Effect of Achilles Tendon Repair on Performance Outcomes Following Return to Play in NCAA Division I Basketball Athletes

CATEGORY: Sports; Ankle INTRODUCTION/PURPOSE: Achilles tendon ruptures are devastating injuries highly prevalent among athletes. Despite our understanding of the impact of Achilles tendon rupture in professional athletes, and in particular its relationship to basketball, no study has examined the effect of Achilles tendon rupture on performance metrics in National Collegiate Athletic Association (NCAA) Division I basketball players. METHODS: NCAA Division I basketball players who sustained a surgically repaired Achilles tendon rupture between the 2000 and 2019 seasons were identified by systematic evaluation of individual injury reports from the NCAA career statistics and individual school statistics databases. 65 male and 41 female players were identified. Athletes were included if they participated in at least one collegiate season before tearing their Achilles tendon, and at least one season after operative repair. A total of 50 male and 30 female athletes were ultimately included in the analysis. Each injured athlete was matched to a healthy control by conference, position, starter-status at time of injury, class year, and number of games played. Matched controls were healthy players and experienced no significant injuries during their NCAA careers. RESULTS: Following Achilles tendon rupture and subsequent surgical repair, male athletes played significantly more minutes per game (19.7 vs. 22.6, p=0.017), scored more points per game (6.7 vs 7.9, p=0.024), and had more assists per game (1.4 vs. 1.7, p=0.036), when compared to their pre-injury statistics. The only area of worsened athletic performance following injury was total blocks, which significantly decreased post-injury (18.1 vs. 10.2, p=0.004). Matched healthy controls demonstrated a higher percent change in assists per game (+39.0% vs +21.8%, p=0.036) and total blocks (+55.1% vs -43.5%, p=0.031) between the matched pre- injury and post-injury periods. Female athletes scored significantly more points per game after returning from injury (7.6 vs 6.3, p=0.032) but demonstrated a significantly lower 3-point shooting percentage (10% vs. 20%, p=0.047). CONCLUSION: Male athletes who returned to play following Achilles tendon rupture demonstrated significant increases in various offensive performance metrics, while suffering a significant decrease in total blocks. Female athletes demonstrated a significant improvement in points per game following Achilles tendon rupture, but suffered a significant decline in 3-point shooting percentage. Despite suffering an Achilles tendon rupture, 14% of the male cohort reached the NBA, and 16.7% of the female cohort reached the WNBA.