Meniscectomy can shorten NFL careers

KEYSTONE, Colo. — A matched control study of National Football League (NFL) players indicated that those who underwent isolated meniscectomy had significantly shorter careers and played fewer games in the league, whereas players who had ACL reconstruction actually had slightly longer careers and played more games than the controls.

“On average, athletes who had a history of meniscectomy had about 1.5 years less in the league and they played about 23 fewer games in the league,” Robert H. Brophy, MD, said at the American Orthopaedic Society for Sports Medicine 2009 Annual Meeting, here. “There was a trend toward fewer games started, but that did not reach significance.”

He said isolated ACL reconstruction did not reduce the mean length of the careers of the cohort. “In fact, the median career of those with an ACL reconstruction was slightly longer than the control group in both years and games played.”

Reconstruction plus meniscectomy

A combination of ACL reconstruction and meniscectomy, however, may be more detrimental to an athlete’s career than the ACL surgery alone, he said.

“Meniscectomy is the most common surgical procedure performed on American football athletes. The morbidity of the meniscectomy in this group may be related to the increased body weight of these athletes as well as the high loads placed on the knees in professional football,” he said. “Also, the functional demand in professional football may increase degenerative change in the meniscectomized knee.”

For the investigation, Brophy and colleagues used a database containing career history and NFL statistics on athletes who entered the league from 1987 to 2000 to match athletes with a history of meniscectomy or ACL reconstruction to controls. Overall, they found 54 athletes who had a history of meniscectomy, 29 with a history of ACL reconstruction and 11 with a history of both procedures.

Matching controls

Control patients were matched by position played and had to enter the league within 2 years and get drafted within two rounds of the player with whom he was matched. “We had one matched control for each player; 32 of them were in the same year and round drafted, 57 were within 1 year and/or round, and 5 were within 2 years and/or rounds,” Brophy said.

According to Brophy, weaknesses of the study included:

it was a retrospective review of a database of information that was collected prospectively at the combine;
there are no data on the status of the articular cartilage or the size or location of the meniscal lesion;
the small sample size; and
there were no meniscal repairs.

“Successful ACL reconstruction enabled these athletes to have a similar length career as their counterparts,” he said. “Meniscectomy has a shorter recovery time, but these surgeries lead to a significantly shorter career over time, and a combination of these surgeries may be more detrimental to the athletes than either surgery in isolation.”

Reference:
Brophy RH, Gill CS, Lyman S, et al. Effect of ACL reconstruction and meniscectomy on career length in NFL athletes: A case control study. Presented at the American Orthopaedic Society for Sports Medicine 2009 Annual Meeting. July 9-12, 2009. Keystone, Colo.