Summary
ACL reconstruction in teenage soccer players does not hinder their potential to reach the elite level or remain active in soccer as seniors, although a significant proportion may require additional ACL surgery in the future, emphasizing the importance of long-term knee health considerations in return-to-play decisions
Abstract
Introduction
Anterior cruciate ligament (ACL) injuries are common among young soccer players, with soccer being a high-risk activity for such injuries. ACL reconstruction is often recommended to restore knee stability and enable a return to play. This study aimed to investigate whether ACL reconstruction in teenage soccer players affects their potential to remain active in soccer and reach the elite level as seniors.
Methods
Examining a cohort of 5,285 soccer players who participated in the Swedish National Elite Camp for 15-year-olds between 2005 and 2011 (2631 boys and 2654 girls), we utilized the Swedish National Knee Ligament Registry to identify players who had undergone ACL reconstruction. Data on player participation in Swedish league games and their level of play were extracted from the Swedish Football Association's administrative data system. We compared players who underwent ACL reconstruction between the ages of 15 and 19 with their counterparts in the National Elite Camp, assessing the impact of early ACL reconstruction on their continued participation in soccer and their chances of reaching the elite level as seniors.
Results
Among the participants, 524 players (9.9%) had undergone ACL reconstruction, with 292 players (5.5%; 75 males and 217 females) sustaining their injuries between the ages of 15 and 19. During the follow-up period, 122 players (23.3%) underwent a second ACL reconstruction: either a revision (11.5%; n = 60) or a contralateral procedure (11.8%; n = 62). Remarkably, male and female soccer players who underwent ACL reconstruction between the ages of 15 and 19 showed no significant decrease in activity or chances of playing at the elite level by the time they turned 21. In fact, 12% of male players and 11.5% of female players who underwent ACL reconstruction progressed to the elite level at the age of 21, surpassing the figures of 10.3% for men and 11.1% for women among the uninjured players.
CONCLUSION(S): The results suggest that ACL reconstruction during the teenage years does not negatively impact the potential for talented youth soccer players to reach the elite level or remain active as seniors. However, it is crucial to acknowledge that nearly 1 in 4 players may require additional ACL surgery in the future, necessitating consideration of their long-term knee health when making decisions about a return to play. These findings can contribute to evidence-based counselling and treatment decisions for young athletes with ACL injuries.