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Our aim in performing this study was to evaluate whether fantasy and wins above replacement (WAR) scores of athletes undergoing anterior cruciate ligament (ACL) reconstructive surgery in the National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) could be utilized in evaluating their performance post-surgery. We identified publicly accessible data on professional athletes from 1992 to 2015. Fantasy and WAR scores were calculated for each player. A total of 83 professional players met the inclusion criteria for this cross-sectional study. Decreased fantasy scores ranged from 33% to 42% across the four leagues after the index operation. NHL players had the lowest return-to-play (RTP) rate at 11/17 (82%), and MLB players had the highest RTP rate at 14/15 (93%). RTP rates of NBA and NFL players were comparable at 22/26 (85%) and 22/25 (88%), respectively. NFL players had the lowest average career length after surgery at 26 months, while NBA players had the longest average career length at 64 months. MLB players on average required the longest time to return to the pre-surgical level of performance (21 months). NHL players had the shortest average recovery time (eight months), and NBA players had the longest average recovery time (13 months). Approximately, more than half of all the studied players exhibited a decline in fantasy or WAR scores. In addition, NFL players had the lowest average career length, and NBA players enjoyed the longest average career length after surgery. NHL players had the lowest recovery time, while NBA players had the longest recovery time. The strength of this study is the utilization of fantasy points and WAR scores as a single unifying measure of a player's performance, which acts as an objective measure after ACL reconstruction. The average performance of a professional athlete, as evaluated through their fantasy score output, tends to decrease after undergoing ACL reconstruction. There is an overall long-term performance decline after initial spikes in their performance after surgery. Additional larger studies are needed to fully understand the effects of ACL reconstruction in professional athletes; however, the use of fantasy scores may be an objective tool in measuring the success rate of ACL reconstruction.
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Purpose: To demonstrate the learning curve associated with the arthroscopic Latarjet procedure and create a timetable to proficiency. Methods: Using retrospective data of a single surgeon, consecutive patients who had an arthroscopic Latarjet procedure performed between December 2015 and May 2021 were initially reviewed for inclusion in the study. Patients were excluded if medical data were insufficient for accurate surgical time record, their surgery was transitioned to open or minimally invasive, or if their surgery was performed in conjunction with a second procedure for a separate issue. All surgeries were performed on an outpatient basis and sports participation was the most common reason for initial glenohumeral dislocation. Results: Fifty-five patients were identified. Of these, 51 met the inclusion criteria. Analysis of operative times for all 51 procedures demonstrated that proficiency with the arthroscopic Latarjet procedure was obtained after 25 cases. This number was determined by 2 methods using statistical analysis (P < .05). The average operative time over the course of the first 25 cases was 105.68 minutes and beyond 25 cases was 82.41 minutes. Male gender was seen in 86.3 percent of the patients. The average age of the patients was 28.6 years old. Conclusions: With continued transition towards bony augmentation procedures for addressing glenoid bone deficiency there is an increasing demand for the arthroscopic bony glenoid reconstruction procedures including the Latarjet procedure. It is a challenging procedure with a substantial initial learning curve. For a skilled arthroscopist there is a significant decrease in overall surgical time after the first 25 cases. Clinical Relevance: The arthroscopic Latarjet procedure has advantages over the open Latarjet approach; however, it is controversial because it is technically challenging. It is important for surgeons to understand when they can expect to be proficient with the arthroscopic approach.
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Background: Several reports have shown that shoulder stabilizing procedures lead to postoperative external rotation (ER) deficits. However, no study on arthroscopic Latarjet procedures has investigated the effect on ER when the arm is abducted at 0° (ER0) and 90° (ER90). This study examined the relationship between the arthroscopic Latarjet procedure and the subsequent effect on ER0 and ER90. Methods: Patients who underwent an arthroscopic Latarjet procedure from December 2015 to April 2021 were retrospectively evaluated. Preoperative ER0 and ER90 values were obtained from the contralateral shoulder. ER0 and ER90 values from the operative side were collected at both 3 and 6 months postoperatively. A repeated measures ANOVA was performed to assess the mean preoperative and postoperative values. Results: Forty-six patients met the inclusion criteria. Mean ER0 for the 3- and 6-month time frames measured 44.2° and 54.6°, respectively. Mean ER90 for the 3- and 6-month time frames measured 78.4° and 90.4°, respectively. Comparison to the contralateral arm at the 3-month follow-up period showed a deficit of 14.9° (P = .0001) and 17.2° (P = .0001) for ER0 and ER90, respectively. At the 6-month follow-up period, patients demonstrated an average decline in ER0 and ER90 of 4.57° (P = .063) and 5.11° (P = .008), respectively. Conclusion: A nominal deficit in ER occurred for both ER0 and ER90 status post arthroscopic Latarjet procedure. Despite loss of ER90 at 6 months achieving statistical significance, the clinical impact is arguably inconsequential. Such limited loss of ER provides more information regarding bony procedures being a more definitive treatment for glenohumeral instability and the ability to restore native motion.
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Fractures of the coracoid process are uncommon injuries and are usually the result of high-energy trauma or avulsion-type injuries. Typically coracoid fractures treated with nonoperative management have yielded good results. Operative treatment of coracoid fractures is reserved for a subset of clinical situations, including fracture nonunion. We detail our technique for arthroscopic debridement of a Type II coracoid fracture nonunion, as well as the use of arthroscopic-assisted percutaneous fixation for a Type II coracoid fracture.
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INTRODUCTION: The treatment of Lumbar Disc Herniation (LDH) in elite athletes is a debated topic that lacks consensus in the literature due to varying outcome reporting methods. The objective of this study was to quantify the overall performance of a sample of professional athletes before and after receiving a lumbar discectomy or microdiscectomy in a cohort of players in the National Football League (NFL), National Basketball Association (NBA), National Hockey League (NHL) and Major League Baseball (MLB). METHODS: The authors identified publicly accessible data from a cohort of different types of professional players who received either a lumbar discectomy or a microdiscectomy. These records were identified through newspaper archives, injury reports, player profiles and press releases between 1993 through 2015. Fantasy and Wins Above Replacement (WAR) scores were calculated for each player. RESULTS: A total of 38 professional players met study inclusion criteria. NFL players had the lowest return-to-play (RTP) at nine of 14 (64%). The RTP for NBA, NHL and MLB players were comparable with 6/7 (86%) vs 8/9 (89%) vs 7/8 (88%). NFL players had the lowest average career length after surgery at 34.8 months, while NBA players had the longest average career length at 48 months. MLB players on average required the longest time to return to presurgical level of performance (24 months) and required the longest average recovery time at 12 months. CONCLUSIONS: Based on these results, the average performance of most elite athletes are likely to decrease after undergoing a lumbar discectomy. Although it appears that performance peaks in the initial years after the operation for some players, there was an overall long-term decline in this sample of elite athletes. Study limitations included small sample size, lack of controlling for possible confounding variables (e.g., age, etc.) and use of variable reporting sources. Additional studies with larger sample sizes and age-matched controls are needed to examine the effects of lumbar discectomy more comprehensively in elite athletes.
