Elaine He

PUBLICATION: PERFORMANCE AFTER ACL RECONSTRUCTION IN NBA PLAYERS

Abstract

Background:

Anterior cruciate ligament (ACL) injury in National Basketball Association (NBA) players can have a significant impact on player longevity and performance. Current literature reports a high rate of return to play, but there are limited data on performance after ACL reconstruction (ACLR).

Purpose/Hypothesis:

To determine return to play and player performance in the first and second seasons after ACLR in NBA players. We hypothesized that players would return at a high rate. However, we also hypothesized that performance in the first season after ACLR would be worse as compared with the preinjury performance, with a return to baseline by postoperative year 2.

Study Design:

Case series; Level of evidence, 4.

Methods:

An online database of NBA athlete injuries between 2010 and 2019 was queried using the term ACL reconstruction. For the included players, the following data were recorded: name; age at injury; position; height, weight, and body mass index; handedness; NBA experience; dates of injury, surgery, and return; knee affected; and postoperative seasons played. Regular season statistics for 1 preinjury season and 2 postoperative seasons were compiled and included games started and played, minutes played, and player efficiency rating. Kaplan-Meier survivorship plots were computed for athlete return-to-play and retirement endpoints.

Results:

A total of 26 athletes underwent ACLR; of these, 84% (95% CI, 63.9%-95.5%) returned to play at a mean 372.5 days (95% CI, 323.5-421.5 days) after surgery. Career length after injury was a mean of 3.36 seasons (95% CI, 2.27-4.45 seasons). Factors that contributed to an increased probability of return to play included younger age at injury (odds ratio, 0.71 [95% CI, 0.47-0.92]; P = .0337) and fewer years of experience in the NBA before injury (odds ratio, 0.70 [95% CI, 0.45-0.93]; P = .0335). Postoperatively, athletes played a significantly lower percentage of total games in the first season (48.4%; P = .0004) and second season (62.1%; P = .0067) as compared with the preinjury season (78.5%). Player efficiency rating in the first season was 19.3% less than that in the preinjury season (P = .0056). Performance in the second postoperative season was not significantly different versus preinjury.

Conclusion:

NBA players have a high rate of RTP after ACLR. However, it may take longer than a single season for elite NBA athletes to return to their full preinjury performance. Younger players and those with less NBA experience returned at higher rates.

 

To read the full article, please visit the site website here.

Elaine He

PUBLICATION: INCIDENCE OF COMBAT SPORT-RELATED MILD TRAUMATIC BRAIN INJURIES PRESENTING TO THE EMERGENCY DEPARTMENT FROM 2012 TO 2016

Abstract

Objectives: We sought to investigate the incidence and characteristics of traumatic brain injuries [mild traumatic brain injury (MTBI)] presenting to the emergency department as a result of boxing, wrestling, and martial arts (MA).

Design: Retrospective cross-sectional study of MTBI in combat sport athletes who were evaluated in emergency departments in the United States.

Setting: Patient data were taken from the National Electronic Injury Surveillance System.

Participants: All patients with MTBI from 2012 to 2016, which occurred during participation in boxing, MA, or wrestling.

Interventions: None.

Main outcome measures: The incidence of combat sport-related MTBI presenting to emergency departments in the United States.

Results: The mean annual incidence of MTBI due to wrestling was significantly larger (269.3 per 100 000 person-years) than boxing (85.6 per 100 000 person-years) and MA (61.0 per 100 000 person-years) (P < 0.01). The average age at injury was significantly lower for wrestling compared with boxing and MA (15.0 years [SD ± 3.9] vs 21.7 years [SD ± 8.2] vs 19.9 years [SD ± 10.5]; P < 0.01). A significantly larger proportion of MTBIs (95.3%; P < 0.01) in patients younger than 20 years were related to wrestling, compared with boxing (55.8%) and MA (54.1%). Most patients with combat sport-related MTBIs were treated and discharged (96.3%), with only 1.7% of patients being admitted and 0.6% of patients being held for observation.

Conclusion: Combat sports athletes are at high risk of sustaining an MTBI. Such athletes presenting to the emergency department for combat sport-related MTBI were more likely to be male and younger than 20 years. Of these athletes, wrestlers experience the highest incidence of MTBI-related emergency department visits.”

To read the full article, please visit the journal site here.

Elaine He

RHODE ISLAND MEDICAL JOURNAL: SEPTEMBER SPORTS MEDICINE ISSUE

Dr. Brett Owens and Dr. Ramin Tabaddor were Guest Editors for the Rhode Island Medical Journal September 2020 Sports Medicine issue. This issue covered “The Bigger Picture” of sports medicine in light of COVID-19. Please check out the contributions from multiple members of our lab using the links below!

See the full issue here.

