NFL Careers Shortened by Injury Even After Surgery

Often times in sports medicine, athletes see surgical repair of their injury as the quickest and most effective way to get them back in the game, and while that is often true, a recent study by Houston Methodist Orthopedics and Sports Medicine suggests that even after surgical repair some athletes still play fewer games and have shorter career spans.

In “Performance and Return to Sport After Forearm Fracture Open Reduction and Internal Fixation in National Football League Players” published in the August 2017 issue of HAND, Joshua D. Harris, M.D., a Houston Methodist Orthopedics surgeon and colleagues investigated how well open reduction and internal fixation (ORIF) of a forearm fracture sped up recovery and decreased missed games in the National Football League (NFL).

The researchers compared NFL players who underwent ORIF of a forearm fracture while in the NFL to matched controls. Thirty-six surgeries were analyzed and out of them 92% of the players were able to return to the NFL and most did so within approximately five months of their surgery. However, although they returned at their preoperative performance level and played similarly to the control group, ultimately the controls had a longer NFL career (p < .001) and played in more games per season (p = .026) than players who underwent surgery. In addition, there was a decrease (p =.013) in games/season for defensive backs following surgery.

Harris told OTW that “the cases and controls in the study were matched by position, age, years of experience in NFL, and performance data prior to the surgery date in order eliminate confounding variables. This left the forearm fracture as the only variable to account for the shorter career and fewer games.”

“This is likely secondary to the need for high speed and high impact use of the arms in tackling,” he added.

Harris said that this however doesn’t mean that another treatment would necessarily offer better results. Previous studies have shown that surgical fixation of forearm fractures leads to faster recovery and decreased games missed for elite athletes.

Instead he believes that the biggest takeaway from their results is that study should guide sports medicine physicians and front office personnel in their management of these injuries. This will help ensure a better understanding of what to expect post-surgery, that while the overall prognosis is excellent with greater than 90% of players returning to sport with no significant decrease in performance, the athletes’ career length and games per season still may be negatively impacted by the surgery.