The Effect of Primary ACL Reconstruction on Career Longevity in English Premier League and Championship Soccer Players Compared With Uninjured Controls: A Matched Cohort Analysis.

Autor:	Borque KA; Houston Methodist Hospital, Houston, Texas, USA., Laughlin MS; Houston Methodist Academic Institute, Houston, Texas, USA., Hugo Pinheiro V; Coimbra Hospital and University Centre, Coimbra, Portugal., Ngo D; Houston Methodist Academic Institute, Houston, Texas, USA., Kent M; Houston Methodist Academic Institute, Houston, Texas, USA., Balendra G; Fortius Clinic, London, UK.; FIFA Medical Centre of Excellence, London, UK., Jones M; Fortius Clinic, London, UK.; FIFA Medical Centre of Excellence, London, UK., Williams A; Fortius Clinic, London, UK.; FIFA Medical Centre of Excellence, London, UK.
Jazyk:	angličtina
Zdroj:	The American journal of sports medicine [Am J Sports Med] 2024 Apr; Vol. 52 (5), pp. 1183-1188. Date of Electronic Publication: 2024 Mar 15.
DOI:	10.1177/03635465241235949
Abstrakt:	Background: Because of the multitude of variables that affect the retirement decisions of professional soccer players, it has proven difficult to isolate the effect of undergoing anterior cruciate ligament (ACL) reconstruction (ACLR) on career longevity. Purpose: To compare the career longevity of professional soccer players after a primary ACLR with that of an uninjured matched control cohort. Study Design: Cohort study; Level of evidence, 3. Methods: A retrospective review of a consecutive series of primary ACLR was performed between 2008 and 2018 in professional male soccer players from the senior author's practice. Each athlete with ACLR was matched to 3 control athletes who had not undergone ACLR according to age, league, playing position, and preinjury game appearances/minutes played. Player career statistics-including league, game appearances, and game minutes-were compiled for each year until retirement or July 1, 2022. Results: A total of 82 soccer players in the English Premier League or Championship at the time of their primary ACLR were matched to 246 control athletes. The mean career length after ACLR was 6 ± 2.6 years, while that of the matched control athletes was 7.6 ± 2.8 years ( P < .001). After primary ACLR, an athlete had a 2 times greater chance of retirement compared with the matched control athlete (hazard ratio, 2.19; P < .001). At 5 years after ACLR, 16% of athletes had retired from professional soccer, while 8.5% of the matched cohort were retired ( P = .060). By 10 years, 72% of the ACLR cohort had retired compared with 43% of the matched cohort ( P < .001). Forwards were more likely to have shortened careers compared with goalkeepers ( P = .021); however, no significant differences were observed between midfielders, defenders, and forwards. Within the ACLR cohort, a contralateral ACL tear during the athlete's career caused a 2.30 times ( P = .022) increased chance of retirement compared with athletes with only 1 ACL tear during their career. Mechanism of injury, meniscal pathology, graft rerupture, and chondral lesions did not affect career length. Conclusion: Professional male soccer players who underwent ACLR had decreased career length by approximately 1.6 years compared with a matched player cohort. Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: K.A.B. has received consulting fees from Xiros and DePuy Synthes, speaking fees from Arthrex, support for education from MedInc of Texas, and hospitality payments from Medical Device Business Services. A.W. has received research funding from Smith & Nephew and holds stock in DocComs and Innovate. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.
Databáze:	MEDLINE
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