Can Talented Youth Soccer Players Who Have Undergone Anterior Cruciate Ligament Reconstruction Reach the Elite Level?

2020 ◽  
pp. 036354652097665
Author(s):  
Alexander Sandon ◽  
Tor Söderström ◽  
Andreas Stenling ◽  
Magnus Forssblad
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Reconstructive Surgery ◽  
Cruciate Ligament ◽  
Activity Level ◽  
Return To Play ◽  
Soccer Players ◽  
Youth Soccer ◽  
Elite Level ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) ruptures are common in soccer players, and reconstructive surgery is often performed to restore knee stability and enable a return to play. Purpose: To investigate whether an ACL reconstruction for talented youth soccer players affects their potential to become elite players at the senior level. Study Design: Cohort study; Level of evidence, 3. Methods: All soccer players who participated in the Swedish National Elite Camp for 15-year-old players between 2005 and 2011 (N = 5285 players; 2631 boys and 2654 girls) were matched with the Swedish National Knee Ligament Registry to identify the players who had undergone ACL reconstruction. Information on player participation in Swedish league games and level of play was collected from the Swedish Football Association’s administrative data system. The players with an ACL reconstruction who were injured at the ages of 15 to 19 years were compared with the rest of the players who participated in the National Elite Camp to see whether an early ACL reconstruction affected whether they remained active as soccer players and their chance to play at the elite level as seniors. Results: A total of 524 (9.9%) players had undergone an ACL reconstruction, and 292 (5.5%; 75 male and 217 female) had sustained their injury at age 15 to 19 years. During the follow-up period, 122 (23.3%) players underwent ACL reconstruction: revision (11.5%; n = 60) or contralateral (11.8%; n = 62). Male and female soccer players undergoing an ACL reconstruction at age 15 to 19 years experienced no significant effect on being active or playing at the elite level in the season that they turned 21 years old. Of the youth players who underwent ACL reconstruction, 12% of the male players and 11.5% of the female players progressed to the elite level at the age of 21 years compared with 10.3% of the men and 11.1% of the women among the uninjured players. Conclusion: ACL reconstructive surgery in talented youth soccer players offers them the opportunity to become elite players as seniors and permits an activity level on a par with that of their uninjured peers. However, almost 1 in 4 requires further ACL surgery, so the players’ future knee health should be considered when deciding on a return to play.

scholarly journals Performance After Anterior Cruciate Ligament Reconstruction in National Basketball Association Players

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712098164
Author(s):  
Steven F. DeFroda ◽  
Devan D. Patel ◽  
John Milner ◽  
Daniel S. Yang ◽  
Brett D. Owens
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Odds Ratio ◽  
Cruciate Ligament ◽  
Case Series ◽  
National Basketball Association ◽  
High Rate ◽  
Return To Play ◽  
Lower Percentage ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) injury in National Basketball Association (NBA) players can have a significant impact on player longevity and performance. Current literature reports a high rate of return to play, but there are limited data on performance after ACL reconstruction (ACLR). Purpose/Hypothesis: To determine return to play and player performance in the first and second seasons after ACLR in NBA players. We hypothesized that players would return at a high rate. However, we also hypothesized that performance in the first season after ACLR would be worse as compared with the preinjury performance, with a return to baseline by postoperative year 2. Study Design: Case series; Level of evidence, 4. Methods: An online database of NBA athlete injuries between 2010 and 2019 was queried using the term ACL reconstruction. For the included players, the following data were recorded: name; age at injury; position; height, weight, and body mass index; handedness; NBA experience; dates of injury, surgery, and return; knee affected; and postoperative seasons played. Regular season statistics for 1 preinjury season and 2 postoperative seasons were compiled and included games started and played, minutes played, and player efficiency rating. Kaplan-Meier survivorship plots were computed for athlete return-to-play and retirement endpoints. Results: A total of 26 athletes underwent ACLR; of these, 84% (95% CI, 63.9%-95.5%) returned to play at a mean 372.5 days (95% CI, 323.5-421.5 days) after surgery. Career length after injury was a mean of 3.36 seasons (95% CI, 2.27-4.45 seasons). Factors that contributed to an increased probability of return to play included younger age at injury (odds ratio, 0.71 [95% CI, 0.47-0.92]; P = .0337) and fewer years of experience in the NBA before injury (odds ratio, 0.70 [95% CI, 0.45-0.93]; P = .0335). Postoperatively, athletes played a significantly lower percentage of total games in the first season (48.4%; P = .0004) and second season (62.1%; P = .0067) as compared with the preinjury season (78.5%). Player efficiency rating in the first season was 19.3% less than that in the preinjury season ( P = .0056). Performance in the second postoperative season was not significantly different versus preinjury. Conclusion: NBA players have a high rate of RTP after ACLR. However, it may take longer than a single season for elite NBA athletes to return to their full preinjury performance. Younger players and those with less NBA experience returned at higher rates.