SPORTS MEDICINE
Guest Editors:   BRETT D. OWENS, MD; RAMIN R. TABADDOR, MD
[Complete 49-page Themed Section]
Sports Medicine: The Bigger Picture
BRETT D. OWENS, MD
RAMIN R. TABADDOR, MD
COVID-19 and Review of Current Recommendations for Return to Athletic Play
JAMES DOVE, MD
ANDREW GAGE, MD
PETER KRIZ, MD;
RAMIN R. TABADDOR, MD
BRETT D. OWENS, MD
Shoulder and Elbow Injuries in the Adolescent Throwing Athlete
STEVEN DeFRODA, MD, MEng
PATRICK McGLONE, BS, MD’21
JAMES LEVINS, MD
RYAN O’DONNELL, MD
ARISTIDES I. CRUZ, MD, MBA
PETER K. KRIZ, MD
Management of Anterior Shoulder Instability for the In-Season Athlete
NICHOLAS J. LEMME, MD
RYAN O’DONNELL, MD
JACOB MODEST, MD
MATTHEW QUINN, MD
BRETT D. OWENS, MD
Bridge-Enhanced Anterior Cruciate Ligament Repair: The Next Step Forward in ACL Treatment
ERIN K. HAGGERTY, MD
STEPHEN E. MARCACCIO, MD
PAUL D. FADALE, MD
MICHAEL J. HULSTYN, MD
BRETT D. OWENS, MD
A Clinician’s Guide to Femoacetabular Impingement in Athletes
KEVIN DiSILVESTRO, MD
MATTHEW QUINN, MD
RAMIN R. TABADDOR, MD
The Weekend Warrior: Common Hand and Wrist Injuries in Athletes
JOSEPH A. GIL, MD
ARNOLD-PETER C. WEISS, MD
Foundational Health for Runners: Is it the Key to Minimizing Injury?
MICHAEL SILVA, MS, PT, CSCS
LAUREN V. READY, MPH, MD’21
CHRISTINE M. ETZEL, ScB
Athletic Pubalgia
WILLIAM BINDER, MD
RAMIN R. TABADDOR, MD
JEFFREY FEDEN, MD
Elaine He

SPORTS INJURY LAB FEATURED IN THE BROWN DAILY HERALD: HOW OUR LAB IS ADJUSTING RESEARCH DUE TO COVID-19

Faculty reimagine their research, research-based courses during COVID-19:

Despite the extraordinary situation our labs have been placed in due to the pandemic, we’ve been adjusting our research schedules to work with students remotely. Given the nature of the current semester, we are doing our best to support our students during this difficult time while forging ahead with work in the Sports Injury Lab and the Cartilage Research Lab led by Dr. Brett Owens.

Read more from the Brown Daily Herald about how Covid-19 has impacted our lab and other labs on Brown’s campus and how we’re dealing with this unique time. Please see the full article here.

Elaine He

DR. OWENS RANKED AMONG THE TOP WORLDWIDE IN ORTHOPEDIC EXPERTISE BY EXPERTSCAPE

Dr. Owens is 1 of 13 members from University Orthopedics to be recognized as an Expertscape Experts or World Experts in one or more medical topics. This is a particularly significant distinction, as this recognition is objectively arrived at using the latest ten years of NIH’s PubMed database and Expertscape’s patented methodology. Dr. Owens was noted for his expertise in Orthopedic Procedures, Arthroscopy, and Shoulder Injuries.

This award is a direct result of the extensive research and complex clinical cases Dr. Owens completes, evident by his 300+ peer-reviewed publications. To be considered an Expertscape Expert, the person needs to be among the top 1% worldwide in research and publications in a specific medical topic, and to be recognized as a World Expert requires the faculty member to be among the top 0.1% worldwide.

To read more from the University Orthopedics press release, please go here.

To learn more about Expertscape, visit their website here.

Elaine He

RECENT STUDY FEATURED IN THE BROWN DAILY HERALD TO PROMOTE EQUITABLE HEALTHCARE IN RHODE ISLAND

Dr. Brett Owens was mentioned in a Brown Daily Herald article to discuss the advancement of healthcare in Rhode Island. The article focuses on a study by Dr. Owens looking at socioeconomic status and insurance status of patients affected by shoulder instability injuries in the All-Payers Claim Database (APCD) of RI. This project looks to better understand the long-term outcomes for orthopedic injuries and better grasp the state of care in RI with the hope of ensuring equitable care for all in the future.

To read the full article by Zachary Levin, please go to the Brown Daily Herald website here.

Elaine He

SPORTS INJURY LAB IN THE NEWS: AAOS NOW SPECIAL EDITION PUBLICATION

Sports Injury Lab member Lauren V. Ready’s article on Achilles Tendon Tears in the NFL was recently featured in the AAOS Now Special Edition.

