We reviewed professional sportsmen who had undertaken Anterior Cruciate Ligament reconstruction to determine their actual and perceived sporting performance and long term outcome. The specific aim was to determine whether the players returned to the same standard of play, following reconstructive surgery. After IRAS approval, a questionnaire survey was distributed to 55 professional players on the Sports Injury Surgery ACL database. 24players returned questionnaires (response rate of 43.6%). Dates of surgery ranged from January 1998-February 2006. The mean elapsed time following surgery was 48 months (range 13-120 months). 12 patients had injured their left knee, 8 their right and 4 both knees. The respondents played rugby league 37% (9), soccer 33.3% (8), rugby union 21% (5) and netball 8.3% (2). 12 respondents were playing in the top leagues in their sports. 15 were regular first team players and 6 were squad players. 62.5% (15) thought they had returned to their previous standard of play, 29% (7) said that they had not and 2 did not know. 71% (17) of respondents thoughts their knee returned to normal however 25% (6) did not. The mean time for RTP was 10 months (5-21 months). Those that returned to the same standard were younger (21yrs) compared to those who did not (25yrs) (P=0.108). 4 players had torn the ACL in the opposite knee or ruptured their reconstruction. Additional meniscal injuries did not influence outcome and at 4 years most players had no or only slight symptoms with sport or activities of daily living. The rupture of the ACL is no longer a career ending injury for the professional sportsman. The majority (62.5%) of players will return to their pre-injury standard of play following reconstruction. The age at injury and additional meniscal injuries were not shown to be significant factors in this series.
Avascular meniscal tears can be repaired with good clinical outcomes. The mechanical disadvantage and detrimental effect to articular cartilage following meniscectomy has been well documented in the literature. Meniscal repair in the avascular (white on white zone) is controversial and would be deemed inappropriate by many.Hypothesis
Background