School of Allied Health, La Trobe University, Melbourne, Australia.
OrthoSport Victoria, Melbourne, Australia.
Am J Sports Med. 2018 Dec;46(14):3353-3360. doi: 10.1177/0363546518803932. Epub 2018 Nov 2.
Anterior cruciate ligament (ACL) injury has been a major cause of missed game time among Australian Football League (AFL) players. Return to play after ACL reconstruction is not always achieved, even among elite athletes. The rate of subsequent ACL injury in the AFL from 1990 to 2000 was high as compared with that of other elite sports.
To determine the rates of return to play and subsequent ACL injury after ACL reconstruction among AFL players from 1999 to 2013 and to explore factors associated with differing rates of return to play and subsequent ACL injury.
Case series; Level of evidence, 4.
A total of 158 AFL players who underwent ACL reconstruction were identified from a prospectively maintained registry of AFL player injuries. Further data were gathered from official playing statistics, surgical records, and structured phone interviews.
The rate of return to play after an initial ACL injury was 77% (121 of 158 players). Greater preinjury playing experience and earlier selection in the AFL draft were associated with higher rates of return to play. The rate of subsequent ACL injury to either knee was 30% (48 of 158 players) and was especially high among players aged <21 years (23 of 46 players, 50%). After subsequent ACL injury, 34 of 48 players (71%) returned to play. In primary ACL reconstruction, the use of Ligament Augmentation and Reconstruction System grafts resulted in a faster return to play ( P = .001) but had a higher risk of subsequent revision reconstruction (risk ratio = 2.8, P = .048). Family history of ACL injury was associated with an increased risk of subsequent contralateral ACL injury (risk ratio = 3.8, P = .002).
Most AFL players who underwent ACL reconstruction returned to play at least 1 AFL match. The high rate of subsequent ACL injury among AFL players demonstrates the highly demanding nature of Australian football, particularly at the elite level. The risk factors for subsequent ACL injury should be considered carefully when treatment and rehabilitation decisions are made for these high-demand athletes.
前交叉韧带（ACL）损伤一直是澳大利亚足球联盟（AFL）运动员错过比赛时间的主要原因。即使是精英运动员，ACL 重建后也并非总能重返赛场。1990 年至 2000 年期间，AFL 球员的 ACL 再次损伤率较高，与其他精英运动相比。
确定 1999 年至 2013 年 AFL 球员 ACL 重建后的重返赛场率和随后的 ACL 损伤率，并探讨与不同重返赛场率和随后的 ACL 损伤率相关的因素。
病例系列；证据水平，4 级。
从 AFL 球员受伤的前瞻性维护登记处确定了 158 名接受 ACL 重建的 AFL 球员。进一步的数据来自官方比赛统计数据、手术记录和结构化电话访谈。
初次 ACL 损伤后重返赛场的比例为 77%（158 名球员中的 121 名）。较高的受伤前比赛经验和更早地在 AFL 选秀中被选中与更高的重返赛场率相关。双侧膝关节的随后 ACL 损伤率为 30%（158 名球员中的 48 名），尤其是年龄<21 岁的球员（46 名球员中的 23 名，50%）。随后 ACL 损伤后，48 名球员中的 34 名（71%）重返赛场。在初次 ACL 重建中，使用 Ligament Augmentation and Reconstruction System 移植物可更快地重返赛场（P =.001），但随后revision 重建的风险更高（风险比=2.8，P =.048）。ACL 损伤家族史与随后对侧 ACL 损伤的风险增加相关（风险比=3.8，P =.002）。
大多数接受 ACL 重建的 AFL 球员至少参加了 1 场 AFL 比赛。AFL 球员随后 ACL 损伤的高发生率表明澳大利亚足球的要求极高，尤其是在精英水平。在为这些高需求运动员做出治疗和康复决策时，应仔细考虑随后 ACL 损伤的风险因素。
