Advertisement

Length of Time Between Anterior Cruciate Ligament Reconstruction and Return to Sport Does Not Predict Need for Revision Surgery in National Football League Players

      Purpose

      To determine whether the length of time between primary anterior cruciate ligament reconstruction (ACLR) and return to sport (RTS) predicted the need for revision ACLR in National Football League (NFL) athletes.

      Methods

      All NFL players who underwent ACLR from 2009 to 2015 were identified. The date of index ACLR and date of return to NFL regular-season game play after surgery were recorded. The length of time between ACLR and RTS was compared between players who required revision ACLR and those who did not. Correlation coefficients were used to assess whether players who RTS sooner sustained recurrent anterior cruciate ligament injury at an earlier date.

      Results

      A total of 130 NFL players (average age, 25.3 ± 3.2 years) who underwent ACLR and returned to sport were identified. The average time to RTS after ACLR was 49.7 weeks after surgery. Of the players, 23 (18%) required revision ACLR. There was no significant difference in the length of time between ACLR and RTS in players who did not require revision ACLR (50.2 ± 10.1 weeks) and those who did (48.3 ± 11.0 weeks, P = .40). Time to RTS was not found to correlate with time to reinjury in athletes requiring revision ACLR (R = 0.21; 95% confidence interval, –0.18 to 0.54). A large proportion of players (56%) sustained a reinjury within the first 10 weeks of returning to NFL game play.

      Conclusions

      Our study found that timing of RTS after ACLR was not a significant risk factor for revision surgery in NFL athletes. Time to RTS was also not shown to correlate with time to reinjury.