Altered Knee Laxity and Stiffness in Response to a Soccer Match Simulation in Players Returning to Sport Within 12 Months After Anterior Cruciate Ligament Reconstruction

2021 ◽  
pp. 036354652110130
Author(s):  
Stefano Nuccio ◽  
Luciana Labanca ◽  
Jacopo Emanuele Rocchi ◽  
Pier Paolo Mariani ◽  
Paola Sbriccoli ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Return To Sport ◽  
Knee Laxity ◽  
Activity Level ◽  
Soccer Players ◽  
Control Group ◽  
Soccer Match ◽  
Anterior Cruciate ◽  
Anterior Knee

Background: The acute effects of exercise on anterior knee laxity (AKL) and anterior knee stiffness (AKS) have been documented in healthy participants, but only limited evidence has been provided for athletes cleared to return to sports after anterior cruciate ligament (ACL) reconstruction (ACLR). Purpose/Hypothesis: The purpose was to determine if 45 minutes of a soccer match simulation lead to acute changes in AKL and AKS in soccer players returning to sport within 12 months after ACLR. We hypothesized that the reconstructed knee of the ACLR group would exhibit an altered response to sport-specific exercise. Study Design: Controlled laboratory study. Methods: A total of 13 soccer players cleared to return to sport after ACLR and 13 healthy control soccer players matched for age, physical activity level, limb dominance, and anthropometric characteristics were recruited. To assess the effects of a standardized soccer match simulation (Soccer Aerobic Field Test [SAFT45]) on AKL and AKS, an arthrometric evaluation was carried out bilaterally before and immediately after SAFT45. To conduct a comprehensive examination of the force-displacement curve, the absolute and side-to-side difference (SSD) values of both AKL and AKS were extracted at 67, 134, and 200 N. Results: The ACLR and control groups showed similar AKL and AKS at baseline ( P > .05). In response to SAFT45, laxity increased bilaterally at all force levels by 14% to 17% only in the control group ( P < .025). Similarly, AKS at 134 and 200 N decreased in response to SAFT45 only in the control group (10.5% and 20.5%, respectively; P < .025). After SAFT45, the ACLR group had 1.9 and 2.5 times higher SSDs of AKS at 67 and 134 N compared with the control group, respectively ( P < .025), as well as a 1.9 times higher SSD of AKS at 134 N compared with baseline ( P = .014). Conclusion: Soccer players at the time of return to sport after ACLR showed an altered mechanical response to a sport-specific match simulation consisting of bilaterally unchanged AKL and AKS. Clinical Relevance: Soccer players showing altered AKL and AKS in response to exercise after ACLR may not be ready to sustain their preinjury levels of sport, thus potentially increasing the risk of second ACL injuries.

Fifteen-Year Audit of Anterior Cruciate Ligament Reconstructions in the Australian Football League From 1999 to 2013: Return to Play and Subsequent ACL Injury

2018 ◽  
Vol 46 (14) ◽  
pp. 3353-3360 ◽  
Author(s):  
Courtney C.H. Lai ◽  
Julian A. Feller ◽  
Kate E. Webster
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
Risk Ratio ◽  
Cruciate Ligament ◽  
Acl Injury ◽  
Return To Play ◽  
Rates Of Return ◽  
Australian Football League ◽  
Australian Football ◽  
Anterior Cruciate

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.

Effect of the FIFA 11+ on Landing Patterns and Baseline Movement Errors in Elite Male Youth Soccer Players

2020 ◽  
Vol 29 (6) ◽  
pp. 730-737 ◽  
Author(s):  
Hadi Akbari ◽  
Mansour Sahebozamani ◽  
Ablolhamid Daneshjoo ◽  
Mohammadtaghi Amiri-Khorasani ◽  
Yohei Shimokochi
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Soccer Players ◽  
Control Group ◽  
Ligament Injuries ◽  
Male Youth ◽  
Warm Up ◽  
Youth Soccer ◽  
Anterior Cruciate Ligament Injuries ◽  
Anterior Cruciate

