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

Knee Surgery, Sports Traumatology, Arthroscopy (2023)Cite this article

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.

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Fig. 1

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Funding

No direct funding was received for this study. Educational grants provided by Smith and Nephew funded Knee Fellowships for the surgical trainees involved in this study.

Author information

Authors and Affiliations

  1. Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ, UK

    Mary Jones, Vitor Hugo Pinheiro, Ganesh Balendra & Andy Williams

  2. FIFA Medical Centre of Excellence, London, UK

    Mary Jones, Vitor Hugo Pinheiro, Ganesh Balendra & Andy Williams

  3. Houston Methodist Orthopedics and Sports Medicine, Houston, TX, USA

    Kyle Borque

Authors
  1. Mary Jones
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  2. Vitor Hugo Pinheiro
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  3. Ganesh Balendra
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  4. Kyle Borque
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  5. Andy Williams
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Contributions

MJ: contributed to the conception and design of the work, data collection and interpretation of the data, drafted the manuscript and finalised revisions of the manuscript. VHP: contributed to the design of the work, data analysis and manuscript revisions. GB: contributed to the design of the work, data collection and interpretation and manuscript revisions. KB: contributed to the design of the work, data interpretation and manuscript revisions. AW: contributed to the conception and design of the work, interpretation of the data, revisions and approval of manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Mary Jones.

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Conflict of interest

AW receives an educational grant from Smith and Nephew to part fund a knee fellowship and has also received funding for research and payments for speaking. He also owns stock in a DoccComms, a digital start-up company developing an app for secure medical communications and Innovate, an orthopaedic company making interference screws.

Ethical approval

REC approval was not required but approval to undertake the study was given by the institution involved in line with UK Health Research Authority guidance.

Informed consent

As a retrospective evaluation of treatment already given and as no identifiable information is included, informed consent was not sought from the subjects.

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Jones, M., Hugo Pinheiro, V., Balendra, G. et al. No difference in return to play rates between different elite sports after primary autograft ACL reconstruction. Knee Surg Sports Traumatol Arthrosc (2023). https://doi.org/10.1007/s00167-023-07654-y

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