      Level of Evidence

      Level III, case-control study.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Arthroscopy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Buller L.T.
        • Best M.J.
        • Baraga M.G.
        • Kaplan L.D.
        Trends in anterior cruciate ligament reconstruction in the United States.
        Orthop J Sports Med. 2015; 3 (2325967114563664)
        • Mall N.A.
        • Chalmers P.N.
        • Moric M.
        • et al.
        Incidence and trends of anterior cruciate ligament reconstruction in the United States.
        Am J Sports Med. 2014; 42: 2363-2370
        • Dodson C.C.
        • Secrist E.S.
        • Bhat S.B.
        • Woods D.P.
        • Deluca P.F.
        Anterior cruciate ligament injuries in National Football League athletes from 2010 to 2013: A descriptive epidemiology study.
        Orthop J Sports Med. 2016; 4 (2325967116631949)
        • Secrist E.S.
        • Bhat S.B.
        • Dodson C.C.
        The financial and professional impact of anterior cruciate ligament injuries in National Football League athletes.
        Orthop J Sports Med. 2016; 4 (2325967116663921)
        • DePhillipo N.N.
        • Cinque M.E.
        • Chahla J.
        • Geeslin A.G.
        • LaPrade R.F.
        Anterolateral ligament reconstruction techniques, biomechanics, and clinical outcomes: A systematic review.
        Arthroscopy. 2017; 33: 1575-1583
        • Read C.R.
        • Aune K.T.
        • Cain Jr., E.L.
        • Fleisig G.S.
        Return to play and decreased performance after anterior cruciate ligament reconstruction in National Football League defensive players.
        Am J Sports Med. 2017; 45: 1815-1821
        • Mai H.T.
        • Alvarez A.P.
        • Freshman R.D.
        • et al.
        The NFL Orthopaedic Surgery Outcomes Database (NO-SOD): The effect of common orthopaedic procedures on football careers.
        Am J Sports Med. 2016; 44: 2255-2262
        • Maletis G.B.
        • Inacio M.C.
        • Funahashi T.T.
        Risk factors associated with revision and contralateral anterior cruciate ligament reconstructions in the Kaiser Permanente ACLR registry.
        Am J Sports Med. 2015; 43: 641-647
        • Okoroha K.R.
        • Kadri O.
        • Keller R.A.
        • Marshall N.
        • Cizmic Z.
        • Moutzouros V.
        Return to play after revision anterior cruciate ligament reconstruction in National Football League players.
        Orthop J Sports Med. 2017; 5 (2325967117698788)
        • Jarvela T.
        Double-bundle versus single-bundle anterior cruciate ligament reconstruction: A prospective, randomize clinical study.
        Knee Surg Sports Traumatol Arthrosc. 2007; 15: 500-507
        • Persson A.
        • Fjeldsgaard K.
        • Gjertsen J.E.
        • et al.
        Increased risk of revision with hamstring tendon grafts compared with patellar tendon grafts after anterior cruciate ligament reconstruction: A study of 12,643 patients from the Norwegian Cruciate Ligament Registry, 2004-2012.
        Am J Sports Med. 2014; 42: 285-291
        • Erickson B.J.
        • Gupta A.K.
        • Harris J.D.
        • et al.
        Rate of return to pitching and performance after Tommy John surgery in Major League Baseball pitchers.
        Am J Sports Med. 2014; 42: 536-543
        • Erickson B.J.
        • Harris J.D.
        • Heninger J.R.
        • et al.
        Performance and return-to-sport after ACL reconstruction in NFL quarterbacks.
        Orthopedics. 2014; 37: e728-e734
        • Farber J.
        • Harris J.D.
        • Kolstad K.
        • McCulloch P.C.
        Treatment of anterior cruciate ligament injuries by Major League Soccer team physicians.
        Orthop J Sports Med. 2014; 2 (2325967114559892)
        • Keller R.A.
        • Steffes M.J.
        • Zhuo D.
        • Bey M.J.
        • Moutzouros V.
        The effects of medial ulnar collateral ligament reconstruction on Major League pitching performance.
        J Shoulder Elbow Surg. 2014; 23: 1591-1598
        • Lansdown D.A.
        • Feeley B.T.
        The effect of ulnar collateral ligament reconstruction on pitch velocity in Major League Baseball pitchers.
        Orthop J Sports Med. 2014; 2 (2325967114522592)
        • Erickson B.J.
        • Chalmers P.N.
        • Bach Jr., B.R.
        • et al.
        Length of time between surgery and return to sport after ulnar collateral ligament reconstruction in Major League Baseball pitchers does not predict need for revision surgery.
        J Shoulder Elbow Surg. 2017; 26: 699-703
        • Rougraff B.
        • Shelbourne K.D.
        • Gerth P.K.
        • Warner J.
        Arthroscopic and histologic analysis of human patellar tendon autografts used for anterior cruciate ligament reconstruction.
        Am J Sports Med. 1993; 21: 277-284
        • Janssen R.P.
        • van der Wijk J.
        • Fiedler A.
        • Schmidt T.
        • Sala H.A.
        • Scheffler S.U.
        Remodelling of human hamstring autografts after anterior cruciate ligament reconstruction.
        Knee Surg Sports Traumatol Arthrosc. 2011; 19: 1299-1306
        • Okoroha K.R.
        • Khalil L.
        • Jung E.K.
        • et al.
        Single-shot femoral nerve block does not cause long-term strength and functional deficits following anterior cruciate ligament reconstruction.
        Arthroscopy. 2017; 34: 205-212
        • Nawasreh Z.
        • Logerstedt D.
        • Cummer K.
        • Axe M.J.
        • Risberg M.A.
        • Snyder-Mackler L.
        Do patients failing return-to-activity criteria at 6 months after anterior cruciate ligament reconstruction continue demonstrating deficits at 2 years?.
        Am J Sports Med. 2017; 45: 1037-1048
        • Shah V.M.
        • Andrews J.R.
        • Fleisig G.S.
        • McMichael C.S.
        • Lemak L.J.
        Return to play after anterior cruciate ligament reconstruction in National Football League athletes.
        Am J Sports Med. 2010; 38: 2233-2239

      Linked Article