Low Rates of Return to Sport and Reduction in Performance Following Acute Achilles Tendon Ruptures in Elite Rugby Union Players

Category: Sports; Other Introduction/Purpose: The purpose of this study was to assess outcomes following acute Achilles tendon ruptures (AATR) sustained by elite rugby union players. Methods: Elite rugby union players who sustained an AATR were identified using a publicly available database, match reports and injury reports. "Elite rugby union" was defined as a player who played professional rugby in the following competitions: United Rugby Championship, Top 14, English Premiership, Super Rugby and international rugby for a top 20 ranked team. The years of inclusion was from 2015-2022. Data collected and analysed: player demographics, player position, if surgical intervention was warranted, rates of return to play (RTP), time to return to play, games missed. Pre-injury and post-injury performance outcomes collected and analysed: games played, tries scored, points scored. Results: Nintety-three elite rugby union players sustained an AATR between 2015-2022 (0.0146 per 10,000 athlete-exposures). The mean age was 27.8±10.1 years and the mean BMI was 30.5±7.6kg/m 2 . There were 61 (65.5%) AATRs sustained by forwards and 32 (34.5%) AATRs sustained by backs. Forty-five (48.3%) of AATRS occurred during the in-season and 48 (51.7%) AATRs occurred during training. All athletes (100%) underwent surgical intervention. The most common mechanism of injury was a non-contact injury (86.4%). The RTP rate was 68.9% at mean time of 8.9±3.9 months. There was a statistically significant decrease in the mean number of games played, tries scored and points scored following RTP. Conclusion: This current study found that AATRs were an uncommon injury in elite rugby union players with an incidence of 0.0146 per 10,000 athlete-exposures. Sustaining an AATR was associated with a 68.9% return to play rate at a mean time of 8.9±3.9 months. There was a statistically significant deterioration in key performance metrics such as mean games played, tries scored and points scored This study reinforces the potentially devastating sequelae following AATR in the elite athletic population.