Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Male Major League Soccer Players

Abstract

Background:Anterior cruciate ligament (ACL) rupture is a significant injury in male Major League Soccer (MLS) players in the United States.Purpose:To determine (1) return-to-sport (RTS) rate in MLS following ACL reconstruction (ACLR), (2) timing of RTS, (3) performance upon RTS, and (4) the difference in RTS and performance between players who underwent ACL reconstruction (ACLR) and controls.Study Design:Case-control study; Level of evidence, 3.Methods:MLS players undergoing ACLR between 1996 and 2012 were evaluated. Player data were extracted from publically available sources. All demographic data were analyzed. A control group of players matched by age, body mass index (BMI), sex, position, performance, and MLS experience (occurred at 2.6 years into career, designated “index year”) was selected from the MLS during the same years as those undergoing ACLR. The RTS and performance in the MLS were analyzed and compared between cases and controls. Student ttests were performed for analysis of within- and between-group variables.Results:A total of 52 players (57 knees) that met inclusion criteria underwent ACLR while in the MLS. Mean player age was 25.6 ± 3.98 years. Forty players were able to resume play (77%). Of the 40 players (45 knees), 38 (43 knees; 95%) resumed play the season following ACLR (mean, 10 ± 2.8 months after surgery). Mean career length in the MLS after ACLR was 4.0 ± 2.8 years. The revision rate was 10%. There was a significant increase in the incidence of ACL tears in the MLS by year (P < .001), and there was a significantly (P= .002) greater number of ACL tears on the left knee as opposed to the right. Performance in the MLS upon RTS after ACLR was not significantly different versus preinjury. There was no significant difference in survival in the MLS between cases and controls after ACLR or index year. The only significant performance differences between cases and controls were that cases had significantly greater shots taken per season (P= .005) and assists (P= .005) than did controls after the index year.Conclusion:There is a high RTS rate in the MLS following ACLR. Nearly all players resumed play the season after surgery. Performance was not significantly different from preinjury. Only 2 performance measures (shots taken and assists) were significantly different between cases and controls. A significantly greater number of ACL tears occur in the left versus the right knee.

Rate of Return to Pitching and Performance After Tommy John Surgery in Major League Baseball Pitchers

“…This method of data collection has been used in multiple prior publications. 2,4,8,10,16,17 The MLB database (HITS) contains information from 2010 to 2013, and this information was cross-referenced with the publicly available information to ensure accuracy over the available time period. The search was manually conducted by an orthopaedic surgery resident and a board-eligible orthopaedic surgeon with sports medicine fellowship training.…”

Closure of Patellar Tendon Defect in Anterior Cruciate Ligament Reconstruction With Bone–Patellar Tendon–Bone Autograft: Systematic Review of Randomized Controlled Trials

“…[5][6][7][8][9] Even at the most competitive level with professional athletes, ACLR with a BPTB autograft is a reproducible surgical technique that uses a graft with high tensile strength, optimal fixation with bone-to-bone healing, and high return-to-play rates, with low overall complication and failure rates. 9-14 Potential complications 28 are rare, but dysfunction of the extensor mechanism, 19,29-31 including patellar fracture, 17,32-36 tibial tubercle fracture, or failure of the patellar tendon itself, remain the most worrisome.…”

“…[15][16][17][18][19] The surgical technique for ACLR with BTPB a autograft has been previously described 7,8 and involves harvesting the central third of the ipsilateral patellar tendon with bone plugs from the patella and tibia. After incision through the skin and subcutaneous tissue, the peritenon surrounding the patellar tendon is incised, allowing full exposure of the patellar tendon, followed by harvest of the central third of the tendon.…”

Biomechanical Adaptations After Fatiguing Exercise in Healthy and ACL Reconstructed Individuals

“…10 Even in professional athletics, not all athletes are able to return to sport after ACLR. 51 ACL injuries may therefore be career ending injuries for high school and college athletes who cannot return to pre-injury level after ACLR.…”

“…This is a concern for sports medicine providers and orthopaedic surgeons whose goal is return patients to activity after ACLR, however less 45% return to activity or sport at 12 months post-ACLR, 81,99,172,193 and less than 30% are able to return to competitive sports 2-7 years post-ACLR. 10 Even in professional athletics, not all athletes are able to return to sport after ACLR, 51,197 and career lifespan significantly decreases after ACLR. 33,197 Some of these poor outcomes may be associated with increased kinesiophobia or may be the result of neuromuscular changes after ACLR.…”