ArticleOrthopaedic journal of sports medicine2025
Return to Sport and Risk of Second Anterior Cruciate Ligament (ACL) Injury in Elite Male Footballers: 10-Year Experience From a Single Center.
Article in Orthopaedic journal of sports medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Time to return to sports in football players recovering from lower limb soft tissue injuries: a systematic review with meta-analysis.BMJ open sport & exercise medicine · 2026Article
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Background: Anterior cruciate ligament (ACL) injury among professional footballers represents a career-threatening injury with a high burden for athletes and teams. Debated issues in professional footballers after ACL reconstruction (ACLR) include time to return to play (RTP), level of play after surgery, and incidence and timing of sustaining a second ACL injury. Purposes: To analyze RTP and performance 2 seasons after surgery of professional footballers who underwent ACLR, to evaluate factors influencing the timing of RTP and second injury risk, and to assess the level of RTP and performance after surgery. Study Design: Case series; Level of evidence, 4. Methods: All professional male footballers who underwent ACLR using a hamstrings graft with or without a lateral extra-articular procedure at a single institution between 2002 and 2013 were retrospectively included. Demographic and intraoperative findings were extracted from the medical records. Data regarding the number of matches played in 5 seasons (injury season, the 2 seasons before, and the 2 seasons after the injury), the level of play in those 5 seasons, the time to return to the first official match, and reinjuries were extracted from publicly available databases, and patients were contacted to confirm. Univariate and multivariate analyses were conducted to identify factors influencing RTP and risk factors for second ACL injury. Results: A total of 58 primary ACLRs were included; 20 (34.5%) participated in the first division (Serie A). RTP was 96.6% (56/58) after a mean of 6.4 ± 2.3 months, and return to match occurred after a mean of 7.5 ± 3.3 months. Patients without meniscal injury had a faster RTP (5.6 ± 1.6 months; Conclusion: Almost all patients returned to play after ACLR using hamstrings graft with over-the-top techniques, typically regaining preinjury performance by the second season after the injury. RTP time was shorter for isolated ACL injuries and longer when associated with meniscal or cartilage injury. Given the high risk of a second ACL injury on either knee and the high reoperation rate, RTP before 5 months should be discouraged, particularly in athletes <21 years.
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