Impact of anterior cruciate ligament tears on player efficiency ratings and salary in National Basketball Association over the past 20 years: a retrospective case control study.

OBJECTIVES

Players in the National Basketball Association (NBA) are at high risk for ACL tears which are detrimental to their career due to the months of rehabilitation. The authors hypothesize that after anterior crucial ligament (ACL) injury, older players will be less likely to return to the NBA, players that do return will have a lower performance efficiency rating (PER), and the decrease in PER will be associated with a lower salary.

METHODS

This case-control study utilized the publicly available database maintained by the NBA, professional basketball players from 2002 to 2022 who suffered an ACL tear were identified. Controls, without ACL tears, were matched by age, BMI, position, race, and average minutes played before the injury date to uninjured controls. Return to NBA, pre-injury and post-return player efficiency ratings (PER), and salary change after injury were analyzed by multivariate analyses.

RESULTS

A total of 67 players suffered an ACL tear. Fifty-six (83.6%) players returned to the NBA at some point after their injury, while 11 (16.4%) did not. Multivariate logistic regression showed that older age and the presence of multi-ligament injury predicted retiring from the NBA (ß = 1.4 and 10.7). Older age and greater minutes played before surgery to be the only significant predictors of decreased PER after return to the NBA (ß = -0.5 and -0.2). Players with a multiyear contract and with improvements in PER after injury tended to have greater salary increases (ß = 6.5 and 0.7). All  < 0.05. PER in players with ACL tears decreased by about 3 points (13.1 to 9.9) compared to controls without ACL tears (13.2 to 12.9).

CONCLUSION

Older age and multiligament injuries are associated with retiring for the NBA; older and increased minutes played are associated with a decreased PER upon return; and, PER decreases are associated with decreased salary. Players with ACL tears, even when case-control matched, showed decreased PER upon return. These results can be attributed to age-related changes in athleticism and health.