How do Elite Athletes Perform After ACL Reconstruction?

One study found that 86% of NBA players successfully made a comeback in the next playing season. However, total games started, total games played and player efficiency ratings were all significantly lower in their first season back compared to age-matched controls. Their careers were almost 2 years shorter as well (1).

Here are some interesting results by sport:

 MLS Soccer players: (2)

77% players returned to sport around 10 months post-op
10% ACL re-rupture rate (data unclear as to whether ipsilateral or contralateral)
Average career length after ACLR was 4 years
ACL surgery had no significant effect on player performance in post-op follow-up period
 

NFL players #1: (3)

82% of 559 athletes returned to sport after ACL at average of 378 days (>12 months).
Career length following ACLR was only 1.6 years
ACLR led to significantly worse performances in the first 3 seasons upon return to sport (if able to continue to play that long)



NFL players #2: (4)

63% returned to sport around 10 months post-op.
Those who returned to sport played significantly more games prior to injury (av. 50) vs those that didn’t (av. 28).
Players who were drafted in the first 4 rounds were 12x more likely to return to sport, rather those drafted in rounds 5-7.
Interesting conclusion that highly skilled and experienced athletes more likely to return to NFL than those that aren’t as skilled or have as much playing experience


NHL players: (5)

97% players returned to sport at 7.8 months post-op.
ACL Re-rupture rate was only 2.5% (data unclear as to whether ipsilateral or contralateral).
Players who returned to sport, played another 4.5 years post-op.
Performance measures actually increased in ACL patients than age-matched player controls (mean goals and points per season, mean power play and strength goals per season, and mean shots and shooting percentage per season)




References:

1. Kester BS, Behery OA, Minhas SV, Hsu WK. Athletic performance and career longevity following anterior cruciate ligament reconstruction in the National Basketball Association. Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA. 2016 Mar 12. PubMed PMID: 26971105. Epub 2016/03/14. Eng.

2. Erickson BJ, Harris JD, Cvetanovich GL, Bach BR, Bush-Joseph CA, Abrams GD, et al. Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in Male Major League Soccer Players. Orthopaedic journal of sports medicine. 2013 Jul;1(2):2325967113497189. PubMed PMID: 26535238. Pubmed Central PMCID: PMC4555483. Epub 2013/07/01. eng.

3. Mai HT, Alvarez AP, Freshman RD, Chun DS, Minhas SV, Patel AA, et al. The NFL Orthopaedic Surgery Outcomes Database (NO-SOD): The Effect of Common Orthopaedic Procedures on Football Careers. The American journal of sports medicine. 2016 Jun 16. PubMed PMID: 27311414. Epub 2016/06/18. Eng.

4. Shah VM, Andrews JR, Fleisig GS, McMichael CS, Lemak LJ. Return to play after anterior cruciate ligament reconstruction in National Football League athletes. The American journal of sports medicine. 2010 Nov;38(11):2233-9. PubMed PMID: 20610771. Epub 2010/07/09. eng.

5. Erickson BJ, Harris JD, Cole BJ, Frank RM, Fillingham YA, Ellman MB, et al. Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in National Hockey League Players. Orthopaedic journal of sports medicine. 2014 Sep;2(9):2325967114548831. PubMed PMID: 26535359. Pubmed Central PMCID: PMC4555634. Epub 2014/09/01. eng.

6. Mehran N, Williams PN, Keller RA, Khalil LS, Lombardo SJ, Kharrazi FD. Athletic Performance at the National Basketball Association Combine After Anterior Cruciate Ligament Reconstruction. Orthopaedic journal of sports medicine. 2016 May;4(5):2325967116648083. PubMed PMID: 27294169. Pubmed Central PMCID: PMC4887878. Epub 2016/06/14. eng.

7. Keller RA, Mehran N, Austin W, Marshall NE, Bastin K, Moutzouros V. Athletic Performance at the NFL Scouting Combine After Anterior Cruciate Ligament Reconstruction. The American journal of sports medicine. 2015 Dec;43(12):3022-6. PubMed PMID: 26493338. Epub 2015/10/24. eng.