Length of Time Between Anterior Cruciate Ligament Reconstruction and Return to Sport Does Not Predict Need for Revision Surgery in National Football League Players

Arthroscopy. 2019 Jan;35(1):158-162. doi: 10.1016/j.arthro.2018.08.007.


Purpose: To determine whether the length of time between primary anterior cruciate ligament reconstruction (ACLR) and return to sport (RTS) predicted the need for revision ACLR in National Football League (NFL) athletes.

Methods: All NFL players who underwent ACLR from 2009 to 2015 were identified. The date of index ACLR and date of return to NFL regular-season game play after surgery were recorded. The length of time between ACLR and RTS was compared between players who required revision ACLR and those who did not. Correlation coefficients were used to assess whether players who RTS sooner sustained recurrent anterior cruciate ligament injury at an earlier date.

Results: A total of 130 NFL players (average age, 25.3 ± 3.2 years) who underwent ACLR and returned to sport were identified. The average time to RTS after ACLR was 49.7 weeks after surgery. Of the players, 23 (18%) required revision ACLR. There was no significant difference in the length of time between ACLR and RTS in players who did not require revision ACLR (50.2 ± 10.1 weeks) and those who did (48.3 ± 11.0 weeks, P = .40). Time to RTS was not found to correlate with time to reinjury in athletes requiring revision ACLR (R = 0.21; 95% confidence interval, -0.18 to 0.54). A large proportion of players (56%) sustained a reinjury within the first 10 weeks of returning to NFL game play.

Conclusions: Our study found that timing of RTS after ACLR was not a significant risk factor for revision surgery in NFL athletes. Time to RTS was also not shown to correlate with time to reinjury.

Level of evidence: Level III, case-control study.

MeSH terms

  • Adult
  • Anterior Cruciate Ligament Injuries / physiopathology
  • Anterior Cruciate Ligament Injuries / surgery*
  • Anterior Cruciate Ligament Reconstruction / methods*
  • Athletes*
  • Case-Control Studies
  • Follow-Up Studies
  • Football / injuries*
  • Humans
  • Male
  • Prognosis
  • Reoperation
  • Return to Sport*
  • Time Factors
  • United States