2023 ISAKOS Biennial Congress Paper
Professional Level and the Midfielder Position Predict a Successful Return to Sport after Anterior Cruciate Ligament Reconstruction: A Multiparametric Evaluation in Soccer Players
Filippo Familiari, MD, Prof., Catanzaro ITALY
Michele Mercurio, MD, Catanzaro ITALY
Orlando Cosentino, MD, Catanzaro ITALY
Simone Cerciello, MD, Rome ITALY
Katia Corona, MD, Campobasso, Molise ITALY
Germano Guerra, MD, Prof., Campobasso ITALY
Roberto Simonetta, Messina, Sicily ITALY
Olimpio Galasso, MD, Prof., Catanzaro ITALY
Giorgio Gasparini, MD, Prof., Catanzaro ITALY
Magna Graecia University, Catanzaro, ITALY
FDA Status Not Applicable
Summary
Professional soccer players and the midfielder position predict better functional scores upon returning to the sport. A history of noncontact ACL injury and playing on a single type of surface are risk factors for lower functional outcomes upon returning to the sport. Lower mental health scores can be expected after injury of the dominant limb.
Abstract
Objectives
The aim of this study was to identify successful return to sport (RTS) predictors after ACL reconstruction (ACLR) in soccer players.
Methods
One hundred sixty-eight out of 231 patients who underwent primary unilateral arthroscopic anatomic single-bundle ACLR were available at follow-up. Postoperatively, knee function, generic health outcomes, and psychological impact were assessed using the IKDC, the KOOS, the Lysholm Knee Scoring Scale, the SF-12, and the ACL return to sports after injury (ACL-RSI) scale.
Results
After a mean follow-up of 35.5±22.6 months, 85% of soccer players returned to their previous level of play. Midfielder position predicted a better SF-12 PCS score (p=0.013), IKDC (p=0.003), total KOOS (p<0.001), KOOS symptoms (p=0.004), KOOS pain (p=0.029), KOOS-ADL (p=0.044), KOOS sport (p=0.001), KOOS-QoL (p<0.001), and Lysholm score (p=0.008). Playing only on natural grass predicted lower SF-12 PCS scores (p=0.003), total KOOS (p=0.001), and KOOS sport (p=0.011). Playing only on artificial turf predicted a lower Lysholm score (p=0.018) and total KOOS (p=0.014). The contact mechanism predicted higher IKDC (p=0.044) and KOOS-QoL (p=0.048), and injury affecting the dominant limb predicted lower SF-12 MCS (p=0.012). Playing at a nonprofessional level predicted lower total KOOS (p=0.028), KOOS symptoms (p=0.002), KOOS-ADL (p=0.033), and KOOS sports (p=0.016).
Conclusion
Professional soccer players and the midfielder position predict better functional scores upon returning to the sport. A history of noncontact ACL injury and playing on a single type of surface are risk factors for lower functional outcomes upon returning to the sport. Lower mental health scores can be expected after injury of the dominant limb.