Eighty-three per cent of elite athletes return to preinjury sport after anterior cruciate ligament reconstruction: a systematic review with meta-analysis of return to sport rates, graft rupture rates and performance outcomes

Abstract

Objectives The primary objective was to calculate the rate of return to sport (RTS) following anterior cruciate ligament (ACL) reconstruction in elite athletes. Secondary objectives were to estimate the time taken to RTS, calculate rates of ACL graft rupture, evaluate postsurgical athletic performance and identify determinants of RTS. Design Pooled RTS and graft rupture rates were calculated using random effects proportion metaanalysis. Time to RTS, performance data and determinants of RTS were synthesised descriptively. Data sources MEDLINE, EMBASE, AMED, CINAHL, AMI, PEDro, SPORTDiscus and The Cochrane Library were searched from inception to 19 January 2016. Hand searching of 10 sports medicine journals and reference checking were also performed. Eligibility criteria for selecting studies Studies were included if they reported the ratio of elite athletes who returned to their preinjury level of sport following ACL reconstruction. Twenty-four studies were included. results The pooled RTS rate was 83% (95% CI 77% to 88%). The mean time to RTS ranged from 6 to 13 months. The pooled graft rupture rate was 5.2% (95% CI 2.8% to 8.3%). Six out of nine studies that included a noninjured control group found no significant deterioration in athletic performance following ACL reconstruction. Indicators of greater athletic skill or value to the team were associated with RTS. summary and conclusions Eighty-three per cent of elite athletes returned to sport following ACL reconstruction, while 5.2% sustained a graft rupture. Most athletes who returned to sport performed comparably with matched, uninjured controls. This information may assist in guiding expectations of athletes and clinicians following ACL reconstruction.

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

“…These figures are broadly comparable to the findings of Lai et al, 6 who in a recent systematic review reported that a mean of 83% of elite athletes were able to return to the preinjury level of sport; they took a mean time of 6 to 13 months to do so, and the pooled graft rupture rate was 5.2%. However, it is important to note that both the return to sport rates (42%-100%) [22][23][24] and the graft rupture rates (0%-19.3%) 23,[25][26][27] reported in the studies included by Lai et al 6 varied broadly. This highlights the fact that the risk of graft rupture is higher in certain sports or even certain positions within the same sport.…”

“…individuals who return to elite sport, there is evidence that they may not be used by their team in competition as frequently, that their earning potential is significantly reduced, and that their overall careers may be shorter than age-matched controls. 4,5 However, in contrast to the general population, the rate of return to sport in professional athletes is very high, 6 but this also means that they are at significantly greater risk of ACL graft rupture when compared with those with a sedentary lifestyle. 7,8 Walden et al 9 highlighted that the rates of ACL graft rupture were unacceptably high in professional soccer athletes, and these concerns are mirrored in numerous reports of graft rupture rates between 18% and 20% in high-risk populations.…”

Return to pivoting sport after ACL reconstruction: association with osteoarthritis and knee function at the 15-year follow-up

“…Elite athletes are more than twice as likely to return to preinjury sport than recreational athletes,41 and a new meta-analysis showed that 83% of elite athletes returned to preinjury sport after ACLR 15. In our study we did not use the broad term return to sport.…”

Tendencia al riesgo y lesión deportiva en fútbol y fútbol sala femenino

“…La lesión deportiva parece adquirir gran importancia en el interés de los investigadores, sobre todo en los últimos años (Lai, Ardern, Feller, & Webster, 2017;Slimani et al, 2018). Además, la lesión empieza a ser estudiada desde diferentes perspectivas como los aspectos físicos, fisiológicos, biomecánicos, psicológicos y, evidentemente, médicos (Bahr & Krosshaug, 2005;Brewer & Redmond, 2016;Udry & Andersen, 2008).…”