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Matched cohort study evaluates performance and career longevity in NFL players post-Achilles injury, indicating lingering effects.
PURPOSE: To evaluate the impact of Achilles tendon ruptures (ATRs) on return to play, longitudinal performance, and career longevity in National Football League (NFL) players using a matched cohort design. METHODS: A retrospective matched cohort study of 62 NFL players who sustained ATRs between 2008 and 2022, matched 1:1 to 62 non-injured controls by position, age (±1 year), height (±2 inches), weight (±10 lbs), and years in league (±1 year). Return-to-play (RTP) was assessed using multivariable logistic regression. Performance was measured using Approximate Value (AV) across three seasons before and after injury. Mixed-effects difference-in-differences modeling with placebo testing and survival analysis were the primary analytic methods. CONCLUSIONS: ATRs in NFL players are associated with significant and persistent performance decline beyond natural career aging, despite a high RTP rate. Return to play does not equate to restoration of pre-injury performance or preservation of career longevity. LEVEL OF EVIDENCE: Level III, retrospective matched cohort study.
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Prempeh et al. (2026) studied this question.
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