ArticleOrthopaedic journal of sports medicine2025
Return to Play and Performance Outcomes After Extensor Mechanism Ruptures in National Football League Athletes.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Extensor mechanism ruptures are career-threatening injuries for professional athletes, especially in the National Football League (NFL). Purpose: To determine the overall return to play (RTP) rate after extensor mechanism ruptures in the NFL, to identify factors influencing injury and return, and to compare postinjury outcomes between patellar tendon (PT) and quadriceps tendon (QT) tears. Study Design: Case series; Level of evidence, 4. Methods: A search of all available PT and QT injuries in NFL history was performed using publicly accessible data. Demographic and player performance data were compared to assess factors influencing the occurrence of either injury type and overall RTP. Among players that returned, mean performance data were compared at 1 and 2 full seasons before and after injury. Results: A total of 74 extensor mechanism injuries were identified, including 45 PT tears and 29 QT tears. The overall RTP rate after extensor mechanism ruptures was 56.8% with a median time to return of 11.3 months. No differences in RTP rates or timing were observed between PT and QT tears. Higher body mass index, lineman positions, and longer preinjury careers were significantly correlated with QT tears. Preseason injuries were associated with significantly lower RTP rates. Overall, athletes who returned played significantly fewer snaps and had lower approximate value in the first full season after return compared with 1 season before injury, with reductions in approximate value persisting into the second season after injury. PT tears were associated with worse deficits in approximate value at 1 season after injury compared with QT tears. Conclusion: Extensor mechanism ruptures in NFL athletes are associated with a low rate of RTP and an extensive recovery period. Athletes and staff should expect reductions in game play and performance in the first season after return, with worse performance deficits after PT tears compared with QT tears. This study highlights the challenges that professional athletes face in resuming play after extensor mechanism ruptures, emphasizing the need for improved prevention and rehabilitation measures tailored to these career-threatening injuries.
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