The negative impact of anterior cruciate ligament reconstruction in professional male footballers

Background: Soccer is one of the most common international sports in which ACL injuries occur, with previous studies reporting high return-to-play rates following ACL reconstruction (ACLR). Return-to-play analysis fails to take into consideration how effective a player remains once returning to competition. The aims of this study are to provide a large-scale international analysis of return-to-play and player performance statistics among professional soccer athletes following ACLR. Methods: Using publicly available sources, professional soccer athletes who have undergone ACLR between the 1996 and 2015 seasons were identified. Player metrics including statistical performance, recovery time, and return-to-play rates were analyzed both before and after reconstruction. Furthermore, player performance statistics during each of three consecutive seasons post-ACLR were compared. Results: A total of 176 athletes who underwent ACLR were included in this study. The return-to-play rate was 93.2% (164 athletes). Cumulative post-surgical statistical analysis of ACLR players demonstrated fewer games/season, minutes/season, minutes/game, goals/season, and more fouls/season following ACLR (p < 0.04). Analysis of player performance statistics suggests that athletes do not return to their baseline number of games/season and minutes/game until two and three seasons post-ACLR, respectively. At three seasons post-ACLR, athletes are still starting fewer games/season and scoring fewer goals/90 min (p < 0.04). Conclusion: Return-to-play rate is high following ACLR; however, athletes exhibit poorer statistical performance, especially in the first few seasons upon return. Our data shows that athletes continue to start fewer games/season and score fewer goals/90 min at three seasons post-ACLR.