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Journal Article

Citation

Webster KE, Klemm HJ, Feller JA. Orthop. J. Sports Med. 2022; 10(2): e23259671221074999.

Copyright

(Copyright © 2022, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/23259671221074999

PMID

35178464

PMCID

PMC8844735

Abstract

BACKGROUND: Return to sport is a goal for most patients who undergo anterior cruciate ligament (ACL) reconstruction. However, at a nonelite level, there are limited sport-specific data regarding rates or factors associated with return to play.

PURPOSE: To report rates and determinants of returning to play Australian Rules football after ACL reconstruction in male nonprofessional athletes. STUDY DESIGN: Case-series; Level of evidence, 4.

METHODS: A total of 354 male nonprofessional Australian Rules football players who had undergone primary ACL reconstruction were asked to complete detailed sports activity questions at 12 months and 2 to 5 years (mean, 3 years) after surgery. Rates of return to play were calculated for both timepoints, along with preoperative patient expectations and postoperative sport performance. The following predictors of return to play were examined: age at surgery; height; weight; frequency of weekly football participation; sport participation level; psychological readiness to return to sport; and knee-related quality of life. Further ACL injuries were also documented. Descriptive statistics were used to summarize return-to-play data and contingency analysis for predictors of return to sport.

RESULTS: The rate of return to any level of play was 35% (95% CI, 30%-41%; n = 284) at the 12-month follow-up and 78% (95% CI, 72%-83%; n = 233) at the 2- to 5-year follow-up. Overall, 64% (95% CI, 57%-70%) of the patients were able to return to their same or higher level of play. Before surgery, 92% of the patients expected to return to their same preinjury level of Australian football participation. At the 2- to 5-year follow-up, 61% who returned to play felt that they could perform as well as they could before their ACL injury. A greater psychological readiness to return to sport preoperatively and higher level of sport participation were significant predictors of a return at 2 to 5 years. Further ACL injuries were sustained by 21% of the cohort (15% graft rupture; 6% contralateral ACL injury).

CONCLUSION: Most male athletes who participate in Australian Rules football returned to some level of play after ACL reconstruction; however, only 64% returned to preinjury levels. Preoperative expectations were not met, and high reinjury rates are a cause for concern.


Language: en

Keywords

ACL reconstruction; Australian Rules football; knee injury; return to sport; sport performance

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