Note: I read Moneyball in 2004. I immediately thought that the Moneyball concept – using data to predict player and team performance – could apply to injuries and surgeries as well. Just like teams are starting to track sleep, hydration, fatigue and other physical data of players, they would collect data on injuries to make better decisions for their teams. When I saw a recent study about the NFL Orthopaedic Surgery Outcomes 
Database, I thought it would make an interesting topic for my newspaper column.
I had the privilege of meeting Billy Beane last summer. Beane is the general manager of the Oakland A’s, best known as the subject of the Michael Lewis bestseller Moneyball.
After he spoke about the use of all kinds of on-field data to predict future performance of players, I asked him about the role of injuries. Beane told me that teams were collecting injury data and that it could soon play a large role in their decision making.
Using data to predict post-injury performance of football players
Football, and the NFL in particular, has the highest injury rates in popular professional sports. Data on return to play and performance after injury would be extremely helpful in a league where return to pre-injury level of performance is necessary for a player to keep his job.
Using injury data to predict performance is challenging in football. Dr. Matt Matava, a former president of the NFL Physicians Society, explained to me that unlike baseball and basketball, football players come in all different sizes and have many different duties on the field. Would an ACL tear in a kicker or quarterback have the same effect on his career that it would for a 300-pound defensive lineman?
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NFL Orthopaedic Surgery Outcomes Database
We are starting to get answers to those questions. A study published last week in the American Journal of Sports Medicine reviewed surgeries collected in the NFL Orthopaedic Surgery Outcomes Database. The authors reviewed data on surgeries performed over a 10-year period. They looked for the effects of those surgeries on return to play, dropout rates from the NFL and on-field performance.
Return to play is likely after many orthopedic surgeries
The study had some good news for NFL players. Overall, 79.4% of players did return to play after undergoing surgery. Some injuries, especially fixation of fractures, like broken legs and forearms, had return to play rates around 90%.
Knee tendon and ligament injuries can have a negative impact on performance
Unfortunately, tendon and ligament injuries of the lower body had a much greater negative impact. Repairs of patella tendon ruptures (the tendon below the kneecap) had the lowest return to play rates of all surgeries. Only 50% of players returned to play after that surgery. ACL reconstructions, patellar tendon repairs and Achilles tendon repairs had the longest average return to play times – all over one year. Plus, they were some of the main surgeries associated with decreased performance after the player returns. They also had the highest rates of dropout from the league in seasons two and three after the surgeries.
Using data on the outcomes of orthopedic surgeries
There are several reasons athletes should care about this study and the data teams and team physicians are starting to collect. First, doctors will be better able to predict how likely an athlete can not only fully recover from a surgery but also return to his preinjury level of performance.
Injury data used for drafts and contracts
This data will increasingly become critical components of teams’ draft selections and contract negotiations. An NFL team faced with the choice of two essentially equal players in terms of athletic performance will likely draft the player who has never torn his ACL instead of the one who has. 
Likewise, the team might offer a shorter contract with a lower salary to a player who has had an Achilles or patellar tendon rupture.
Of course, this data is not perfect. Just because a cornerback tears his ACL doesn’t mean he can’t regain his speed and power after ACL reconstruction surgery or play for many more years. Dr. Matava explained that fact remains one of the biggest challenges using this information to project a player’s post-injury career. He knows of a player who had over 10 operations on his knee but still went on to make the Hall of Fame.
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The need to prevent ankle and knee injuries
Still, this study should concern athletes who suffer knee and ankle injuries. Jumping, stopping and instantly changing directions are crucial skills in the NFL. Efforts to prevent these lower extremity injuries, such as injury prevention exercise programs, will become more important, even in college and high school.
With championships and millions of dollars at stake, we shouldn’t be surprised that teams would want to use this data to build their rosters. We might even see it used at the college and high school levels one day. There is no doubt that in a Moneyball-driven sports environment, professional organizations in all of the major sports will utilize data on the outcomes of the injuries and surgeries of their athletes.
Note: A modified version of this article appears as my sports medicine column in the June 22, 2016 issue of The Post and Courier.
Reference:
Mai HT, Alvarez AP, Freshman RD, Chun DS, Minhas SV, Patel AA, Nuber GW, Hsu WK. The NFL Orthopaedic Surgery Outcomes Database (NO-SOD): The Effect of Common Orthopaedic Procedures on Football Careers. American Journal of Sports Medicine. Published online June 16, 2016.
