouped into cohorts based on operation type. Athlete performance outcome measures were calculated based on sport-specific statistics and assessed as a percentage change after surgery to standardize comparison across sports. RESULTS A total of 101 professional athletes were identified (ACDF=86, PF=13, and TDR=2). The PF cohort had a significantly greater return to play rate and shortest time to return after surgery (P=0.03 and P=0.04, respectively). However, the reoperation rate at the index level was significantly higher in PF athletes compared with ACDF (46.2% vs. 5.8%; P<0.001) over the study follow-up period (average, 13.5 y). There was no significant difference in performance score after surgery for all surgical cohorts (P=0.41) and among cohorts (P=0.41). When analyzed by sport only baseball athletes experienced a significant decrease in performance after surgery (P=0.049). CONCLUSIONS ACDF and PF are both viable options with excellent outcomes in professional athletes. PF allows a significantly higher rate and quicker return to play but portends a higher risk for reoperation compared with ACDF. TDR results are limited in our cohort and require further study to determine professional athlete outcomes. LEVEL OF EVIDENCE Level IV.
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Athletic performance and career longevity following anterior cruciate ligament reconstruction in the National Basketball Association. Knee Surg Sports Traumatol Arthrosc 2017; 25:3031-3037. [PMID: 26971105 DOI: 10.1007/s00167-016-4060-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2015] [Accepted: 02/16/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE To identify the impact of anterior cruciate ligament (ACL) reconstruction on performance and career longevity for National Basketball Association (NBA) players. METHODS Seventy-nine players (80 knees) with acute ACL tears in the NBA between the 1984-2014 seasons, and 112 age, height, weight, and performance-matched controls were identified. Pre- and post-injury performance outcomes including seasons played, games played, games started, minutes per game, points per game, field goals, 3-point shots, rebounds, assists, steals, blocks, turnovers, personal fouls, usage percentage and player efficiency ratings were compared between cases and controls using independent samples t tests and Fisher's exact tests. RESULTS Sixty-eight of seventy-nine players (86.1 %) returned to play in the NBA following ACL reconstruction. Mean length of post-operative play was 1.84 years shorter than matched controls (P = 0.001). There was a significantly higher rate of attrition from professional basketball for players with a history of ACL reconstruction (P = 0.014). In the first full season following surgery, players started in 15.5 fewer games (P = 0.001), they played in 17.3 fewer games (P < 0.001), and had combined player efficiency ratings 2.35 points lower (P = 0.001) when compared to matched controls. Over the length of their careers, players competed in 22.2 fewer games per season (P = 0.009). CONCLUSIONS There is a high rate of return to sport in the NBA following ACL reconstruction, although playing time, games played, player efficiency ratings and career lengths are significantly impacted in the post-operative period. These data should be used to manage patients' expectations regarding their abilities to return to elite levels of athletic performance.
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Return to Sports After Cervical Total Disc Replacement. World Neurosurg 2017; 97:241-246. [DOI: 10.1016/j.wneu.2016.10.042] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 11/23/2022]
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Guss MS, Begly JP, Ramme AJ, Hinds RM, Karia RJ, Capo JT. Performance Outcomes After Metacarpal Fractures in National Basketball Association Players. Hand (N Y) 2016; 11:427-432. [PMID: 28149209 PMCID: PMC5256657 DOI: 10.1177/1558944716628500] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: The aim was to determine whether players in the National Basketball Association (NBA) who sustain metacarpal fractures demonstrate decreased performance upon return to competition when compared with their performance before injury and that of their control-matched peers. Methods: Data for 32 NBA players with metacarpal fractures incurred over 11 seasons (2002-2003 to 2012-2013) were obtained from injury reports, press releases, and player profiles (www.nba.com and www.basketballreference.com). Player age, body mass index (BMI), position, shooting hand, number of years in the league, and treatment (surgical vs nonsurgical) were recorded. Individual season statistics for the 2 seasons immediately prior to injury and the 2 seasons after injury, including player efficiency rating (PER), were obtained. Thirty-two controls matched by player position, age, and performance statistics were identified. A performance comparison of the cohorts was performed. Results: Mean age at the time of injury was 27 years with an average player BMI of 24. Players had a mean 5.6 seasons of NBA experience prior to injury. There was no significant change in PER when preinjury and postinjury performances were compared. Neither injury to their shooting hand nor operative management of the fracture led to a decrease in performance during the 2 seasons after injury. When compared with matched controls, no significant decline in performance in PER the first season and second season after injury was found. Conclusion: NBA players sustaining metacarpal fractures can reasonably expect to return to their preinjury performance levels following appropriate treatment.
