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Knee

DETERMINANTS OF PERFORMANCE IN 200 PROFESSIONAL FOOTBALLERS AT TWO AND FIVE YEARS AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION

The British Association for Surgery of the Knee (BASK) May 2023 Meeting, London, England, 16–17 May 2023.



Abstract

Abstract

Introduction

The aim of this study was to determine which factors affect a professional footballer's return to play performance level after ACL reconstruction (ACL-R). Additionally, to report their playing performance at 2 and 5 years post ACL-R compared to their preinjury performance.

Methods

A retrospective review of a consecutive series of primary ACL-R undertaken in professional footballers between 2005 and 2019 was undertaken. Performance was determined by the number of minutes played and the league level compared to their pre-injury baseline. Playing time (minutes) was classified as same (within 20%), more, or less playing time for each season compared to the one year prior to surgery.

Results

Two hundred footballers (mean age 24.1 ± 4.2 years) were included. 194 (97%) returned to professional football.

At 2-years after ACL-R 61% of footballers were playing in the same/ higher league, 29% were playing in a lower league and 10% were not playing. At 5-years this was 35%, 37% and 28% respectively.

Forty-six percent of footballers were playing the same or more minutes as pre-injury at 2 years post-surgery, 51% were at 3 and 4 years but this reduced to 45% at 5 years.

The presence of >50% thickness chondral pathology, ACL-R lacking lateral extra-articular tenodesis and age over 25 years at surgery were all significant risk factors of worse performance rates after ACL-R.

Conclusion

While professional footballers achieved high initial RTP rates after ACL-R, with the majority returning to pre-operative levels of competition, significant decreases in performance rates were noted over time.