Original Article
Performance Outcomes of Anterior Cruciate Ligament Reconstruction in the National Basketball Association

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Purpose

The purpose of this study was to determine the rate of return to play and to quantify the effect on the basketball player's performance after surgical reconstruction of the anterior cruciate ligament (ACL).

Methods

Surgical injuries involving the ACL were queried for a 10-year period (1993-1994 season through 2004-2005 season) from the database maintained by the National Basketball Association (NBA). Standard statistical categories and player efficiency rating (PER), a measure that accounts for positive and negative playing statistics, were calculated to determine the impact of the injury on player performance relative to a matched comparison group. Over the study period, 31 NBA players had 32 ACL reconstructions. Two patients were excluded because of multiple ACL injuries, one was excluded because he never participated in league play, and another was the result of nonathletic activity.

Results

Of the 27 players in the study group, 6 (22%) did not return to NBA competition. Of the 21 players (78%) who did return to play, 4 (15%) had an increase in the preinjury PER, 5 (19%) remained within 1 point of the preinjury PER, and the PER decreased by more than 1 point after return to play in 12 (44%). Although decreases occurred in most of the statistical categories for players returning from ACL surgery, the number of games played, field goal percentage, and number of turnovers per game were the only categories with a statistically significant decrease. Players in the comparison group had a statistically significant increase in the PER over their careers, whereas the study group had a marked, though not statistically significant, increase in the PER in the season after reconstruction.

Conclusions

After ACL reconstruction in 27 basketball players, 22% did not return to a sanctioned NBA game. For those returning to play, performance decreased by more than 1 PER point in 44% of the patients, although the changes were not statistically significant relative to the comparison group.

Level of Evidence

Level IV, therapeutic case series.

Section snippets

Methods

The National Basketball Athletic Trainers Association maintains a database of all injuries and illnesses occurring in NBA players that (1) required physician referral and/or prescription medication, (2) resulted in a practice or game being missed, or (3) caused emergency care to be rendered to the athlete. These records are based on a standardized, league-wide injury-reporting instrument that is completed by each team's athletic trainer. The primary information collected includes the player's

Results

Of the 1,144 players in the database during the seasons studied, we identified 31 players (2.7%) who underwent 32 ACL reconstructions. From this group, 4 players were excluded from further analysis: One player sustained a non–sports-related injury, one player did not participate in a league game before injury (training camp injury), and two patients had multiple ACL injuries to the same knee. A total of 27 cases (0.5%) were used for further analysis (Table 1). Of the 27 patients, 21 (78%)

Player Outcomes

Although complete ACL injuries are relatively rare in the NBA, with a game-related injury rate of 0.1 per 1,000 athletic exposures, the rate of return to sports participation and the effect on player performance have not been previously evaluated.1 In a previous NBA study, ACL injuries resulted in 1,997 games and 3,703 days (practices and games) missed.1

The results of our study are similar to those of a previous study of NFL running backs and wide receivers after ACL reconstruction. We found

Conclusions

After ACL reconstruction in 27 basketball players, 22% did not return to a sanctioned NBA game. Performance decreased by more than 1 PER point in 44% of the patients returning to play, although the changes were not statistically significant relative to the comparison group.

Acknowledgment

The authors thank the National Basketball Athletic Trainers Association for their assistance in collecting these data and Stephen G. Busfield for creating the figures.

References (12)

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The authors report no conflict of interest.

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