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Affiliation(s)
- Michael S. Guss
- NYU Hospital for Joint Diseases, New York City, USA,Michael S. Guss, Department of Orthopaedic Surgery, Division of Hand Surgery, NYU Hospital for Joint Diseases, 301 E 17th Street, New York, NY 10003, USA.
| | | | | | | | - Raj J. Karia
- NYU Hospital for Joint Diseases, New York City, USA
| | - John T. Capo
- NYU Hospital for Joint Diseases, New York City, USA
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Minhas SV, Kester BS, Larkin KE, Hsu WK. The Effect of an Orthopaedic Surgical Procedure in the National Basketball Association. Am J Sports Med 2016; 44:1056-61. [PMID: 26801923 DOI: 10.1177/0363546515623028] [Citation(s) in RCA: 80] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Professional basketball players have a high incidence of injuries requiring surgical intervention. However, no studies in the current literature have compared postoperative performance outcomes among common injuries to determine high- and low-risk procedures to these athletes' careers. PURPOSE To compare return-to-play (RTP) rates and performance-based outcomes after different orthopaedic procedures in National Basketball Association (NBA) players and to determine which surgeries are associated with the worst postoperative change in performance. STUDY DESIGN Cohort study; Level of evidence, 3. METHODS Athletes in the NBA undergoing anterior cruciate ligament reconstruction, Achilles tendon repair, lumbar discectomy, microfracture, meniscus surgery, hand/wrist or foot fracture fixation, and shoulder stabilization were identified through team injury reports and archives on public record. The RTP rate, games played per season, and player efficiency rating (PER) were determined before and after surgery. Statistical analysis was used to compare the change between pre- and postsurgical performance among the different injuries. RESULTS A total of 348 players were included. The RTP rates were highest in patients with hand/wrist fractures (98.1%; mean age, 27.0 years) and lowest for those with Achilles tears (70.8%; mean age, 28.4 years) (P = .005). Age ≥30 years (odds ratio [OR], 3.85; 95% CI, 1.24-11.91) and body mass index ≥27 kg/m(2) (OR, 3.46; 95% CI, 1.05-11.40) were predictors of not returning to play. Players undergoing Achilles tendon repair and arthroscopic knee surgery had a significantly greater decline in postoperative performance outcomes at the 1- and 3-year time points and had shorter career lengths compared with the other procedures. CONCLUSION NBA players undergoing Achilles tendon rupture repair or arthroscopic knee surgery had significantly worse performance postoperatively compared with other orthopaedic procedures.
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Affiliation(s)
- Shobhit V Minhas
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Benjamin S Kester
- Department of Orthopaedic Surgery, New York University Hospital for Joint Diseases, New York, New York, USA
| | - Kevin E Larkin
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
| | - Wellington K Hsu
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois, USA
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Abstract
STUDY DESIGN Systematic literature review and meta-analysis of English language studies. OBJECTIVE This study is a meta-analysis assessing elite athlete's return-to-play (RTP) rates after a lumbar herniated nucleus pulposus (HNP) treated with microdiscectomy. Additionally, we compare RTP rates of those treated operatively versus nonoperatively. SUMMARY OF BACKGROUND DATA Microdiscectomy for a lumbar HNP in elite athletes remains a controversial subject with no consensus in the literature regarding true RTP. METHODS A literature search of Medline, Embase, and Cochrane Reviews was performed. The pooled results were analyzed by calculating the effect size based on the logit event rate. Studies were weighted by the inverse of the variance, which included both within and between study errors. Confidence intervals (CIs) were reported at 95%. Heterogeneity was assessed using the Q statistic and I. RESULTS The initial literature search resulted in 547 articles, of which 14 were determined relevant on abstract review. Overall, nine studies provided data for 558 patients who underwent a lumbar microdiscectomy. The pooled clinical success rate was 83.5% (CI: 79.7%, 88.0%), which was statistically significant (P < 0.0001). The studies demonstrated minimal heterogeneity Q value of 7.41 and I value of 5.53. Four studies included operative and nonoperative cohorts. The odds ratio of RTP with a symptomatic lumbar disc herniation was 1.13 (CI: 0.37-5.90). There was no statistical difference in RTP between the two groups (P = 0.59). CONCLUSION Elite athletes return to competition 83.5% of the time after undergoing a single level lumbar microdiscectomy. Additionally, when comparing lumbar microdiscectomy to non-operative treatment, there is no difference in RTP rates, suggesting that a more aggressive approach to managing a symptomatic HNP in this population with earlier surgical intervention may be employed judiciously if timing necessitates for the athlete's benefit. LEVEL OF EVIDENCE 3.
