No difference in return to play rates between different elite sports after primary autograft ACL reconstruction

Abstract

Purpose To demonstrate return to play (RTP) rates, the level of RTP and time taken to RTP in different sports after anterior cruciate ligament reconstruction (ACL-R) and compare the differences between football and rugby. The secondary aims were to compare the differences in intra articular injuries and their treatments and reoperation rates between these sports. Methods A retrospective review of a consecutive series of all primary ACL-R undertaken by the senior author between 2005 and 2019 was undertaken. Patients were included if they were elite athletes and were a minimum of 2 year post-primary autograft ACL-R. The outcomes measured were RTP (defined as participation in a professional match or in national/ international-level competition in amateur sports), time to RTP after surgery and RTP level (Tegner score). Results Three hundred and ninety-four elite athletes, with 420 ACL-Rs were included. 235 (55.9%) were in footballers and 125 (29.8%) were in rugby players. 399 (95.0%) of all elite athletes returned to competition at an average of 10.3 months after ACL-R. 386 (90.2% played at the same or higher level post-surgery. Although there was no difference in RTP rates between different sports, rugby players RTP significantly faster than footballers (9.6 vs 10.6 months, (p = 0.027). Footballers were more likely to rupture their ACL during jumping/landing manoeuvres and to receive a PT graft than rugby players. There were no other significant differences between football and rugby players regarding patient characteristics, intraoperative findings, re-rupture and re-operation rates. Conclusions Over 95% of all elite athletes RTP after primary ACL-R with 90% able to play at the same level. Rugby players RTP significantly faster than footballers. Level of evience Level IV.

Return to badminton play following an ACL injury is common, but only a few return to previous performance

“…The tournament players seem to RTS more frequently than the recreational players, but there was no difference in return to preinjury level. This differs from other studies in the literature where elite players had almost 83%-96% return to preinjury level rates [10,13]. The definition of tournament players in this study may differ from the elite athletes in other sports; however, it may also reflect that the Danish tournament players lack support from health professionals and coaches since few players in Denmark are professionals.…”

“…A retrospective study on elite rugby and football players demonstrates an impressive return to preinjury level rates of 92% and 96%, respectively [10]. The definition of RTS was playing one match at the same level as preinjury, which is not as strict as the criteria in the present study.…”

“…However, if RTS Level 2 is also included in successful RTS, which is typical in other studies, the percentage of successful return to performance reaches almost 50% among tournament players. This corresponds to other sports with RTS of 65% and return to performance of 55%; however, elite athletes have even higher return to performance rates in other sports [3,10,13]. It may not be surprising since badminton is played with explosive movements, change of direction, jumps and lunges which demand high stability of the knee [16].…”