Anterior Cruciate Ligament Injuries in National Football League Athletes From 2010 to 2013

Dodson, Christopher C.; Secrist, Eric; Bhat, Suneel B.; Woods, Daniel P.; DeLuca, Peter F.

doi:10.1177/2325967116631949

Cited by 75 publications

(106 citation statements)

References 13 publications

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“…For example, in the National Football League, receivers and backs have a significantly greater injury risk than players in other positions. 28 To the authors' knowledge, the highest rates of graft rupture in professional athletes are reported in female patients participating in handball (19.3%) 28 and alpine skiing (27% revision rate). 29 In the current study, there were no graft ruptures in the skiers or handball athletes, but the overall numbers of patients in these categories were too small to gain a reliable estimate of the graft rupture rate.…”

Section: Discussionmentioning

confidence: 91%

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Rosenstiel

Praz

Ouanezar

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Purpose: To evaluate clinical outcomes in professional athletes after combined anterior cruciate ligament (ACL) and anterolateral ligament (ALL) reconstruction at a minimum follow-up of 2 years. Methods: A retrospective analysis of prospectively collected data from the Scientific Anterior Cruciate Ligament Network International (SANTI) Study Group database was performed. All professional athletes who underwent primary combined ACL and ALL reconstruction between January 2011 and March 2016 were included. Patient assessment included physical examination, pre-and postoperative subjective and objective International Knee Documentation Committee (IKDC), Tegner activity scale, and Lysholm scores. Results: Seventy-two professional athletes underwent primary ACL and ALL reconstruction; 70 (97%) were available, with a mean follow-up of 3.9 years (range, 2-7). The preoperative side-to-side anteroposterior laxity difference was 7.1 AE 1.4 mm, and this decreased significantly after surgery to 0.4 AE 0.9 mm (P < .0001). Pivot-shift grade evolved from 16 grade I (22.8%) and 54 grade II or III (77.2%) preoperatively, to 66 absent pivot shift (94.3%) and 4 grade I (5.7; P < .001). By 1-year postoperatively, 60 athletes (85.7%) returned to professional sport, with a mean time interval of 7.9 months (range, 5-12). Preoperatively, the mean subjective IKDC was 56.1 AE 12.3, the Lysholm score was 48.4 AE 12.5, and the Tegner score was 9.3 AE 1. At final follow-up, the mean subjective IKDC was 90.5 AE 7.6 (P < .0001), the Lysholm score was 94.4 AE 7.5 (P < .0001), and the Tegner score was 8.8 AE 1.5 (P < .004). The objective IKDC evolved from 39 grade C (55.7%) and 31 grade D (44.3%) preoperatively to 65 grade A (92.9%) and 5 grade B (7.1%) (P < .0001). Eleven Patients (15,7%) underwent a subsequent ipsilateral reoperation including 4 (5.7%) revision ACL reconstructions. The risk of graft rupture was significantly higher in female patients (13.6% vs 2.1% in male patients; P ¼ .048). Conclusions: Combined ACL and ALL reconstruction is associated with excellent outcomes in professional athletes with respect to graft rupture rates, return to sport, knee stability, and reoperation rates after injury. Level of Evidence: Level IV, case series. See commentary on page 893 D espite a major focus on injury prevention, the rates of anterior cruciate ligament (ACL) rupture have remained relatively unchanged over the last 25 years. 1-3 ACL rupture continues to represent a devastating injury with potentially career-ending consequences for the professional athlete. Even for those

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Section: Discussionmentioning

confidence: 91%

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Rosenstiel

Praz

Ouanezar

et al. 2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Rates of injury and RTP have also been shown to differ by position. Dodson et al 14 discovered that certain skilled players, such as wide receivers and running backs, faced a significantly greater risk of ACL injuries than the rest of the NFL. Positional differences in the rates of RTP remain largely unknown.…”

Section: Discussionmentioning

confidence: 99%

“…Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, 14 we identified NFL players with publicly disclosed ACL tears occurring between the start of the 2010 season and the end of the 2013 season. To develop this database, an anonymized list of ACL injuries from the NFL Injury Surveillance System for the 2004 to 2013 NFL seasons was provided by Edgeworth Economics.…”

Section: Methodsmentioning

confidence: 99%

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National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury