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Begly JP, Guss M, Ramme AJ, Karia R, Meislin RJ. Return to Play and Performance After Jones Fracture in National Basketball Association Athletes. Sports Health 2015; 8:342-6. [PMID: 26627111 PMCID: PMC4922517 DOI: 10.1177/1941738115621011] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background: Basketball players are at risk for foot injuries, including Jones fractures. It is unknown how this injury affects the future play and performance of athletes. Hypothesis: National Basketball Association (NBA) players who sustain Jones fractures of the base of the fifth metatarsal have high rates of return to play and do not experience a decrease in performance on return to competition when compared with preinjury and with control-matched peers. Study Design: Retrospective cohort study. Level of Evidence: Level 5. Methods: Data on 26 elite basketball players with Jones fractures over 19 NBA seasons (1994-1995 to 2012-2013) were obtained from injury reports, press releases, player profiles, and online public databases. Variables included age, body mass index (BMI), player position, experience, and surgical treatment. Individual season statistics pre- and postinjury were collected. Twenty-six controls were identified by matched player position, age, and performance statistics. Results: The mean age at the time of injury was 24.8 years, mean BMI was 24.7 kg/m2, and the mean experience prior to injury was 4.1 NBA seasons. Return to previous level of competition was achieved by 85% of athletes. There was no change in player efficiency rating (PER) when pre- and postinjury performance was compared. When compared with controls, no decline in PER measured performance was identified. Conclusion: The majority of NBA players sustaining a Jones fracture return to their preinjury level of competition. These elite athletes demonstrate no decrease in performance on their return to play. Clinical Relevance: Jones fractures are well-studied injuries in terms of etiology, diagnosis, and management. However, the effect of these injuries on future performance of athletes is unknown. Using the findings of our study, orthopaedic surgeons may be better prepared to counsel and educate elite athletes who sustain a Jones fracture.
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Affiliation(s)
- John P Begly
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Michael Guss
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Austin J Ramme
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Raj Karia
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Robert J Meislin
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
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Reiman MP, Sylvain J, Loudon JK, Goode A. Return to sport after open and microdiscectomy surgery versus conservative treatment for lumbar disc herniation: a systematic review with meta-analysis. Br J Sports Med 2015; 50:221-30. [PMID: 26491033 DOI: 10.1136/bjsports-2015-094691] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 11/04/2022]
Abstract
BACKGROUND Lumbar disc herniation has a prevalence of up to 58% in the athletic population. Lumbar discectomy is a common surgical procedure to alleviate pain and disability in athletes. We systematically reviewed the current clinical evidence regarding athlete return to sport (RTS) following lumbar discectomy compared to conservative treatment. METHODS A computer-assisted literature search of MEDLINE, CINAHL, Web of Science, PEDro, OVID and PubMed databases (from inception to August 2015) was utilised using keywords related to lumbar disc herniation and surgery. The design of this systematic review was developed using the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Methodological quality of individual studies was assessed using the Downs and Black scale (0-16 points). RESULTS The search strategy revealed 14 articles. Downs and Black quality scores were generally low with no articles in this review earning a high-quality rating, only 5 articles earning a moderate quality rating and 9 of the 14 articles earning a low-quality rating. The pooled RTS for surgical intervention of all included studies was 81% (95% CI 76% to 86%) with significant heterogeneity (I(2)=63.4%, p<0.001) although pooled estimates report only 59% RTS at same level. Pooled analysis showed no difference in RTS rate between surgical (84% (95% CI 77% to 90%)) and conservative intervention (76% (95% CI 56% to 92%); p=0.33). CONCLUSIONS Studies comparing surgical versus conservative treatment found no significant difference between groups regarding RTS. Not all athletes that RTS return at the level of participation they performed at prior to surgery. Owing to the heterogeneity and low methodological quality of included studies, rates of RTS cannot be accurately determined.
