Publication Name	World Journal of Meta-Analysis
Manuscript ID	111108
Country	Ireland

Category	Orthopedics
Manuscript Type	Systematic Reviews
Article Title	Low return to play and performance in national football league athletes after Achilles tendon rupture: A systematic review
Manuscript Source	Invited Manuscript
All Author List	James Joseph Butler, Davis Hedbany, Charles C Lin, Luilly Vargas, Matthew T Kingery, Nathaniel P Mercer, Bradley A Lezak, Alexander Tham, Jared Rubin and John G Kennedy
Funding Agency and Grant Number
Corresponding Author	James Joseph Butler, Research Fellow, Department of Orthopedic Surgery, Royal College Surgeons in Ireland, 123 St Stephen‘s Green, Dublin 18, Ireland. jamesjbutler@rcsi.ie
Key Words	National football league; Acute Achilles tendon rupture; Return to play; Player performance; Career longevity; Professional athletes; Athletic injuries; Tendon injury outcomes; Systematic review; American football
Core Tip	This systematic review investigates outcomes following acute Achilles tendon rupture (AATR) in national football league athletes. AATR is a serious injury associated with a 66.2% return-to-play rate and significant post-injury performance decline, regardless of player position. The review highlights decreased career longevity, positional variability in outcomes, and the potential impact of inactivity periods – such as during the coronavirus disease 2019 pandemic – on injury risk. These findings underscore the career-threatening nature of AATR in elite-level athletes.
Citation	Butler JJ, Hedbany D, Lin CC, Vargas L, Kingery MT, Mercer NP, Lezak BA, Tham A, Rubin J, Kennedy JG. Low return to play and performance in national football league athletes after Achilles tendon rupture: A systematic review. World J Meta-Anal 2025; In press

Received	2025-06-23 00:52
Peer-Review Started	2025-06-23 00:52
First Decision by Editorial Office Director	2025-06-30 06:43
Return for Revision	2025-06-30 06:43
Revised	2025-09-26 02:02
Publication Fee Transferred
Second Decision by Editor	2025-12-29 02:34
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2025-12-29 08:46
Articles in Press	2025-12-29 08:46
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	2308-3840 (online)
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