Return to Play and Risk of Re-injury in Soccer Players


Female athletes face a higher risk of requiring additional knee surgery.

©Darrin Henry/

A study presented at the 2018 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans looked at soccer athletes who underwent an anterior cruciate ligament (ACL) reconstruction to better understand the average return to play time and the risk of re-injury.

While soccer athletes can return to their sport following a revision ACL reconstruction, the rate of participation drops significantly over time for both males and females because of knee issues.

Robert H. Brophy, MD, orthopaedic surgeon and professor of orthopaedic surgery at Washington University School of Medicine in St. Louis, conducted one of the first studies to look at revision ACLs in soccer athletes to determine their success rate when they return to the field.

The study
The study found that 62% of soccer athletes returned to the sport at an average of 9.6 months after revision ACL surgery. In addition, there was no significant difference between males and females in the rate of return (males, 70% vs females, 56%) or time to return to play.

Overall, 12% of patients underwent subsequent knee surgery. However, female soccer players faced a higher risk of requiring additional knee surgery after revision ACL reconstruction than males; about 1 in 5 needed additional knee surgery, compared with 1 in 20 men.

Among the study findings:
• The rate of recurrent ACL graft tear was 5.6%, with no significant difference between males and females.

• At an average follow-up of 6.4 years, only 19% of soccer athletes who underwent revision ACL reconstruction were still playing the sport-a significant decrease compared with initial return to play. There was no significant difference in the long-term return to play between males (21%) and females (18%).

• The majority of athletes stopped playing soccer because of their knee (72%), and it was essentially the same for men (73%) and women (72%).

“Patients and providers can use this information to guide their expectations about return to play and risk for re-injury in soccer athletes,” said Dr. Brophy.


Return to play for soccer athletes and risk for future injury [press release]. Rosemont, IL: American Academy of Orthopaedic Surgeons; March 6, 2018.

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