Professional Soccer Players’ Return to Play and Performance After Operative Repair of Achilles Tendon Rupture

Abstract

Background:The majority of Achilles tendon ruptures are sports related; however, no investigation has examined the impact of surgical repair for complete ruptures on professional soccer players.Purpose:To examine the return to play, playing time, and performance of professional soccer players following Achilles tendon repair.Study Design:Cohort study; Level of evidence, 3.Methods:Union of European Football Associations (UEFA) and Major League Soccer (MLS) athletes who sustained a primary complete Achilles tendon rupture and were treated surgically between 1988 and 2014 were identified via public injury reports. Demographic information and performance-related statistics for the identified athletes were recorded for the season before surgery and 2 seasons after surgery and were compared with information for matched controls. Statistical analyses were used to assess differences in recorded metrics.Results:A total of 24 athletes with Achilles ruptures met inclusion criteria, 17 (70.8%) of whom were able to return to play. On average, players had 8.3 years of professional-level experience prior to sustaining an Achilles rupture. Among athletes who returned to play, no differences were found in the number of games played or started, minutes played, or goals scored 1 year postoperatively compared with the year prior to injury. However, 2 years postoperatively, these athletes played 28.3% (P = .028) fewer minutes compared with their preoperative season, despite starting and playing in an equivalent number of games. Matched controls had baseline playing time and performance statistics similar to those of players. However, controls played and started in significantly more games and played more minutes at 1 and 2 years compared with players (P < .05). No differences were found in goals scored at any time point.Conclusion:This is the first investigation examining the effect of an Achilles repair on the career of professional soccer players. This is a difficult injury that most commonly occurs in veteran players and prevents 29.2% of players from returning to play despite surgical management. Additionally, athletes able to return to play were found to play fewer minutes 2 years postoperatively compared with their baseline as well as playing less at 1 and 2 years postoperatively compared with uninjured matched controls. The reduction in playing time following an Achilles repair has significant implications for professional players and teams.

Achilles Tendon Rupture: Mechanisms of Injury, Principles of Rehabilitation and Return to Play

“…The mean rate of athletes being unable to RTP among the above-mentioned studies was 29.7 ± 6.738 [ 19 , 57 , 101 , 102 ], and athletes who did not return to their previous level of sport was 25.5 ± 7.5 [ 103 , 104 ].…”

“…They found that the 70.8% of the selected soccer players were able to return to play, confirming that nearly the 30% of them (29.2%) were unable to return to play, as reported in their other above-mentioned study [ 57 ]. In any case, the major difference between the two studies is that, while in the first study professional athletes reached the same pre-injury performance 2 years post-operatively [ 57 ], in the present study, soccer players were found to play fewer minutes 2 years post-operatively compared with their baseline as well as playing less at 1 and 2 years post-operatively compared with uninjured matched controls [ 102 ]. The reduction in playing time following an Achilles repair has significant implications for professional players and teams [ 102 ].…”

“…Another study by Trofa et al [ 102 ] examined the RTP, playing time, and performance of professional soccer players of the Union of European Football Associations (UEFA) and Major League Soccer (MLS) following ATR. They found that the 70.8% of the selected soccer players were able to return to play, confirming that nearly the 30% of them (29.2%) were unable to return to play, as reported in their other above-mentioned study [ 57 ].…”

Association of Strength Following Achilles Tendon Repair With Return to Same Level of Play in High-Level Athletes

“…27 A meta-analysis comparing minimally invasive vs open repair reported an overall return to play of 78% in 422 patients, with no difference in return to sport between operative techniques. 1 Numerous studies have reported on return to play in professional athletes, including 69.4% in a group of 62 mixed sport professional athletes (National Basketball Association [NBA], National Football League [NFL], and Major League Baseball [MLB]), 38 70.8% to 82% in professional soccer players, 14,39 61% in 18 NBA players, 2 and 72% in 95 NFL players. 18 The method in which “return to play” was defined and the degree to which the same level of play vs any level of play was considered is heterogenous or unclear in these prior studies.…”

“…Following Achilles tendon rupture, return to play has been reported to be 67% to 78% in a general population and between 61% and 82% in professional athletes. 1,2,14,18,20,26,27,38,39 However, existing literature has poorly defined factors that are associated with the ability to return to play.…”