Treatment of Anterior Cruciate Ligament Injuries in Professional Soccer Players by Orthopedic Surgeons

Abstract

Objective To describe the treatment provided by specialists for ACL lesions in professional soccer players. Methods A cross-sectional study in which orthopedic surgeons affiliated to soccer teams competing in the Brazilian Soccer Championship answered a questionnaire about the treatment of ACL injuries in professional soccer players. Results The specialists wait between one to four weeks after the ACL injury to perform the surgical treatment. They use a single incision and single-bundle reconstruction, assisted by arthroscopy, femoral tunnel drilling by an accessory medial portal, and quadruple flexor tendon autografts or patellar tendon autografts. After three to four months, the players are allowed to run in a straight line; after four to six months, they begin to practice exercises with the ball without contact with other athletes; and, after six to eight months, they return to play. The main parameter used to determine the return to play is the isokinetic strength test. The specialists estimate that more than 90% of elite soccer players return to playing professionally after an ACL reconstruction, and 60 to 90% return to play at their prior or at a greater level of performance. Conclusion The present article successfully describes the main surgical practices and post-surgery management adopted by specialists in this highly-specific population of patients.

Keywords: anterior cruciate ligament; knee/surgery; rehabilitation; soccer.

Fig. 1

Distribution of the answers obtained from question 6. Statistically, there was no difference between the most recurrent response (“postoperative flexor muscle weakness”) and the responses “graft loss or rupture” ( p  = 0.661) and “graft resistance and strength” ( p  = 0.105).

Fig. 2

Distribution of the answers obtained from question 5. The major concern was anterior knee pain. Other conditions mentioned by 5.8% of the respondents included knee extension block and absence of concern.

Fig. 3

Distribution of answers obtained from question 15. There was no statistical difference between the “80-90%” (more frequent) and “60-80%” ( p  = 0.848) options.

Fig. 4

Average number of reconstructions. The responses involving the values “25-50”, “50-100” and “100-200” were statistically equal ( p  = 0.846 and p  = 0.154).

Fig. 5

Average number of ACL reconstructions performed per year specifically among soccer players. Statistically, the responses “25-50”, “10-25” and “< 10” did not show differences ( p  = 0.696 e p  = 0.154).

Fig. 1

Distribuição das respostas obtidas na questão 6. Estatisticamente, não houve diferença entre a resposta mais recorrente (“fraqueza dos músculos flexores no pós-operatório”) e as respostas “perda ou ruptura do enxerto” ( p  = 0,661) e “resistência e força do enxerto” ( p  = 0,105).

Fig. 2

Distribuição das respostas obtidas na questão 5. A maior preocupação consistiu na dor na região anterior do joelho. Entre as outras condições citadas por 5,8% dos entrevistados constaram o bloqueio de extensão do joelho e a ausência de preocupação.

Fig. 3

Distribuição das respostas obtidas na questão 15. Não houve diferença estatística entre as opções “80-90%” (mais frequente) e “60-80%” ( p  = 0,848).

Fig. 4

Média de reconstruções. As respostas envolvendo os valores “25-50”, “50-100” e “100-200” foram estatisticamente iguais ( p  = 0,846 e p  = 0,154).

Fig. 5

Média de reconstruções do LCA realizadas por ano especificamente em jogadores de futebol. Estatisticamente, as respostas “25-50”, “10-25” e “< 10” não apresentaram diferenças ( p  = 0,696 e p  = 0,154).