Return to Play and Performance After Achilles Tendon Rupture in Women’s National Basketball Association Players

CATEGORY: Sports; Trauma INTRODUCTION/PURPOSE: For the professional athlete, an Achilles tendon rupture is a devastating and potentially career ending injury. Basketball players with Achilles tendon injuries have among the lowest reported return to play rates for orthopaedic injuries. Among National Basketball Association (NBA) players, Achilles rupture has been shown to result in difficulty with returning to competition and significantly decreased productivity exhibiting a large effect size (0.95). Comparable data regarding Women’s National Basketball Association (WNBA) players is lacking. This study evaluated the impact of Achilles tendon rupture on return to play and post-injury performance among WNBA players in order to test the null hypothesis of equal negative impact as observed in the NBA. METHODS: This was an IRB exempt retrospective matched cohort study. Public records indicated 12 WNBA players incurred Achilles tendon ruptures between the 2006 and 2018 seasons. Demographic data and performance statistics were collected for pre and post-injury seasons. A control cohort was matched for age, height, weight, years of experience in WNBA, position, and pre-injury player efficiency rating (PER). Individual pre versus post injury and injury cohort versus control cohort performance statistics were compared using paired and independent samples t-tests, respectively. Injury effect size on performance was calculated. The primary outcome was difference in PER. Secondary outcomes included differences in itemized performance statistics. A priori sample size based on effect size of 0.95 indicated that 12 players per cohort were needed for 80% power to detect a difference in PER at alpha of 0.05. RESULTS: 7 (58%) players returned to WNBA play by mean 9.5 months. There was no significant difference in pre injury PER from seasons matched for years of WNBA experience between cohorts (13.7 vs 11.9; P = 0.6). Mean PER significantly decreased in the first year (13.66 vs 9.00; P = .04; Cohen’s d = .99) and approached a significance difference in the second year (14.56 vs 9.95; P = 05; Cohen’s d = 1.02) in the injured cohort only. Minutes per game (MPG) significantly decreased only year 1 post-injury (25.84 vs 19.54; P = .04; Cohen’s d = 6.56). Points per game (PPG), field goals attempted per game (FGA), and free throws attempted per game (FTA) significantly decreased in both years post-injury (all p < 0.05). CONCLUSION:: WNBA players incurred Achilles tendon ruptures at a rate of 2% annually. This was associated with a moderate rate of return to play and significantly reduced production (PER, MPG, PPG, FGA, and FTA) in the first year. The second season following injury found players returning closer to pre-injury performance, with persistent significant reduction in PPG, FGA, and FTA. Effect sizes were uniformly large. These data were consistent with NBA results, supporting the null hypothesis. Providers may use this data to counsel high and elite level female basketball players on return to play and performance expectations following Achilles tendon ruptures.