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Affiliation(s)
- Michael P Reiman
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
| | - Jonathan Sylvain
- Department of Rehabilitation and Sports Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA
| | - Janice K Loudon
- Department of Physical Therapy Education, Rockhurst University, Kansas City, Missouri, USA
| | - Adam Goode
- Department of Orthopaedic Surgery, Duke University School of Medicine, Durham, North Carolina, USA
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Minhas SV, Kester BS, Hsu WK. Outcomes After Lumbar Disc Herniation in the National Basketball Association. Sports Health 2015; 8:43-9. [PMID: 26502185 PMCID: PMC4702156 DOI: 10.1177/1941738115608361] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Professional basketball players are at risk for lumbar disc herniation (LDH), yet the evidence guiding treatment after operative or nonoperative management of this condition in the National Basketball Association (NBA) is limited. HYPOTHESIS NBA players with LDH will have different performance outcomes based on treatment type. STUDY DESIGN Case-control study. LEVEL OF EVIDENCE Level 4. METHODS Athletes in the NBA with an LDH were identified through team injury reports, transaction records, and public sports archives. A 1:2 case-control study was performed in which LDH players and players without LDH were matched for player variables. Statistical analysis was employed to compare pre- and postindex season performance (games played and player efficiency rating [PER]) and career longevity between test subjects and controls in the operatively treated (OT) and nonoperatively treated (NOT) cohorts. RESULTS A total of 61 NBA players with LDH were included, of whom 34 underwent discectomy and 27 were managed nonoperatively. Return-to-play (RTP) rates did not differ between NOT and OT players (77.8% vs. 79.4%). When compared with controls, OT players played significantly fewer games and had a lower PER than controls during the first postoperative season, but no difference was seen 2 and 3 years after surgery, with no difference in postoperative career length. In contrast, no difference in games played or PER was seen between NOT players and controls, although NOT players played significantly fewer postindex seasons. CONCLUSION NBA players have a high RTP rate regardless of type of treatment for LDH; however, postindex performance differs between surgically and nonoperatively managed patients when compared with players without an LDH. However, further studies with a larger sample size are required for more definitive recommendations. CLINICAL RELEVANCE There is a high RTP rate after LDH in the NBA, although postindex performance may differ based on operative versus nonoperative treatment.
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Affiliation(s)
- Shobhit V Minhas
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Benjamin S Kester
- Department of Orthopaedic Surgery, NYU Hospital for Joint Diseases, New York, New York
| | - Wellington K Hsu
- Department of Orthopaedic Surgery, Northwestern University, Chicago, Illinois
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35
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Nair R, Kahlenberg CA, Hsu WK. Outcomes of Lumbar Discectomy in Elite Athletes: The Need for High-level Evidence. Clin Orthop Relat Res 2015; 473:1971-7. [PMID: 25002213 PMCID: PMC4419017 DOI: 10.1007/s11999-014-3762-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Although lumbar discectomy for treatment of lumbar disc herniation in the general population generally improves patients' pain, function, and validated outcomes scores, results of treatment in elite athletes may differ because of the unique performance demands required of competitive athletes. QUESTIONS/PURPOSES We performed a systematic review to answer the following questions: (1) What proportion of athletes return to play after lumbar discectomy, and what is the effect of sport? (2) What is the expected recovery time after lumbar discectomy in elite athletes? (3) What is the expected career length and performance of elite athletes after lumbar discectomy? METHODS We performed a systematic literature review of articles of lumbar discectomy in the elite athlete population through the MEDLINE and EMBASE databases from 1947 to 2013. Elite athletes were defined as professional, Olympic, or National Collegiate Athletic Association Division I collegiate level. A hand search of the references of all key articles was performed to ensure inclusion of all relevant studies. Information regarding study design, types of athletes, level of sport, recovery time, return to sport, length of career after surgery, and career performance after surgery was extracted. Ten articles met the inclusion and exclusion criteria for this review. These articles consisted of levels III and IV data and were graded based on the