Context: There is no evidence regarding the effect of the FIFA 11+ on landing kinematics in male soccer players, and few studies exist regarding the evaluating progress of interventions based on the initial biomechanical profile. Objective: To investigate the effect of the FIFA 11+ program on landing patterns in soccer players classified as at low or high risk for noncontact anterior cruciate ligament injuries. Design: Randomized controlled trial. Setting: Field-based functional movement screening performed at the soccer field. Participants: A total of 24 elite male youth soccer players participated in this study. Intervention: The intervention group performed the FIFA 11+ program 3 times per week for 8 weeks, whereas the control group performed their regular warm-up program. Main Outcome Measures: Before and after the intervention, all participants were assessed for landing mechanics using the Landing Error Scoring System. Pretraining Landing Error Scoring System scores were used to determine risk groups. Results: The FIFA 11+ group had greater improvement than the control group in terms of improving the landing pattern; there was a significant intergroup difference (F1,20 = 28.86, P < .001, ). Soccer players categorized as being at high risk displayed greater improvement from the FIFA 11+ program than those at low risk (P = .03). However, there was no significant difference in the proportion of risk category following the routine warm-up program (P = 1.000). Conclusions: The present study provides evidence of the usefulness of the FIFA 11+ program for reducing risk factors associated with noncontact anterior cruciate ligament injuries. The authors’ results also suggest that soccer players with the higher risk profile would benefit more than those with lower risk profiles and that targeting them may improve the efficacy of the FIFA 11+ program.

scholarly journals Factors Associated With Psychological Readiness to Return to Sports With Cutting, Pivoting, and Jump-Landings After Primary ACL Reconstruction

2020 ◽  
Vol 8 (11) ◽  
pp. 232596712096448
Author(s):  
Junya Aizawa ◽  
Kenji Hirohata ◽  
Shunsuke Ohji ◽  
Takehiro Ohmi ◽  
Hideyuki Koga ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Regression Analysis ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Return To Sports ◽  
Factors Associated ◽  
Anterior Cruciate ◽  
Primary Acl Reconstruction ◽  
Jump Landings

Background: High psychological readiness is an important element for returning to sports after anterior cruciate ligament (ACL) reconstruction. Identifying factors that contribute to psychological readiness is essential for planning interventions to return to play. No studies have used multivariate analysis to clarify factors associated with psychological readiness to return to specific sports. Hypothesis: To identify factors that contribute to an athlete’s psychological readiness to return after ACL reconstruction to sports that require cutting, pivoting, and jump-landings. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Study participants were athletes who before injury had participated in sports with limited contact that required cutting, pivoting, and jump-landings (basketball, soccer, futsal, volleyball, badminton, tennis, and frisbee) and hoped to return to the same sport after reconstruction. Psychological readiness was measured using the Anterior Cruciate Ligament–Return to Sport After Injury Scale (ACL-RSI) in athletes more than 6 months after primary ACL reconstruction. To clarify factors associated with the ACL-RSI, univariate regression analysis and multivariate regression analysis were performed using the following independent variables: age, sex, body mass index, time from injury to reconstruction, time from reconstruction to testing, meniscal surgery, modified Tegner activity scale before injury, kinesiophobia, limb symmetry index of knee strength, limb symmetry indices of single-leg hop (SLH) distances, and subjective running ability. Results: Higher subjective running ability, a lower kinesiophobia score, and greater limb symmetry in the lateral SLH were positively associated with psychological readiness. Conclusion: The psychological readiness of athletes aiming to return after ACL reconstruction to limited-contact sports that require cutting, pivoting, and jump-landings was affected by subjective running ability, kinesiophobia, and asymmetry of lateral SLH distance. This information may be useful in planning appropriate interventions and thereby increasing the likelihood of an athlete’s returning to such sports.

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

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.

Anterior cruciate ligament ruptures in German elite soccer players: Epidemiology, mechanisms, and return to play

The Knee ◽  
2018 ◽  
Vol 25 (2) ◽  
pp. 219-225 ◽  
Author(s):  
Erik Schiffner ◽  
David Latz ◽  
Jan P. Grassmann ◽  
Alberto Schek ◽  
Simon Thelen ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Soccer Players ◽  
Anterior Cruciate

The Role of Patient Characteristics in the Success of Nonoperative Treatment of Anterior Cruciate Ligament Injuries

