Purpose
Examine the association between preoperative, intraoperative and postoperative variables, including on-field rehabilitation (OFR) participation and return to play (RTP) rates and re-injury risk in a large cohort of 11-a-side football (soccer) players after anterior cruciate ligament reconstruction (ACLR).
Methods
Data from 401 male football players who underwent primary ACLR were retrospectively analysed. All players completed a standardised rehabilitation protocol, involving a period of OFR. Participants were stratified by competitive level (professionals and amateurs), and between-group differences in RTP and re-injury outcomes were documented. The association between preoperative, intraoperative and postoperative variables for each outcome was assessed using logistic regressions, controlling for competitive level.
Results
Median follow-up time was 40.6 months post-ACLR. Eighty-four percent of players RTP at their pre-injury competitive level, with professionals (88%) and amateurs (83%) returning in 5.9 ± 2.1 and 6.9 ± 3.2 months, respectively. Greater OFR volume (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; p = 0.034) and weekly frequency (OR, 1.53; 95% CI, 1.00-1.07; p = 0.014) were associated with increased RTP likelihood. High OFR compliance was associated with higher odds of RTP (OR = 2.62, p = 0.003), in which 91% of compliant players RTP at their pre-injury competitive level. Forty-two players (10%) sustained a second ACL injury (20 ipsilateral and 22 contralateral). OFR variables were not significantly associated with overall second ACL re-injury risk. In an exploratory subgroup analysis of young (