Getting on the Ball, Post-ACL Surgery

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Most competitive high school athletes receiving anterior cruciate ligament (ACL) reconstruction surgery are able to return to their sport at the same level, and males and females return to competition at the same rate. A new study presented today at the 2009 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) also found that although athletes who sustain an ACL tear have a high risk of reinjuring that ligament, returning to sports quickly does not increase the risk of re-injury.

This is the first study to specifically address the teenage athlete’s ability to return to high-level competition after an ACL reconstruction. In addition, the researchers sought to determine whether gender plays a role in a patient’s rehabilitation.

“For competitive athletes, the measure of a successful ACL reconstruction is whether they are able to return to the same level of competition,” says K. Donald Shelbourne, M.D., an orthopaedic surgeon at the Shelbourne Knee Center in Indianapolis. “This is especially important to high-school athletes, because they often want to continue playing at that high level for years, so they can compete in college as well.”

Researchers studied more than 400 patients who were 17 years old or younger at the time of their first ACL reconstruction, and who participated in basketball or soccer, sports that are especially hard on the ACLs. They found the following:

• 87 percent of both girls and boys returned to basketball after surgery
• 93 percent of girls and 80 percent of boys were able to return to soccer
• For both sports and both sexes, the mean time to return to full participation was just over 5 months
• 20 percent of the patients went on to compete at the collegiate level

In addition, the study’s results indicate that patients who feel able to return to sports should be allowed to do so. They should not be restricted to a predetermined timeline, because the study showed that although the athletes had a high risk of reinjuring the reconstructed ACL or injuring the other ACL within 5 years of the original surgery, that risk was not any higher for those who returned to their sport sooner.

Dr. Shelbourne added, “Time frames for getting back to sports may vary among athletes based on differences in surgical techniques and rehabilitation programs prescribed.”

ACL Fast Facts:
• The ACL connects the front part of the shin bone to the back part of the thigh bone, keeping the shin bone from sliding forward.
• The ACL is usually injured either by a direct blow to the knee or through a non-contact injury resulting from planting the foot and cutting, landing on a straight leg, or making an abrupt stop. When the ACL is torn, it often must be repaired through ACL reconstruction surgery and subsequent rehabilitation.
• About 200,000 ACLs are injured in the United States each year, resulting in approximately 100,000 ACL reconstructions.

Disclosure: Dr. Shelbourne and his co-authors received no compensation for this study.

Source: American Academy of Orthopaedic Surgeons (AAOS)

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