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Return to play and performance after patellar fracture in American professional sports: a case-control cohort
Brady P Moore1, Caitlin M Hackl1, Sterling C Kneedler2
1John Sealy School of Medicine, The University of Texas Medical Branch, Galveston, TX, USA.
Objectives:
This study describes the effects of patellar fracture on return to play (RTP) and functional outcomes among athletes in American professional sports.
Methods:
Professional athletes from the National Football League (NFL), National Basketball Association (NBA), Major League Baseball (MLB), and National Hockey League (NHL) who suffered a patellar fracture between January 1965 and December 2021 were identified through injury reports and public archives. Performance scores, play time, and games played were collected for the season preceding patellar fracture and 2 seasons after RTP, and differences in recorded metrics compared to pre-injury levels and matched controls were analyzed.
Results:
Twenty-nine of 41 (71%) injured athletes returned to play at an average of 217 days. Among all players, play volume decreased in year 1 compared to baseline but recovered to pre-injury levels in year 2. Athletes treated operatively experienced an initial decline in performance (p < 0.01) but recovered to pre-injury performance level in year 2. Nonoperative management resulted in a decline in performance in year 2 of RTP (p = 0.02). Athletes treated operatively performed significantly worse than matched controls in year 1 of RTP (64% vs. 99%; p = 0.04) but recovered to a similar level of performance as controls in year 2 (87% vs. 91%; p = 0.90).
Conclusion:
A 71% rate of RTP was demonstrated among this limited cohort of 29 athletes in American professional sports after isolated patellar fracture. Although details regarding fracture characteristics and operative reports were not available for analysis, operative management was not associated with longer absence from play compared to nonoperative treatment. Despite the limitations of this study, the findings suggesting operative management may improve prospects of maintaining elite performance following RTP warrant further investigation.
Level Of Evidence:
Case-control cohort analysis; Level of evidence, 3.
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