Methodological Index for Non-Randomized Studies (MINORS) scale. RESULTS Overall, the studies included in this review found that 75% to 100% of athletes were able to return to elite competition after operative treatment. In general, a higher proportion of baseball players returned to elite competition compared with other athletes. The reported recovery period after lumbar discectomy ranged from 2.8 to 8.7 months. The average career length after lumbar discectomy ranged from 2.6 to 4.8 years. Elite athletes reached an average of 64.4% to 103.6% of baseline preoperative statistics after lumbar discectomy with variable performance based on sport. CONCLUSIONS A high proportion of elite athletes undergoing lumbar discectomy return to play with variable performance scores on return. Future prospective studies are needed to compare the recovery time, career longevity, and performance for athletes undergoing lumbar discectomy versus nonoperative treatment for lumbar disc herniation.
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Affiliation(s)
- Rueben Nair
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1350, Chicago, IL 60611 USA
| | - Cynthia A. Kahlenberg
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1350, Chicago, IL 60611 USA
| | - Wellington K. Hsu
- Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 N St Clair Street, Suite 1350, Chicago, IL 60611 USA
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36
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Abe M, Takata Y, Higashino K, Sakai T, Matsuura T, Suzue N, Hamada D, Goto T, Nishisho T, Goda Y, Tsutsui T, Tonogai I, Miyagi R, Morimoto M, Mineta K, Kimura T, Nitta A, Hama S, Higuchi T, C. Jha S, Takahashi R, Fukuta S, Sairyo K. Foraminoplastic transforaminal percutaneous endoscopic discectomy at the lumbosacral junction under local anesthesia in an elite rugby player. THE JOURNAL OF MEDICAL INVESTIGATION 2015; 62:238-41. [DOI: 10.2152/jmi.62.238] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
| | | | | | | | | | - Naoto Suzue
- Department of Orthopedics, Tokushima University
| | | | | | | | | | | | | | - Ryo Miyagi
- Department of Orthopedics, Tokushima University
| | | | | | | | | | - Shingo Hama
- Department of Orthopedics, Tokushima University
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37
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Harris JD, Walton DM, Erickson BJ, Verma NN, Abrams GD, Bush-Joseph CA, Bach BR, Cole BJ. Return to Sport and Performance After Microfracture in the Knees of National Basketball Association Players. Orthop J Sports Med 2013; 1:2325967113512759. [PMID: 26535256 PMCID: PMC4555513 DOI: 10.1177/2325967113512759] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Use of microfracture in the knees of National Basketball Association (NBA) players is controversial. Hypotheses: (1) There would be a high rate of return to sport (RTS) in NBA players following microfracture, (2) players would RTS the season following surgery, (3) preoperative player performance would not be significantly different on RTS, and (4) there would be no significant difference in RTS rate or postoperative performance in players undergoing microfracture in comparison with an age-, position-, NBA experience–, and performance-matched control group. Study Design: Cohort study; Level of evidence, 3. Methods: NBA players undergoing microfracture were evaluated. Age-, body mass index–, position-, NBA experience–, and performance-matched controls were selected from the NBA during the same years as those undergoing microfracture. An index year was selected (controls) to match the number of seasons of NBA experience in microfracture cases. RTS and performance were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. Results: A total of 41 NBA players underwent microfracture and were compared with 41 demographic- and performance-matched controls. Rate of RTS after microfracture was 73% in the NBA and 83% in professional basketball (NBA, D-league, and International Basketball Federation [FIBA]). Time to RTS in NBA was 9.20 ± 4.88 months. Seventy-one percent (29/41) of players RTS the season following microfracture. Length of NBA career following microfracture (4.10 ± 3.91 years) was not significantly different from controls. After microfracture, case athletes played fewer games per season and with fewer points and steals per game (relative to premicrofracture; P < .05). Performance was better in control (after index year) versus case players (after microfracture) with regard to points per game, games played per season, and field goal and free throw percentage (P < .05). Conclusion: Eighty-three percent of NBA players undergoing microfracture returned to professional basketball. Career length was not significantly different between players undergoing microfracture and controls. However, following microfracture, players competed in fewer games per season with fewer points and steals.
