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There is a high return to sport rate but with reduced career lengths after Achilles tendon repair in Major League Soccer players
  1. Kyle R Sochacki,
  2. Robert A Jack II,
  3. Takashi Hirase,
  4. Patrick C McCulloch,
  5. David M Lintner,
  6. Kevin E Varner,
  7. Pedro E Cosculluela,
  8. Joshua D Harris
  1. Orthopedic and Sports Medicine, Houston Methodist, Houston, Texas, USA
  1. Correspondence to Dr Joshua D Harris, Houston Methodist Orthopedics & Sports Medicine, Houston TX 77030, USA; joshuaharrismd{at}


Objectives To determine (1) return to sport (RTS) rate in Major League Soccer (MLS) players following Achilles tendon repair, (2) postoperative career length and games per season, (3) preoperative and postoperative performance, and (4) postoperative performance compared with control players matched by position, age, body mass index, sex, years of experience and performance.

Methods Publicly available records were used to identify MLS players who underwent Achilles tendon repair with a minimum of 1 year follow-up. Demographic and performance data were collected for each player. Matched controls were identified. RTS was defined as playing in one or more MLS games after surgery. Comparisons between case and control groups and preoperative and postoperative time points were made using paired sample Student’s t-tests.

Results Twenty-two players (mean age 28.4±4.0 years; mean 3.0±2.2 years follow-up) and 23 Achilles tendon repairs (one bilateral repair) were analysed. Seventeen players (18 Achilles tendon repairs; 77.3%) were able to RTS in the MLS at mean 306.6±199.2 days. Players who RTS after repair had shorter careers than matched controls (2.5±2.2 vs 4.5±3.0 seasons, respectively; p=0.021). Additionally, players who RTS after repair played in fewer games per season than matched controls (13.4±8.4 vs 23.2±6.5, respectively; p<0.001). There was no significant decrease in performance postsurgery compared with presurgery.

Conclusion There is a 77.3% RTS rate in the MLS following Achilles tendon repair. Following repair, players had shorter careers and played fewer games per season than matched controls. There was no significant decrease in performance postsurgery compared with presurgery nor in postsurgery compared with postindex. A significantly greater number of Achilles tendon tears occurred in the left versus the right lower extremity.

Level of evidence Level III.

  • ankle
  • outcome studies
  • sport specific injuries
  • tears
  • tendon
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  • Contributors All the authors have been actively involved in the planning and enactment of the study, and have also assisted with the preparation of the submitted article. The manuscript has been read and approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests PCM: speaker’s bureau/paid presentation by company/supplier (Vericel); research support from company/supplier (DePuy, a Johnson & Johnson company; Arthrex); Medical/Orthopaedic Publications editorial/governing board (Journal of Knee Surgery; KEV: IP royalties: Solana; consultant (paid): Solana; stock/stock options: Wright Medical. JDH: AAOS: board or committee member; American Orthopaedic Society for Sports Medicine: board or committee member; Arthroscopy: editorial or governing board; Arthroscopy Association of North America: board or committee member; DePuy, a Johnson & Johnson company: research support; Frontiers In Surgery: editorial or governing board; NIA Magellan: paid consultant; SLACK: publishing royalties, financial or material support; Smith & Nephew: paid presenter or speaker, paid consultant, research support; Ossur: paid speaker. KRS, RAJ, TH, DML and PEC declare no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

  • Patient consent Not required.

  • Ethics approval An ethics committee was not required during this research. Data were obtained from publicly available records.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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