ACL injuries in men's professional football: a 15-year prospective study on time trends and return-to-play rates reveals only 65% of players still play at the top level 3 years after ACL rupture

Abstract

Background Studies investigating the development of ACL injuries over time in football are scarce and more data on what happens before and after return to play (RTP) are needed. Aim To investigate (1) time trends in ACL injury rates, (2) complication rates before return to match play following ACL reconstruction, and (3) the influence of ACL injury on the subsequent playing career in male professional football players. Methods 78 clubs were followed between 2001 and 2015. Time trend in ACL injury rate was analysed using linear regression. ACL-injured players were monitored until RTP and tracked for 3 years after RTP.Results We recorded 157 ACL injuries, 140 total and 17 partial ruptures, with a non-significant average annual increase in the ACL injury rate by 6% (R 2 =0.13, b=0.059, 95% CI −0.04 to 0.15, p=0.20). The match ACL injury rate was 20-fold higher than the training injury rate (0.340 vs 0.017 per 1000 h). 138 players (98.6%) with a total rupture underwent ACL reconstruction; all 134 players with RTP data (4 players still under rehabilitation) were able to return to training, but 9 of them (6.7%) suffered complications before their first match appearance (5 reruptures and 4 other knee surgeries). The median layoff after ACL reconstruction was 6.6 months to training and 7.4 months to match play. We report 3-year follow-up data for 106 players in total; 91 players (85.8%) were still playing football and 60 of 93 players (65%) with ACL reconstruction for a total rupture played at the same level. Conclusions The ACL injury rate has not declined during the 2000s and the rerupture rate before return to match play was 4%. The RTP rate within a year after ACL reconstruction was very high, but only two-thirds competed at the highest level 3 years later.

ACL Return to Sport Guidelines and Criteria

“…The majority of the literature [7-12, 13•, 14•, [15][16][17][18][19][20][21][22] indicates a battery of tests is necessary to assess various outcome parameters and establish criterionbased clinical reasoning for RTS. This review acknowledges multiple tests that should be done aside from medical approval and clearance by the physician to verify a successful RTS such as follows: range of motion, KT1000/KT2000, Lachman's test, Pivot shift test, isotonic strength tests, isokinetic strength tests, maximum force/peak torque, angle-specific torque testing, rate of force development, hop tests, jump landing tasks (LESS), knee proprioception/kinesthesia/joint position sense testing, quality of movement tests, kinematic analysis, psychological factors/tests based on the anterior cruciate ligament-return to sport after injury (ACL-RSI) scale, PROs: anterior cruciate ligament-return to sport after injury (ACL-RSI) scale, IKDCs, KOOSs, ADL scales, Sport scales, knee self efficacy scale, Quality of Scales, ACL-RSI, Tegner Activity Scale (TAS), Lysholm Scale, and Tampa Kinesiophobia Index.…”

Kreuzbandruptur

“…Die Häufigkeit, eine vordere Kreuzbandruptur im professionellen Fußball zu erleiden, ist mit 0,34-mal pro 1000 h Wettkampfsport und 0,017 pro 1000 h Training im Fußballsport beschrieben [1]. Auch wenn es somit eine sehr viel seltenere Verletzung als z.…”

ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION & THE HAMSTRINGS Implications for injury prevention & rehabilitation

“…ACL injuries are debilitating and usually result in a lengthy period out of sport and are sometimes career ending (Roi, Nanni, & Tencone, 2006;Walden, Hagglund, Magnusson, & Ekstrand, 2016). Collectively, there are reportedly 100,000 to 300,000 ACL injuries each year in Australia and the United States (Boden, Griffin, et al, 2000;Prodromos, Han, et al, 2007) and many occur in men and women between 15 and 25 years of age (Renstrom et al, 2008).…”