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Affiliation(s)
- Joshua D Harris
- Houston Methodist Center for Orthopaedics & Sports Medicine, Houston, Texas, USA. ; Rush University Medical Center, Chicago, Illinois, USA
| | | | | | | | - Geoffrey D Abrams
- Rush University Medical Center, Chicago, Illinois, USA. ; Orthopedic Surgery, Stanford University and Veterans Administration-Palo Alto, Palo Alto, California, USA
| | | | | | - Brian J Cole
- Rush University Medical Center, Chicago, Illinois, USA
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38
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Schroeder GD, McCarthy KJ, Micev AJ, Terry MA, Hsu WK. Performance-based outcomes after nonoperative treatment, discectomy, and/or fusion for a lumbar disc herniation in National Hockey League athletes. Am J Sports Med 2013; 41:2604-8. [PMID: 23956134 DOI: 10.1177/0363546513499229] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Ice hockey players have a high incidence of lumbar spine disorders; however, there is no evidence in the literature to guide the treatment of an ice hockey player with a herniated lumbar disc. PURPOSE To determine the performance-based outcomes in professional National Hockey League (NHL) athletes with a lumbar disc herniation after either nonsurgical or surgical treatment. STUDY DESIGN Descriptive epidemiological study. METHODS Athletes in the NHL with a lumbar disc herniation were identified through team injury reports and archives on public record. The return-to-play rate, games played per season, points per game, and performance score for each player were determined before and after the diagnosis of a lumbar disc herniation. Statistical analysis was used to compare preinjury and postinjury performance measures for players treated with either nonsurgical or surgical treatment. RESULTS A total of 87 NHL players met the inclusion criteria; 31 underwent nonoperative care, 48 underwent a discectomy, and 8 underwent a single-level fusion. The return-to-play rate for all players was 85%. There was a significant decrease in performance in all players after a lumbar disc herniation in games played per season, points scored per game, and performance score. A comparison of the posttreatment results for the nonsurgical and surgical patient groups revealed no significant difference in performance measures. Notably, the lumbar fusion group did not show a decrease in games played per season or performance score after surgery, likely secondary to a small sample size. CONCLUSION National Hockey League players with a lumbar disc herniation have a high return-to-play rate regardless of the type of treatment; however, performance-based outcomes may decrease compared with preinjury levels. The study data suggest that a lumbar fusion is compatible with a return to play in the NHL, which is in contrast to other professional sports.
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Affiliation(s)
- Gregory D Schroeder
- Gregory D. Schroeder, Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, 676 North St Clair, Suite 1350, Chicago, IL 60611.
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39
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Nandyala SV, Marquez-Lara A, Frisch NB, Park DK. The Athlete’s Spine—Lumbar Herniated Nucleus Pulposus. OPER TECHN SPORT MED 2013. [DOI: 10.1053/j.otsm.2013.10.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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40
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Watkins RG, Hanna R, Chang D, Watkins RG. Return-to-play outcomes after microscopic lumbar diskectomy in professional athletes. Am J Sports Med 2012; 40:2530-5. [PMID: 22986297 DOI: 10.1177/0363546512458570] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND It has been shown a microscopic lumbar diskectomy (MLD) is effective in getting professional athletes back to their sport after a herniated nucleus pulposus (HNP). There is a need for more information on the time it takes professional athletes to return after surgery. PURPOSE To determine average time for return to play and success in returning to play for professional athletes undergoing MLD. STUDY DESIGN Case series; Level of evidence, 4. METHODS Between 1996 and 2010, the senior authors treated 171 professional athletes for lumbar HNP. A retrospective review was performed using patient charts, operative reports, team medical records, and internet search. Eighty-five patients were treated with MLD, and 86 patients were treated nonoperatively. This study focused on the return to play of the operatively treated patients. Primary outcome measures were return rate and average return time, considering only patients whose sport is in season at specific postoperative time points. RESULTS Of surgically treated patients, 89.3% returned to sport. The average time it took operative patients to return to their sport (return time) was 5.8 months. Progressive return data for surgically treated patients showed the percentage of athletes who returned increased from 50% at 3 months to 72% at 6 months to 77% at 9 months and 84% at 12 months. CONCLUSION The chance a player returns to play after MLD is 50% at 3 months, 72% at 6 months, 77% at 9 months, and 84% at 12 months. The overall chance of returning to play at any point is 89%.
