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Knee. 2019 Jan;26(1):142-148. doi: 10.1016/j.knee.2018.10.004. Epub 2018 Nov 16.

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

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Northwestern Memorial Hospital, Department of Orthopedic Surgery, 676 North St. Clair St., Suite 1350, Chicago, IL, 60661, USA.
Northwestern Memorial Hospital, Department of Orthopedic Surgery, 676 North St. Clair St., Suite 1350, Chicago, IL, 60661, USA. Electronic address:
Loyola University Chicago, Department of Mathematics and Statistics, 1032 West Sheridan Road, Chicago, IL, 60660, USA.



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.


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.


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).


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.


Anterior cruciate ligament; Anterior cruciate ligament reconstruction; Major League Soccer; Player performance; Professional soccer; Return-to-play

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