Reduced performance after return to competition in ACL injuries: an analysis on return to competition in the ‘ACL registry in German Football’

Szymski, Dominik; Achenbach, Leonard; Weber, J. Robert; Huber, Lorenz; Memmel, Clemens; Kerschbaum, Maximilian; Alt, Volker; Krutsch, Werner

doi:10.1007/s00167-022-07062-8

Cited by 16 publications

(24 citation statements)

References 30 publications

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“…Considering the duration of RTC, high-level ski jumping seems to be a demanding discipline. In other sports (e.g., alpine skiing or football), on average, elite athletes are able to return to competitive level within 1 year after ACL injury, while in ski jumping this process is longer than 1 year (mean 14.6 months in males and 13.5 months in females) [6,18]. Muller et al determined the factors (athletes' age, sport at competitive level, associated injuries, time between injury and surgery) which predict the RTC process after ACLR but unfortunately more data are needed in order to prove if they are applicable in ski jumping [13].…”

Section: Discussionmentioning

confidence: 99%

“…One male athlete did not take part in any competition until the third postinjury season. Mean RTC time was 14.6 (8-28) months for male and 13.5 (10)(11)(12)(13)(14)(15)(16)(17)(18) months for female jumpers. Regarding the mean number of competitions per athlete and year, males took part in the following number of WC competitions (ordered from two seasons before to three seasons after ACL injury): 18.8 ± 10.7 (n = 8), 15.4 ± 11.2 (n = 11), 8.7 ± 4.5 (n = 3), 6.3 ± 4.4 (n = 4), 12.8 ± 8.4 (n = 9) and 6.7 ± 7.4 (n = 6).…”

Section: Return To Competitionmentioning

confidence: 99%

“…However, depending on the sports discipline, a wide range of performance level after surgery was observed. In the group of professional German footballers, not even 50% were able to keep their level of play after ACLR, whereas in many other disciplines, it was on average over 60% [1, 18]. To the best of the authors' knowledge, there are neither any published reports on RTC after ACL injury in elite ski jumping nor detailed follow‐up performance data of the ACL‐injured athletes in this discipline.…”

Section: Introductionmentioning

confidence: 99%

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Anterior cruciate ligament injuries in elite ski jumping reliably allow return to competition but severely affect future top performance

Oronowicz,

Seil,

Hörterer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeIn recent years, anterior cruciate ligament (ACL) injuries have been frequently observed in ski jumping. However, available data in this discipline are very scarce. Therefore, the purpose of this study was to investigate whether an ACL injury in elite‐level ski jumping limits the performance level after ACL reconstruction (ACLR).MethodsBoth male and female elite‐level ski jumpers from five national A‐teams who suffered an ACL injury were identified retrospectively by searching available media reports and Fédération Internationale de Ski (FIS) database. World Cup (WC) results and time‐out‐of‐competition before ACL injury and after ACLR were compared. Only athletes who suffered the injury during or after the 2009–2010 season and who participated in at least one WC competition before the injury were included in this study. The level of athletes' performance from two full seasons before until three seasons after the injury was compared.ResultsEighteen elite‐level ski jumpers (11 males/seven females) were eligible for the study. All male and four female athletes returned to professional competition after ACLR. One female athlete ended her career due to prolonged recovery and two have not yet recovered due to a recent injury. The mean return‐to‐competition (RTC) time was 14.6 months in males and 13.5 months in females. The mean WC placement decreased after the ACL injury: two seasons before injury the mean position was 17.9 ± 11.0 (n = 12), one season before it was 22.4 ± 12.8 (n = 15). After recovery, the mean placement in seasons 1–3 was: 26.4 ± 8.9 (n = 7), 25.7 ± 10.3 (n = 13), 33.6 ± 12.2 (n = 10) (p = 0.008). Among the athletes returning to competition, only six males and three females reached their preinjury level and only one male and one female (compared to seven males and three females preinjury) reached an individual top‐3 placement after ACLR, accounting for less than 10% of podiums compared to preinjury.ConclusionOnly 60% of the professional ski jumpers reached the preinjury level and less than 15% reached a top‐3 placement after the ACL injury. These results support the fact that ACL tear during a ski jumping career may be a significant factor limiting high‐level performance. In terms of clinical relevance, the findings implicate the need to analyse the reasons of these very low rates of return to elite‐level performance, to analyse ACL injury and RTC rates at lower levels of performance and to develop specific prevention strategies in order to reduce the number of ACL injuries in this sport.Level of EvidenceLevel IV.

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Section: Discussionmentioning

confidence: 99%

Section: Return To Competitionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Anterior cruciate ligament injuries in elite ski jumping reliably allow return to competition but severely affect future top performance

Oronowicz,

Seil,

Hörterer

et al. 2024

Knee surg. sports traumatol. arthrosc.