Yang

Hodax

Machan

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:Anterior cruciate ligament (ACL) injuries pose a significant risk to the careers of players in the National Football League (NFL). The relationships between draft round and position on return to play (RTP) among NFL players are not well understood, and the ability to return to preinjury performance levels remains unknown for most positions.Purpose:To test for differences in RTP rates and changes in performance after an ACL injury by position and draft round. We hypothesized that skilled positions would return at a lower rate compared to unskilled positions. We further hypothesized that early draft-round status would relate to a greater rate of RTP and that skilled positions and a lower draft round would correlate with decreased performance for players who return to sport.Study Design:Case-control study; Level of evidence, 3.Methods:Utilizing a previously established database of publicly available information regarding ACL tears among NFL players, athletes with ACL tears occurring between the 2010 and 2013 seasons were identified. Generalized linear models and Kaplan-Meier time-to-event models were used to test the study hypotheses.Results:The overall RTP rate was 61.7%, with skilled players and unskilled players returning at rates of 64.1% and 60.4%, respectively (P = .74). Early draft-round players and unskilled late draft-round players had greater rates of RTP compared to skilled late draft-round players and both unskilled and skilled undrafted free agents (UDFAs). Skilled early draft-round players constituted the only cohort that played significantly fewer games after an injury. Unskilled UDFAs constituted the only cohort to show a significant increase in the number of games started and ratio of games started to games played, starting more games in which they played, after an injury.Conclusion:Early draft-round and unskilled players were more likely to return compared to their later draft-round and skilled peers. Skilled early draft-round players, who displayed relatively high rates of RTP, constituted the only cohort to show a decline in performance. Unskilled UDFAs, who exhibited relatively low rates of RTP, constituted the only cohort to show an increase in performance. The significant effect of draft round and position type on RTP may be caused by a combination of differences in talent levels and in opportunities given to returning to play.

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“…Rupture or injury to the ACL is one of the most common lower limb injuries seen in sports, with potential career ending outcomes as some athletes may fail to achieve preinjury level of performance. 24 Reinjury and graft rupture have been reported as a result of returning to play too early resulting in excessive load on a poorly rehabilitated knee. 25 Therefore, it is highly important to continuously monitor the athlete rehabilitation to ensure optimum loading of injured and recovering tissues through an individualized approach according to the sport and its physical demand.…”

Section: Stages Of Sports Injury Rehabilitation: Evidence-based Practmentioning

confidence: 99%

Current Concepts in Sports Injury Rehabilitation

Dhillon¹,

Dhillon

Dhillon³

2017

IJOO

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In the modern era, rehabilitation after sports injury has become a domain for specialists, and its evolution has necessarily brought together the sports physiotherapist, the sports physician, and the orthopedic surgeon. The changing profile of sports related injury, as well as limited availability of facilities for rehabilitation in many areas of India, is a matter of concern. Elite sportspersons have some protection, but the average athlete is often left to fend for himself. Key factors in successful sports injury rehabilitation protocols are the application of modern rehabilitation protocols under appropriate supervision, appropriate and well timed surgical interventions, and judicious and need based use of pharmaceutical agents. Modern rehabilitation protocols emphasize teamwork and proper rehabilitation planning, and the rehabilitation team has to be lead by a trained sports physiotherapist, with an understanding of the protocols and interventions required at various stages. Injury specific rehabilitation protocols are being practiced worldwide but need to be introduced according to the nature of the sport as well as available facilities. Even in India, sports physicians are increasingly joining specialist rehabilitation teams, and they can help with medication, nutritional supplements, and specialized tests that could improve injury understanding. Inputs from surgeons are mandatory if surgical interventions have been performed. What is often missing in the underdeveloped world is psychological support and a clear understanding by the athlete of his/her rehabilitation protocols. World over, the primary aims are safe return to sports and minimizing reinjury on return to sport; this involves rehabilitation in stages, and current methodology clearly demarcates acute and chronic phases of injury. Close coordination with trainers and coaches is mandatory, and all need to understand that the reconditioning phase is crucial; skill assessment before progression has now become a specialized domain and needs to be introduced at all levels of the sport. A key factor in all sports injury rehabilitation protocols is injury prevention; this involves data maintenance by teams or trainers, which is still not fully developed in the Indian context. The injury and subsequent problems need to be comprehended both by athletes and their coaches. The current review is an attempt to clarify some of the issues that are important and routinely used world over, with the aim to improving rehabilitation after sports even in the underdeveloped world.

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Anterior Cruciate Ligament Injuries in National Football League Athletes From 2010 to 2013

Cited by 75 publications

References 13 publications

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

Combined Anterior Cruciate and Anterolateral Ligament Reconstruction in the Professional Athlete: Clinical Outcomes From the Scientific Anterior Cruciate Ligament Network International Study Group in a Series of 70 Patients With a Minimum Follow-Up of 2 Years

National Football League Skilled and Unskilled Positions Vary in Opportunity and Yield in Return to Play After an Anterior Cruciate Ligament Injury

Current Concepts in Sports Injury Rehabilitation

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