Athletic Performance in the National Basketball Association After Arthroscopic Debridement of Osteochondral Lesions of the Talus

Orthop J Sports Med. 2021 Jan 6;9(1):2325967120970205. doi: 10.1177/2325967120970205. eCollection 2021 Jan.


Background: Use of marrow-stimulating techniques to treat osteochondral lesions of the talus (OLTs) in National Basketball Association (NBA) players is controversial.

Hypothesis: NBA players will be able to return to preinjury playing status after treatment of OLTs by arthroscopic debridement alone without marrow-stimulating techniques.

Study design: Cohort study; Level of evidence, 3.

Methods: Between the 2000 and 2015 seasons, 10 NBA players were treated with arthroscopic debridement of an OLT. The following performance outcomes were compared pre- and postoperatively: seasons played, games played, games started, minutes per game, points per game, field goals, 3-point shots, rebounds, assists, double doubles, triple doubles, steals, blocks, turnovers, personal fouls, assists per turnovers, steals per turnovers, NBA rating, scoring efficiency, and shooting efficiency. In addition, the players were compared with a matched control group using mixed effects regression and Fisher least significant difference modeling.

Results: All 10 players returned to play in the NBA after arthroscopic debridement without microfracture or drilling of an OLT. When compared with preoperative performance, postoperative mean points scored, assists made, and steals made increased by 2.86 (P = .042), 0.61 (P = .049), and 0.15 (P = .027), respectively. Only field goal percentage decreased postoperatively when compared with matched controls; however, this normalized by the end of the second season after surgery. There was no statistically significant change in any of the other performance factors when compared with matched controls. All patients returned to basketball during the same season (n = 1) or the following season (n = 9) if the operation was performed off-season. The mean length of career after surgery was 4.1 years, with 5 players still playing in the league at the time of this study.

Conclusion: After arthroscopic debridement of an OLT without drilling or microfracture, there was a high rate of return to the NBA, with improved points scored, assists, and steals made after surgery when compared with preoperative performance. There was no statistically significant change in any performance factors when compared with uninjured matched controls. Lesion size did not affect player career length. These data should be used to manage patients' and teams' expectations regarding players' ability to return to elite levels of athletic performance after surgery of an OLT.

Keywords: NBA players; National Basketball Association; OCD; osteochondral lesions of the talus; return to sport.