2023 ISAKOS Biennial Congress ePoster
ACL Injuries in Major League Soccer: An Analysis of Injury Rate, Associated Factors, and Return to Play
Brian Forsythe, MD, Chicago, IL UNITED STATES
Vahram Gamsarian, BE, Chicago, IL UNITED STATES
Vikranth R Mirle, BS, Chicago, IL UNITED STATES
Aditya Narayanan Krishnan, BS, Alpharetta, GA UNITED STATES
Zachary Levine, BS, North Chicago, IL UNITED STATES
Elyse Berlinberg, BS, New York, NY UNITED STATES
Eric Giza, MD, Sacramento, CA UNITED STATES
Margot Putukian, md UNITED STATES
Holly Silvers-Granelli, PhD, MPT, Santa Monica, CA UNITED STATES
Bert Roland Mandelbaum, MD, DHL(Hon), Santa Monica, California UNITED STATES
Midwest Orthopaedics at Rush University, Chicago, IL, UNITED STATES
FDA Status Not Applicable
Summary
Comparing ACL injuries between 2011-2015 and 2016-2021, there was an 18.7% decrease in days missed, and a 24.6% decrease in average games missed by MLS athletes; moreover, "acute contact injury" was the only characteristic significantly associated with increased games missed.
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Abstract
Purpose
To examine (1) the incidence of anterior cruciate ligament (ACL) injuries in MLS athletes, (2) return-to-sport (RTS) following ACL injury, (3) investigate conditions that are associated with increased time to RTS.
Methodology
The MLS Injury Surveillance database was queried for athletes with ACL injuries from 2009-2021. An ACL injury was defined as an incident involving the ACL, with possible additional co-ligament involvement, that required medical attention. Demographic characteristics and injury characteristics (setting, activity, severity, RTS, and re-injury) were used for descriptive analysis.
Results
146 total injuries were recorded between 2009 and 2021 in 132 MLS players, with 9 (6%) re-injuries. The median absence from sport per injury was 240 days (mean: 246.5). The average number of games missed, and practices missed per injury, were 17.4 +/- 13.3 and 52.8 +/- 50.6, respectively. The average injured player age was 24.8 +/- 4.3 years, with 93% undergoing ACL reconstruction. Time to RTS significantly decreased from 269.6 days in 2009-2015 to 219.0 days in 2016-2021 (p=0.044). Similarly, the average number of games missed decreased from 19.4 games in 2009-2015 to 14.4 games in 2016-2021 (p=0.024). Additionally, acute contact injury (vs non-contact), lead to increased games missed (20.7 games vs 15.6 games, p = 0.024). Concurrent ligamentous and meniscal pathology, position, home vs away, weather, and field type, did not significantly affect time to RTS or average games missed.
Conclusion
Comparing injuries between 2011-2015 and 2016-2021, there was an 18.7% decrease in days missed, and a 24.6% decrease in average games missed. Given that 93% of MLS athletes with ACL injuries underwent surgery, the significant decrease noted from 2016-2021 may indicate an acceleration of ACL injury rehabilitation. Acute contact injury was the only characteristic significantly associated with increased games missed (p=0.024), and this mechanism of injury trended with increased time to RTS (p=0.0756).