The retrospective study was presented as part of the Annual Meeting Virtual Experience and assessed Achilles tendon (AT) tears in National Football League (NFL) players, finding that a relatively large percentage of injuries occurred in rookie players during the preseason, whereas AT tears during the regular season occurred only in veteran players.

 

nfl-rookie-table-1.jpg
In-game Achilles tendon tears by week.

 

Lauren stated, “With more than half of rookies not returning to play post-AT rupture, future research should focus on this overlooked population and attempts to safely introduce athletes to a professional level of play.”

Congrats to Lauren and her co-authors on sharing your research!

To read the Sports Injury Lab publication, please visit the here.

To read the full AAOS article, please click here.

Elaine He

FOCUS ON WHAT YOU CAN CONTROL: DR. OWENS’ ADVICE TO ATHLETES DURING COVID19

Dr. Owens appeared on GoLocalProv LIVE “Smart Health” to offer advice to athletes during Covid19.

“These are unprecedented times and you know sports certainly has taken a back burner at every level — of course, the professional athletes get the most attention but college sports has been a huge hit,” said Owens. “For injured athletes, it does make things a little bit easier in my office. When I’m working with athletes that are recovering from knee or should surgery, there’s very much always that sense of fear of missing out — and that’s not there,” said Owens. “But there’s certainly a lot of missing out to go around.  Athletes want to be able to be back in full performance and I think potentially using this time to really refocus their rehab efforts is helpful, but for all athletes, it’s extremely frustrating.”

Watch the live interview here:

 

 

See the full article online here.

We wish the best for all of our athletes and their families during this time!

Elaine He

SPORTS INJURY LAB PUBLICATION: PERFORMANCE AFTER OPERATIVE VERSUS NON-OPERATIVE MANAGEMENT OF SHOULDER INSTABILITY IN THE NATIONAL BASKETBALL ASSOCIATION

Abstract

Background:

Although nonoperative management after shoulder instability injury allows an athlete to return to play sooner than operative intervention, higher rates of recurrence have been observed after nonoperative management. However, no study has investigated the differences in performance of National Basketball Association (NBA) players after index shoulder instability events managed nonoperatively versus operatively.

Purpose/Hypothesis:

The purpose of this study was to identify shoulder instability events in NBA athletes and assess differences in performance after injury with nonoperative versus operative management. We hypothesized that players who undergo operative intervention have reduced risk of recurrence and are able to continue their elite level of play as opposed to those who undergo nonoperative management.

Study Design:

Cohort study; Level of evidence, 3.

Methods:

Publicly available injury data from the 1986-1987 through 2017-2018 seasons were reviewed to identify NBA athletes sustaining a shoulder instability event. In addition to characteristics, player performance information, including games played, player efficiency rating (PER), and win shares, was analyzed before and for 3 seasons after injury. Statistical learning models were applied to identify performance variables that have the greatest predictive value to determine players who would benefit from surgery.

Results:

A total of 60 players with shoulder instability events were identified between 1986 and 2018. After injury, 37 players (61.7%) eventually underwent surgery and 23 players (38.3%) did not. Players who were treated nonoperatively had significantly decreased PER, games played, and offensive win shares in the season after injury (P < .05). Players who underwent surgery did not see a decline in PER, games played, or win shares. Random forest modeling found that true shooting percentage and win shares per 48 minutes were the performance variables most predictive in determining which players would benefit from surgery after shoulder instability.

Conclusion:

Players who underwent surgical intervention for shoulder instability maintained their PER, games played, and win share performance characteristics, whereas players who did not undergo surgery had declines in these parameters. Given the demands of shoulder function in basketball and the risk of recurrence after an instability event, surgery enhances a player’s opportunity to maintain a high level of performance after injury.”

To read the full article, please visit the journal website here.

Elaine He

SPORTS INJURY LAB PUBLICATION: SUDDEN CARDIAC DEATH IN THE ADOLESCENT ATHLETE: HISTORY, DIAGNOSIS, AND PREVENTION

Abstract

Sudden cardiac death in young athletes is a devastating condition that occurs without warning. While most middle and high school athletes require preparticipation screening, many predisposing conditions go undiagnosed until they occur. The frequency of sudden cardiac death is often under-reported because there is no mandatory system for reporting sports-related death in high school sports. Additionally, there is debate about the cost-effectiveness of more advanced screening tests, such as electrocardiogram, due to high false-positive rates. It is, however, accepted that participants with a family history of sudden cardiac death should undergo more in-depth screening. If sudden cardiac arrest occurs, it is important for the patient to undergo immediate defibrillation. Community outreach to ensure that automated external defibrillators are present at athletic events, as well as cardiopulmonary resuscitation training for coaches, could potentially save lives. Ultimately, prevention of sudden cardiac death depends on physician awareness of how to properly screen and identify those at risk, and how to best be prepared if sudden cardiac arrest occurs.

To read the full article, please visit the journal website here.