Pickleball-Associated Achilles Tendon Ruptures: Shifting Achilles Repair Demographics.

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Biomechanical Injury Analysis

Background:

• Pickleball participation has surged by nearly 1000% since 2019, surpassing 36 million players.
• Concurrent rise in tennis participation (33%) and anecdotal reports of musculoskeletal injuries in pickleball.
• Limited data exists on Achilles tendon rupture (ATR) risk in pickleball compared to tennis.

Purpose of the Study:

• To compare the proportional frequency of Achilles tendon ruptures (ATRs) sustained during pickleball versus tennis and other sports.
• To identify specific risk patterns associated with pickleball-related ATRs.
• To provide data for athlete counseling regarding injury prevention.

Main Methods:

• Retrospective review of Achilles tendon repair CPT code 27650 from January 2018 to December 2022.
• Inclusion of 1028 patients (aged 18-75) with acute ATRs treated operatively.
• Categorization of injury mechanism: pickleball, tennis, or other sports; analysis of demographics, complications, and trends.

Main Results:

• Pickleball ATRs occurred in significantly older patients (median 60 years) compared to tennis (45 years) and other sports (37 years).
• 82.5% of pickleball ATRs were in patients >50 years, a higher proportion than tennis (32.6%) or other sports (18.9%).
• Pickleball-related ATRs increased from 0.5% in 2018 to 6.7% in 2021; complication rates were similar across groups.

Conclusions:

• Pickleball-associated ATRs show a distinct demographic pattern, affecting older adults (>50) with a notable increase post-2020.
• No significant difference in postoperative complication rates was found between pickleball and other sports.
• The limited number of pickleball injuries restricts definitive conclusions on comparative safety and injury patterns.