This is an open access paper published earlier this year in June in the Orthopaedic Journal of Sports Medicine. It is a retrospective case series that looked at elite AFL players who injured their ACL in the time period of 1990-2000.
Published online: 21 June 2017
Open access: YES (on PMC)
From the abstract:
“Purpose: To determine the prevalence of ACL injury and the incidence of further ACL injury, and to consider player return to play and return to preinjury form after ACL reconstruction. It was hypothesized that elite-level Australian Football League (AFL) players do not return to preinjury form until, at minimum, 2 years after returning to play.
Study Design: Case series; Level of evidence, 4.
Methods: A retrospective analysis was undertaken on a cohort of elite AFL players who injured their ACL between 1990 and 2000. Return to play after ACL reconstruction was determined by the mean number of ball disposals, or release of the ball by the hand or foot, at 1, 2, and 3 years after return to play and compared with preinjury form. Associations between player and injury characteristics, method of reconstruction, and outcomes (return to play, preinjury form, and further ACL injury) were examined.
Results: During the included seasons, a total of 2723 AFL players were listed. Of these, 131 (4.8%) sustained an ACL injury, with 115 players eligible for inclusion. Of 115 players, 26% did not return to elite competition, while 28% of those who did return experienced further ACL injury. The adjusted mean number of disposals (± standard error of the mean) was significantly lower at 1 year (12.21 ± 0.63; P = .003), 2 years (12.09 ± 0.65; P = .008), and 3 years (11.78 ± 0.77; P = .01) after return to play compared with preinjury (14.23 ± 0.67). On average, players did not return to preinjury form by 3 years (P < .01). Players aged 30 years or older were less likely to return to play compared with younger players (P = .0002), moderate-weight players were more likely to return to play compared with lighter-weight players (P = .007), and there were significantly increased odds of not returning to play if the dominant side was injured (odds ratio, 0.10; 95% CI, 0.03-0.34; P = .0002).
Conclusion: On average, AFL players do not return to their preinjury form after ACL injury and reconstruction, a common injury in this sporting population. This along with the high occurrence of reinjury highlights the career-threatening nature of ACL injury for elite AFL players.”
So one of the main findings of this study is that those who suffered an ACL injury took much longer (on average 3 yrs) than hypothesised (2 yrs) to return to their preinjury level of play. About a quarter did not return to elite competition, which again highlights the devastating effect ACL injuries can have for some athletes.
This graph was from a recent article highlighting the importance of considering BOTH the PREVALENCE and SEVERITY of a particular injury. This is from UEFA football data. As mentioned in the article, although ACL injuries have a low prevalence compared to other injuries, it is the most severe kind of injury. Not only days lost, but data from this article and many others have shown that it can take much longer for athletes to return to their preinjury levels, and many don’t make it back to their preinjury levels.
Please click on the link below to read the full article: