Liptak Matthew G, Angel Kevin R
Department of Orthopaedic and Trauma Surgery, School of Medicine, Flinders University, Adelaide, South Australia, Australia.
Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, South Australia, Australia.
Orthop J Sports Med. 2017 Jun 21;5(6):2325967117711885. doi: 10.1177/2325967117711885. eCollection 2017 Jun.
Australian Rules football is a highly aerobic and anaerobic game that at times requires players to perform cutting or pivoting maneuvers, potentially exposing them to anterior cruciate ligament (ACL) injury. At present, there are limited data available addressing the impact of ACL injury on return to play and preinjury form after ACL reconstruction.
To determine the prevalence of ACL injury and the incidence of further ACL injury, and to consider player return to play and return to preinjury form after ACL reconstruction. It was hypothesized that elite-level Australian Football League (AFL) players do not return to preinjury form until, at minimum, 2 years after returning to play.
Case series; Level of evidence, 4.
A retrospective analysis was undertaken on a cohort of elite AFL players who injured their ACL between 1990 and 2000. Return to play after ACL reconstruction was determined by the mean number of ball disposals, or release of the ball by the hand or foot, at 1, 2, and 3 years after return to play and compared with preinjury form. Associations between player and injury characteristics, method of reconstruction, and outcomes (return to play, preinjury form, and further ACL injury) were examined.
During the included seasons, a total of 2723 AFL players were listed. Of these, 131 (4.8%) sustained an ACL injury, with 115 players eligible for inclusion. Of 115 players, 26% did not return to elite competition, while 28% of those who did return experienced further ACL injury. The adjusted mean number of disposals (± standard error of the mean) was significantly lower at 1 year (12.21 ± 0.63; = .003), 2 years (12.09 ± 0.65; = .008), and 3 years (11.78 ± 0.77; = .01) after return to play compared with preinjury (14.23 ± 0.67). On average, players did not return to preinjury form by 3 years ( < .01). Players aged 30 years or older were less likely to return to play compared with younger players ( = .0002), moderate-weight players were more likely to return to play compared with lighter-weight players ( = .007), and there were significantly increased odds of not returning to play if the dominant side was injured (odds ratio, 0.10; 95% CI, 0.03-0.34; = .0002).
On average, AFL players do not return to their preinjury form after ACL injury and reconstruction, a common injury in this sporting population. This along with the high occurrence of reinjury highlights the career-threatening nature of ACL injury for elite AFL players.
澳式橄榄球是一项有氧和无氧需求都很高的运动，球员有时需要进行变向或转身动作，这可能使他们面临前交叉韧带（ACL）损伤的风险。目前，关于ACL损伤对ACL重建后重返赛场及伤前竞技水平恢复的影响，可用数据有限。
确定ACL损伤的患病率和再次ACL损伤的发生率，并探讨球员在ACL重建后重返赛场及恢复到伤前竞技水平的情况。研究假设是，澳大利亚足球联赛（AFL）的精英球员在重返赛场至少2年后才能恢复到伤前的竞技水平。
病例系列；证据等级，4级。
对1990年至2000年间ACL受伤的AFL精英球员队列进行回顾性分析。通过重返赛场后1年、2年和3年时的平均控球次数（即手或脚触球次数）来确定ACL重建后重返赛场的情况，并与伤前水平进行比较。研究了球员和损伤特征、重建方法与结果（重返赛场、恢复伤前水平和再次ACL损伤）之间的关联。
在纳入研究的赛季中，共有2723名AFL球员在册。其中，131名（4.8%）发生了ACL损伤，有115名球员符合纳入标准。在这115名球员中，26%没有重返精英比赛，而在那些重返赛场的球员中，28%再次发生了ACL损伤。与伤前（14.23±0.67）相比，重返赛场后1年（12.21±0.63；P = 0.003）、2年（12.09±0.65；P = 0.008）和3年（11.78±0.77；P = 有显著差异。平均而言，球员在3年后仍未恢复到伤前水平（P < 0.01）。30岁及以上的球员比年轻球员重返赛场的可能性更小（P = 0.0002），中等体重的球员比轻体重的球员更有可能重返赛场（P = 0.007），如果优势侧受伤，则重返赛场的几率显著降低（优势比，0.10；95%可信区间，0.03 - 0.34；P = 0.0002）。
平均而言，AFL球员在ACL损伤和重建后无法恢复到伤前水平，ACL损伤在该运动人群中较为常见。再加上再次受伤的发生率较高，这凸显了ACL损伤对AFL精英球员职业生涯的威胁。