2020 ◽  
Vol 48 (7) ◽  
pp. 1657-1664 ◽  
Author(s):  
Jelle P. van der List ◽  
Frans J.A. Hagemans ◽  
Dirk Jan Hofstee ◽  
Freerk J. Jonkers
Keyword(s):  
Anterior Cruciate Ligament ◽  
Multivariate Analysis ◽  
Physical Therapy ◽  
Acl Reconstruction ◽  
Cruciate Ligament ◽  
Patient Characteristics ◽  
Nonoperative Treatment ◽  
Activity Level ◽  
Acl Injuries ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) tears can either be treated nonoperatively with physical therapy and then treated operatively if persistent instability is present, or be directly treated operatively. Advantages of early ACL reconstruction surgery include shorter time from injury to surgery and potentially fewer meniscal injuries, but performing early ACL reconstruction in all patients results in surgery in patients who might not need ACL reconstruction. It is important to assess in which patients nonoperative treatment is successful and which patients will require ACL reconstruction and thus might be better treated surgically in an earlier phase. Purpose: To identify patient characteristics that predict the success of nonoperative treatment. Study Design: Cohort study (Prognosis); Level of evidence, 2. Methods: All patients with complete ACL injuries who were evaluated between 2014 and 2017 at our clinic were included. The minimum follow-up was 2 years. The initial treatment and ultimate ACL reconstruction were reviewed. Univariate analysis was performed using Mann-Whitney U tests and chi-square tests and multivariate analysis using binary logistic regression. Results: A total of 448 patients were included with a median age of 26 years and median Tegner level of 7 and mean Tegner level of 6.4. At initial consultation, 210 patients (47%) were treated nonoperatively with physical therapy and 126 of these patients (60%) ultimately required ACL reconstruction. Nonoperative treatment failed in 88.9% of patients <25 years of age, 56.0% of patients 25 to 40 years, and 32.9% of patients >40 years ( P < .001); and 41.9% of patients with Tegner level 3 to 6, and 82.8% of patients with Tegner level 7 to 10. Age <25 years (odds ratio [OR], 7.4; P < .001) and higher Tegner levels (OR, 4.2; P < .001) were predictive of failing nonoperative treatment in multivariate analysis. Patients in the failed nonoperative group had longer time from diagnosis to surgery than the direct reconstruction group (6.2 vs 2.2 months; P < .001), and more frequently had new meniscal injuries (17.4% vs 3.1%; P < .001) at surgery. Conclusion: Nonoperative treatment of ACL injuries failed in 60% of patients and was highly correlated with age and activity level. In patients aged 25 years or younger or participating in higher-impact sports, early ACL reconstruction should be considered to prevent longer delay between injury and surgery, as well as new meniscal injuries.

scholarly journals Impact of Anterior Cruciate Ligament Reconstruction on NCAA FBS Football Players: Return to Play and Performance Vary by Position

2019 ◽  
Vol 7 (4) ◽  
pp. 232596711984105 ◽  
Author(s):  
Patrick Martin Wise ◽  
Robert A. Gallo
Keyword(s):  
Anterior Cruciate Ligament ◽  
Acl Reconstruction ◽  
National Collegiate Athletic Association ◽  
Functional Performance ◽  
Cruciate Ligament ◽  
Return To Play ◽  
Football Players ◽  
Significant Performance ◽  
Anterior Cruciate ◽  
The Impact

Background: Anterior cruciate ligament (ACL) injuries are devastating for college football players. Although the change in functional performance of National Collegiate Athletic Association (NCAA) football players after reconstruction has been shown to be negligible, studies have failed to analyze the statistical performance of these players upon their return. Purpose/Hypothesis: The purpose of this study was to quantify the impact of ACL reconstruction on the statistical performance of collegiate football players. We hypothesized that statistical performance would vary by position and that running backs, wide receivers, and defensive backs, compared with preinjury and controls, would experience the largest decline in performance after returning from ACL reconstruction. Study Design: Descriptive epidemiology study. Methods: NCAA Football Bowl Subdivision (FBS) football players who experienced ACL tears between the years 2010 and 2015 were identified. The rates of return to play after surgery were determined for each position. Preinjury and postoperative performance statistics of each running back, receiver, defensive lineman, linebacker, and defensive back who met inclusion criteria were compared. A t-test analysis was used to compare the performance changes experienced by these players versus the performance changes of matched controls. Results: A total of 349 players were identified. Only 63.64% of eligible offensive linemen returned to play. Upon return, running backs experienced significant performance decreases compared with controls in carries (mean ± SD, –2.4 ± 2.7 vs 2.8 ± 1.6; P = .003), yards (–12.3 ± 15.5 vs 13.8 ± 7.8; P = .006), and receptions (–0.22 ± 0.32 vs 0.32 ± 0.23; P = .011) per game. Receivers displayed significant performance decreases compared with controls in number of touchdowns (–0.019 ± 0.110 vs 0.18 ± 0.06; P = .004), receptions (–0.11 ± 0.79 vs 1.2 ± 0.4; P = .004), and yards (–3.2 ± 10.6 vs 18.6 ± 5.4; P = .0009) per game. Linebackers demonstrated less improvement than controls in tackles for loss (0.007 ± 0.115 vs 0.31 ± 0.11; P = .0003) and sacks (0.001 ± 0.061 vs 0.10 ± 0.06; P = .026). Conclusion: Although offensive linemen were the least likely to return to play, running backs and receivers returned to play at a lower level of performance. The performance of defensive players was less affected by ACL reconstruction.

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