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“…Szymski et al 26 analyzed the RTP characteristics of men’s professional (1st-3rd league), semiprofessional (4th-6th league), and amateur (7th league) athletes from the ACL Registry in German Football. After primary ACL ruptures, professional players had statistically faster RTP times (247 days) compared to semiprofessional (334 days) and amateur (376 days) players.…”

Section: Discussionmentioning

confidence: 99%

Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in the National Women’s Soccer League

Abed

Dupati

Hawk

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: The anterior cruciate ligament (ACL) is commonly injured in elite-level female athletes, which usually requires ACL reconstruction (ACLR). Purpose: To analyze return to play (RTP) and changes in performance of players in the National Women’s Soccer League (NWSL) after ACLR. Study Design: Descriptive epidemiology study. Methods: NWSL players who sustained an ACL tear and underwent surgery between the 2013 and 2020 seasons were identified by multiple online resources. Players were classified as forwards, defenders, midfielders, and goalkeepers. RTP was assessed according to games played, games started, percentage of minutes played, plus/minus net per 90 minutes (a measure of a player’s contribution to their team’s performance while on the field), goals scored, and assists. A subanalysis was performed based on the median age at the time of the injury (≤24 vs ≥25 years). Nonparametric testing methods were used throughout the analysis. Results: A total of 30 NWSL athletes were included. Midfielders had the highest percentage of injuries (n = 11; 36.7%), followed by forwards (n = 10; 33.3%). Overall, 27 players returned to the NWSL at a median of 12.1 months (IQR, 10.9-14.3 months), constituting a 90.0% RTP rate. There was a significant decrease in the percentage of minutes played from 1 year before the injury to 1 year after the injury (median, 87.9% [IQR, 80.7%-90.6%] vs 25.1% [IQR, 16.3%-57.2%], respectively; P = .031). Forwards and midfielders had a significant decrease in the number of assists from 1 year before the injury to 1 year after the injury (median, 3.0 [IQR, 1.0-3.0] vs 0.0 [IQR, 0.0-1.0], respectively; P = .037) as well as the number of goals scored when averaging across 2 seasons before the injury to 2 seasons after the injury (median, 3.0 [IQR, 1.5-5.5] vs 1.0 [IQR, 0.5-3.5], respectively; P = .031). On subanalysis, older players started in significantly more games (median, 12.0 [IQR, 3.8-18.5] vs 3.0 [IQR, 0.5-6.0], respectively; P = .048) and had a higher percentage of minutes played (median, 63.0% [IQR, 18.8%-77.3%] vs 14.9% [IQR, 2.0%-21.2%], respectively; P = .046) at 1 year after the injury versus younger players. Conclusion: There was a 90.0% RTP rate after ACLR in the NWSL. Players who returned to the NWSL had a lower percentage of minutes played in their first year after RTP, with older players starting in more games and having a greater percentage of minutes played. Compared with preinjury performance, forwards and midfielders had a significant decrease in the number of assists at 1 year after the injury as well as the number of goals scored at 2 years after the injury.

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“…The American Journal of Sports Medicine 2024;52 (5):1183-1188 DOI: 10.1177/03635465241235949 Ó 2024 The Author(s) rate 4,6,13,17,18,35 (80%-98%); nonetheless, little is known about if and how these ACL injuries affect these players' career longevity.…”

mentioning

confidence: 99%

The Effect of Primary ACL Reconstruction on Career Longevity in English Premier League and Championship Soccer Players Compared With Uninjured Controls: A Matched Cohort Analysis

Borque,

Laughlin,

Hugo Pinheiro

et al. 2024

Am J Sports Med

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Background: Because of the multitude of variables that affect the retirement decisions of professional soccer players, it has proven difficult to isolate the effect of undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) on career longevity. Purpose: To compare the career longevity of professional soccer players after a primary ACLR with that of an uninjured matched control cohort. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of a consecutive series of primary ACLR was performed between 2008 and 2018 in professional male soccer players from the senior author's practice. Each athlete with ACLR was matched to 3 control athletes who had not undergone ACLR according to age, league, playing position, and preinjury game appearances/minutes played. Player career statistics—including league, game appearances, and game minutes—were compiled for each year until retirement or July 1, 2022. Results: A total of 82 soccer players in the English Premier League or Championship at the time of their primary ACLR were matched to 246 control athletes. The mean career length after ACLR was 6 ± 2.6 years, while that of the matched control athletes was 7.6 ± 2.8 years ( P < .001). After primary ACLR, an athlete had a 2 times greater chance of retirement compared with the matched control athlete (hazard ratio, 2.19; P < .001). At 5 years after ACLR, 16% of athletes had retired from professional soccer, while 8.5% of the matched cohort were retired ( P = .060). By 10 years, 72% of the ACLR cohort had retired compared with 43% of the matched cohort ( P < .001). Forwards were more likely to have shortened careers compared with goalkeepers ( P = .021); however, no significant differences were observed between midfielders, defenders, and forwards. Within the ACLR cohort, a contralateral ACL tear during the athlete's career caused a 2.30 times ( P = .022) increased chance of retirement compared with athletes with only 1 ACL tear during their career. Mechanism of injury, meniscal pathology, graft rerupture, and chondral lesions did not affect career length. Conclusion: Professional male soccer players who underwent ACLR had decreased career length by approximately 1.6 years compared with a matched player cohort.

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Reduced performance after return to competition in ACL injuries: an analysis on return to competition in the ‘ACL registry in German Football’

Cited by 16 publications

References 30 publications

Anterior cruciate ligament injuries in elite ski jumping reliably allow return to competition but severely affect future top performance

Anterior cruciate ligament injuries in elite ski jumping reliably allow return to competition but severely affect future top performance

Return to Play and Performance After Anterior Cruciate Ligament Reconstruction in the National Women’s Soccer League

The Effect of Primary ACL Reconstruction on Career Longevity in English Premier League and Championship Soccer Players Compared With Uninjured Controls: A Matched Cohort Analysis

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