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Return to Sports After ACL Reconstruction


One question often asked by athletes before they undergo ACL reconstruction is “When and will I be able to return to sports?” This is an important question because returning to play (RTP) is just one of the factors taken into consideration as to the decision to undergo this invasive procedure. The answer to this question depends on many factors: level of activity before the injury, extent of the damage inside the knee, and level of competition.

Namdari et al in The Physician and Sportsmedicine in February 2011 reported on a study of 18 WNBA basketball players who underwent ACL reconstruction. They found reported that 78% returned to play in the WNBA. For those that did return, changes in performance were not statistically reduced compared to a comparison group.

Shah et al reported in The American Journal of Sports Medicine in November 2010 on a group of NFL athletes who had ACL reconstruction.  This study of 49 NFL players who underwent primary (first-time) ACL surgery found that 63% returned to NFL game play at an average of 10.8 months.  They found that the odds of returning to play were higher for those with more than four years of NFL experience.  Furthermore, Shah et al found that those drafted in the first four rounds of the NFL draft had higher odds of returning to play than those drafted later. They concluded that more experienced and established athletes are more likely to return to competition at the same level after ACL reconstruction than those with less experience.

Return to sports two to seven years after ACL reconstruction was studied by Ardern et al and reported in The American Journal of Sports Medicine in January 2012.  This medium-term analysis of 314 patients with the average age of 32.5 years used a self-reported questionnaire to ask questions regarding knee function and attempt to RTP.  Adern et al found that 45% of participants reported playing sports at their pre-injury level and 29% were playing competitive sports. However, younger patients were more likely to return to pre-injury levels of participation, and most patients reported good postoperative function of their knee.

In a separate study reported in The American Journal of Sports Medicine in March 2011, Adern et al reported on RTP 12 months after ACL reconstruction in Australian athletes. These athletes in competitive level Australian football, basketball, netball, or soccer had a return rate to competitive sport of 33% at twelve months. However, 47% indicated in this short term study that they planned on returning.  Ardern et al concluded that people may require a longer rehabilitation period to return to competitive sports than previously believed.

As you can see just from these few studies here, more research is needed to provide patients with the answer of returning to play after ACL reconstruction. Currently, there is a wide range of answers depending on age, athletic ability, and lifestyle that has to be factored into this important issue.


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