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42
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Earhart JS, Roberts D, Roc G, Gryzlo S, Hsu W. Effects of lumbar disk herniation on the careers of professional baseball players. Orthopedics 2012; 35:43-9. [PMID: 22229920 DOI: 10.3928/01477447-20111122-40] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Outcomes after lumbar disk herniation in baseball athletes are currently unknown. It has been postulated that the repetitive torque-producing motions of a baseball player may have negative implications after a disk injury. Sixty-nine lumbar disk herniations (40 treated operatively, 29 nonoperatively) in 64 professional baseball players were identified, and important outcome measures including successful return to play, time to recovery, career longevity, and performance based on vital statistics to each position were documented. Ninety-seven percent of baseball athletes successfully returned to play at an average of 6.6 months after diagnosis. Athletes treated operatively required significantly more time to return to play than those managed nonoperatively (8.7 vs 3.6 months, respectively; P<.0001).
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Affiliation(s)
- Jeffrey S Earhart
- Departmentof Orthopaedic Surgery, Feinberg School of Medicine, NorthwesternUniversity, 676 N Saint Claire St, Ste 1350, Chicago, IL 60611, USA.
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43
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Roberts DW, Roc GJ, Hsu WK. Outcomes of cervical and lumbar disk herniations in Major League Baseball pitchers. Orthopedics 2011; 34:602-9. [PMID: 21800814 DOI: 10.3928/01477447-20110627-23] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The effects of disk herniations on the career and performance outcomes of Major League Baseball (MLB) pitchers are unknown. The purpose of this study is to determine the outcomes after a cervical or lumbar disk herniation for MLB pitchers. Forty MLB pitchers from 1984 to 2009 with a cervical disk herniation or lumbar disk herniation were identified using a previously established protocol. Cervical disk herniation was identified in 11 pitchers, 8 of which were treated operatively. The majority of pitchers with cervical disk herniation (8/11) returned to play at an average of 11.6 months. Lumbar disk herniation was identified in 29 pitchers, 20 of which were treated operatively. All pitchers with lumbar disk herniation (29/29) returned to play at an average of 7.3 months after diagnosis.
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Affiliation(s)
- David W Roberts
- Department of Orthopedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
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44
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Weistroffer JK, Hsu WK. Return-to-play rates in National Football League linemen after treatment for lumbar disk herniation. Am J Sports Med 2011; 39:632-6. [PMID: 21220543 DOI: 10.1177/0363546510388901] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND There is a paucity of evidence demonstrating clinical outcomes of high-end athletes sustaining a treatment for lumbar disk herniation. PURPOSE To evaluate the ability of a National Football League lineman to return to play after lumbar diskectomy. STUDY DESIGN Case series; Level of evidence, 4. METHODS National Football League offensive and defensive linemen diagnosed with a lumbar disk herniation were identified by previously published protocols using multiple sources of the public record. Demographic and statistical performance data were compiled for each player both before and after treatment. RESULTS A total of 66 linemen (36 offensive and 30 defensive) met the inclusion criteria. Fifty-two were treated surgically, and 14 were treated nonsurgically. On average, this group had a body mass index of 35.4 and was 27.6 years old. Of those players treated surgically, 80.8% (42/52) successfully returned to play an average of 33 games over 3.0 years, with 63.5% (33/52) becoming starters after treatment. Conversely, only 28.6% (4/14) of linemen successfully returned to play after nonoperative intervention, which was significantly lower than those treated with a diskectomy (P < .05). Of the linemen in the surgical cohort, 13.5% (7/52) required revision decompression, and 85.7% (6/7) of these players successfully returned to play. CONCLUSION National Football League linemen have high return-to-play rates after lumbar diskectomy. Furthermore, because those linemen requiring revision decompression successfully returned to play 85.7% of the time, this cohort should not be denied surgical treatment after recurrent problems. Although the data in our study suggest that National Football League linemen who are treated surgically have superior outcomes to those treated nonoperatively, because of the limitations with the methodology used in this study, further prospective studies are necessary to accurately compare treatment effects and to determine the long-term prognosis for these athletes after retirement.
