Return to play, performance and career post ACL tear
In this case-control study a media-based analysis of return to play (RTP) rates, playing quality, and career duration after ACL tear in the top 5 football leagues during 2010-2012 has been made.
Although the relative RTP rates after ACL tears are high, career duration and playing quality are significantly affected: when compared to controls, ACL-injured players showed differences in terms of career duration, playing performance, rate of completed passes, and minutes played were also significantly different.
ACL ruptures remain an important issue in professional football. Even after state-of-the-art surgery and rehabilitation, a long period away from sport, high reinjury rates and the risk of osteoarthritis remains. Moreover, studies on rates of return to sport at the same level have been conflicting.
Male athletes with ACL-rupture and matched controls from the 5 European top leagues were identified. Anthropometrics, injury history, time of RTP, quantity of games, and game-related performance data were retrieved.
A total of 132 ACL injuries resulted in a RTP rate of 98.2% and RTP to the same level of 59.4%. Seventy percent of players were still playing after 5 years, 40.9% of which at the same level.
Although the relative RTP rates after ACL tears are high, career duration and playing quality are significantly affected despite the best efforts of health professionals. Performance impairments may last up to 2 years after injury. Specific and improved rehabilitation and prevention strategies are still needed.
Expert opinion by José Pedro Correia
In accordance with recent studies on the same topic, these authors found that - despite excellent RTP rates after ACL tears in professional football players - return to the same level, reinjury risk and playing quality outcomes are far from ideal, even in elite football settings.
Clearly, not enough is being done in terms of secondary prevention and RTP protocols. It is surely not realistic to have a player sidelined for 2 years, but the best evidence available shows that top performance is still a problem after ACL ruptures.
We must take a look at what factors differentiate successful and unsuccessful return to top performance to address what remains a potentially career-changing injury.
> From: Niederer et al., Scand J Sports Med 28 (2018) 2226-2233 (Epub ahead of print). All rights reserved to John Wiley & Sons. Click here for the online summary.