Fifteen-Year Audit of Anterior Cruciate Ligament Reconstructions in the Australian Football League

Background: Anterior cruciate ligament (ACL) injury has been a major cause of missed game time among Australian Football League (AFL) players. Return to play after ACL reconstruction is not always achieved, even among elite athletes. The rate of subsequent ACL injury in the AFL from 1990 to 2000 was high as compared with that of other elite sports. Purpose: To determine the rates of return to play and subsequent ACL injury after ACL reconstruction among AFL players from 1999 to 2013 and to explore factors associated with differing rates of return to play and subsequent ACL injury. Study Design: Case series; Level of evidence, 4. Methods: A total of 158 AFL players who underwent ACL reconstruction were identified from a prospectively maintained registry of AFL player injuries. Further data were gathered from official playing statistics, surgical records, and structured phone interviews. Results: The rate of return to play after an initial ACL injury was 77% (121 of 158 players). Greater preinjury playing experience and earlier selection in the AFL draft were associated with higher rates of return to play. The rate of subsequent ACL injury to either knee was 30% (48 of 158 players) and was especially high among players aged <21 years (23 of 46 players, 50%). After subsequent ACL injury, 34 of 48 players (71%) returned to play. In primary ACL reconstruction, the use of Ligament Augmentation and Reconstruction System grafts resulted in a faster return to play ( P = .001) but had a higher risk of subsequent revision reconstruction (risk ratio = 2.8, P = .048). Family history of ACL injury was associated with an increased risk of subsequent contralateral ACL injury (risk ratio = 3.8, P = .002). Conclusion: Most AFL players who underwent ACL reconstruction returned to play at least 1 AFL match. The high rate of subsequent ACL injury among AFL players demonstrates the highly demanding nature of Australian football, particularly at the elite level. The risk factors for subsequent ACL injury should be considered carefully when treatment and rehabilitation decisions are made for these high-demand athletes.

Download Full-text

Playing Performance After Anterior Cruciate Ligament Reconstruction Among Australian Football League Players From 1999 to 2013

The American Journal of Sports Medicine ◽

10.1177/0363546519843908 ◽

2019 ◽

Vol 47 (7) ◽

pp. 1550-1556

Author(s):

Courtney C.H. Lai ◽

Julian A. Feller ◽

Kate E. Webster

Keyword(s):

Anterior Cruciate Ligament ◽

Acl Reconstruction ◽

Odds Ratio ◽

Cruciate Ligament ◽

Acl Injury ◽

Return To Play ◽

Average Level ◽

Australian Football League ◽

Australian Football ◽

Anterior Cruciate

Background: Achieving preinjury levels of athletic performance has been challenging for elite athletes after anterior cruciate ligament (ACL) reconstruction. Although a recent study found that 77% of Australian Football League (AFL) players who underwent ACL reconstruction from 1999 to 2013 returned to play at the highest level, the study did not indicate how consistently or well they were able to play. Purpose: To identify the number of AFL players who returned to play consistently over 2 seasons after ACL reconstruction, compare their playing performance in these seasons with preinjury performance, and evaluate factors associated with returning to preinjury levels of performance. Study Design: Case series; Level of evidence, 4. Methods: Analysis included 104 AFL players who underwent ACL reconstruction between 1999 and 2013. All had played at least 10 AFL matches in 1 season before ACL injury. Ranking points, as devised by AFL statisticians, were used to measure individual playing performance. Results: Of the 104 players who played at least 10 matches in 1 season before ACL injury, 53 (51%) returned to play at least 10 matches in 2 seasons after surgery. Of these 53 players, 36 (68%) returned to their preinjury levels of performance. The 17 remaining players who did not return to their preinjury performance still performed comparably to the AFL average level after surgery. Players <25 years old (odds ratio = 2.9, P = .01) or <90 kg (odds ratio = 2.7, P = .03) had greater odds of returning to their preinjury levels of performance. Conclusion: Returning to play on a consistent basis was a substantial challenge for AFL players after ACL reconstruction. However, among players who did return to play consistently over 2 seasons, their postsurgery average performance was comparable with the AFL average level of performance, and two-thirds returned to their preinjury levels of performance. Younger and lighter players were more likely to return to their preinjury levels of performance, possibly given the nature of AFL club playing list management decisions.

Download Full-text

Fifteen-year audit of anterior cruciate ligament reconstructions in the Australian football league

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2017.01.039 ◽

2017 ◽

Vol 20 ◽

pp. e82-e83

Author(s):

C. Lai ◽

K. Webster ◽

J. Feller

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Australian Football League ◽

Australian Football ◽

Anterior Cruciate

Download Full-text

Characterising Anterior Cruciate Ligament (ACL) Injury Situations in the Women’s Australian Football League (AFLW)

Journal of Science and Medicine in Sport ◽

10.1016/j.jsams.2021.09.063 ◽

2021 ◽

Vol 24 ◽

pp. S22-S23

Author(s):

A. Fox ◽

T. Rolley ◽

N. Saunders

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Acl Injury ◽

Australian Football League ◽

Australian Football ◽

Anterior Cruciate

Download Full-text

Anterior cruciate ligament injuries in Australian football: should women and girls be playing? You’re asking the wrong question

BMJ Open Sport & Exercise Medicine ◽

10.1136/bmjsem-2020-000778 ◽

2020 ◽

Vol 6 (1) ◽

pp. e000778 ◽

Cited By ~ 1

Author(s):

Aaron Fox ◽

Jason Bonacci ◽

Samantha Hoffmann ◽

Sophia Nimphius ◽

Natalie Saunders

Keyword(s):

Anterior Cruciate Ligament ◽

Cruciate Ligament ◽

Acl Injury ◽

Early Years ◽

High Rate ◽

Acl Injuries ◽

Sports Science ◽

Australian Football ◽

Women And Girls ◽

Anterior Cruciate

Anterior cruciate ligament (ACL) injuries have been a rising concern in the early years of the women’s Australian Football League (AFLW), eliciting headlines of a ‘knee crisis’ surrounding the league. There has been a focus on female biology as the primary factor driving the high rate of ACL injuries in the AFLW. Emphasising Australian football (AF) as being dangerous predominantly due to female biology may be misrepresenting a root cause of the ACL injury problem, perpetuating gender stereotypes that can restrict physical development and participation of women and girls in the sport. We propose that an approach addressing environmental and sociocultural factors, along with biological determinants, is required to truly challenge the ACL injury problem in the AFLW. Sports science and medicine must therefore strive to understand the whole system of women in AF, and question how to address inequities for the benefit of the athletes.

Download Full-text