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Affiliation(s)
- Joseph K Weistroffer
- Department of Orthopaedic Surgery, Feinberg School of Medicine, Northwestern University, 676 N St Clair Street, Chicago, IL 60611, USA.
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45
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Namdari S, Scott K, Milby A, Baldwin K, Lee GC. Athletic performance after ACL reconstruction in the Women's National Basketball Association. PHYSICIAN SPORTSMED 2011; 39:36-41. [PMID: 21378485 DOI: 10.3810/psm.2011.02.1860] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
PURPOSE Females are at greater risk than males for sustaining an anterior cruciate ligament (ACL) tear. Performance outcomes and attrition rates associated with ACL injury and reconstruction in Women's National Basketball Association (WNBA) athletes are unclear. The purpose of this study was to compare athletes who underwent ACL reconstruction with pre-injury and matched controls to determine differences in performance and return to play. METHODS A retrospective review of 18 WNBA players who underwent ACL reconstruction between 1998 and 2008 was conducted. Performance data for 2 full seasons before and after the index surgery were collected. Data were obtained from 36 matched controls. Within-group and between-group comparisons were performed to assess significance of changes in athletic performance between the pre- and post-index seasons, and the odds ratios of return to play following surgery. RESULTS Fourteen (78%) of 18 WNBA athletes who underwent ACL reconstruction returned to play in the WNBA. Within-group comparisons showed that only shooting percentage (P = 0.04) and steals per 40 minutes of play (P = 0.03) were significantly reduced after ACL reconstruction. No other performance variables were significantly different in absolute terms or per 40 minutes of play. Changes in performance variables from the pre- to post-index seasons were not significantly different from those in the control group. CONCLUSION After ACL reconstruction, 78% of athletes returned to professional sports. For those who returned, changes in performance were not statistically significant relative to the comparison group.
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Affiliation(s)
- Surena Namdari
- Department of Orthopaedic Surgery, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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46
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Iwamoto J, Sato Y, Takeda T, Matsumoto H. Return to play after conservative treatment in athletes with symptomatic lumbar disc herniation: a practice-based observational study. Open Access J Sports Med 2011; 2:25-31. [PMID: 24198567 PMCID: PMC3781879 DOI: 10.2147/oajsm.s17523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The purpose of the study was to confirm the short-term outcome of conservative treatment in terms of the ability to return to play and factors influencing return to play in athletes with symptomatic lumbar disc herniation. A total of 100 consecutive athletes (72 male and 28 female) who consulted our sports medicine clinic during the 16-year period between September 1993 and October 2009 because of severe low back pain and/or leg pain/numbness due to lumbar disc herniation were studied. The mean age of the subjects was 23 years. All of them were conservatively treated by being advised to discontinue their sporting activities with/without short-term medication. After the subjective symptoms had reduced by more than 80%, individual training was started in order to allow the athletes to return to play. Seventy-nine athletes (79.0%) returned to play at an average of 4.8 months (range 1–12 months) after the start of treatment and were able to sustain the activities for at least 6 months, the minimum duration of follow-up in the study. The outcome of the conservative treatment was not influenced by the intensity of the sporting activity. Multiple logistic regression analyses showed that the severity of the symptoms prior to the start of treatment was the factor influencing the ability of the athletes to return to play. The present study confirmed the satisfactory short-term outcome of conservative treatment in athletes with symptomatic lumbar disc herniation regarding return to play and revealed that subjective symptoms prior to the start of treatment appeared to be a key factor in return to play after conservative treatment.
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Affiliation(s)
- Jun Iwamoto
- Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, Japan
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