Performance Outcomes After Surgical Repair of Achilles Tendon Rupture in the Women’s National Basketball Association

Abstract

Background: Achilles tendon ruptures are devastating in elite athletes. There are currently no studies examining the effects of Achilles tendon rupture on performance outcomes in the Women’s National Basketball Association (WNBA). Hypothesis: Athletes in the WNBA who sustained an Achilles tendon rupture and underwent subsequent surgical repair will sustain declines in performance metrics when compared with their preinjury statistics and matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: Seventeen WNBA players who sustained an Achilles tendon rupture from 2000 to 2019 were identified through publicly available injury reports and player profiles. Athlete information collected included age, body mass index, position, and service in the WNBA when the tear occurred. Statistics were collected for 1 season before and 2 seasons after the injury, and the player efficiency rating (PER) was calculated. Players were matched to uninjured controls by service in the WNBA, position, and performance statistics. Results: On average, players were 28 years of age at the time of Achilles tendon rupture, with a service time in the WNBA of 6.5 years. Four players never returned to play in the WNBA, while 7 players failed to play more than 1 season. Players who did return played significantly fewer minutes per game compared with preinjury in both postinjury seasons 1 and 2 (mean difference, –6.11 and –6.54 min/game, respectively; P < .01 for both) and had a significantly decreased PER in postinjury season 2 (mean difference, –2.53; P = .024). After returning to play, the injured players experienced significant decreases when compared with controls in field goals (–0.85 vs +0.20; P = .047), free throws (–1.04 vs +0.12; P < .01), steals (–0.48 vs +0.24; P = .018), and points scored (–2.89 vs +0.58; P = .014). Conclusion: WNBA players experienced significant decreases in performance metrics after Achilles tendon rupture compared with their preinjury levels and compared with uninjured controls. Overall, 23.5% of players failed to return to the WNBA, while 41.2% failed to play for more than 1 season.

Performance Differences in Elite National Basketball Association and Women’s National Basketball Association Players Based Upon Whether the Dominant or Non-dominant Achilles Tendon Was Ruptured

“…Achilles tendon ruptures have been considered one of the most detrimental injuries in professional basketball players, overall leading to shortened careers and significantly decreased performance following injury [1][2][3][4][5][6]. Earlier studies examined Achilles tendon ruptures in either all NBA or WNBA players, without specifically focusing on elite or higher-performing players based on their PER [2][3][4][5][6]. Prior research also did not explore the potential disparities in performance in NBA or WNBA players with dominant versus nondominant Achilles tendon ruptures.…”

“…Players also exhibited a decline in minutes and games played, coupled with notably shorter careers compared to age-matched controls. A comparable study conducted on Women’s National Basketball Association (WNBA) players revealed similar outcomes, with only 83% of players returning to play after rupture and experiencing diminished performance post-injury [ 5 , 6 ].…”

“…An Achilles tendon rupture has been regarded as one of the most detrimental injuries in professional basketball players [1][2][3][4][5][6]. Previous studies have found that 20-30% of National Basketball Association (NBA) players do not return to play following Achilles tendon rupture and experience a significant decline in performance following rupture [2][3][4].…”

“…Moreover, prior studies did not focus only on higher-performing players, instead encompassing all NBA or all WNBA players with an Achilles tendon rupture [2][3][4][5][6]. The average career of NBA players is approximately 4.5 years, so it is difficult to assess whether an Achilles tendon rupture was the inciting etiology for the end of a player's career or just an accelerant to their natural career progression.…”

Performance Is Regained Within 2 Seasons After Quadriceps Tendon Tears in National Basketball Association Players

“…Therefore, this study conducted a power analysis paralleling methodology of previous studies that explored changes in PER for other NBA knee injuries. 10 , 18 A sample size of 6 was deemed acceptable to power this study (⍺ = 0.05, power = 0.8, standard deviation = 3). Three of the 9 injured players were excluded from analysis, with 2 suffering career-ending quadriceps tendon injuries, and the other having sustained his injury during the 2020-2021 season.…”