Published 8/1/2009

Football players shouldn’t fear ACL reconstruction

Meniscectomy is more damaging to a player’s career

Knee injuries are a common problem in collegiate and professional football, and may raise fears of a shorter playing career. Although players may be concerned that a torn anterior cruciate ligament (ACL) and subsequent reconstructive surgery will affect their long-term careers, a study presented at the AOSSM annual meeting suggests that a meniscectomy may be more damaging to their professional careers.

“ACL reconstruction is a reliable surgical technique that enables professional football players to have careers that are similar to their counterparts without ACL injuries. Although meniscectomy is a lesser surgery with a shorter recovery time than ACL reconstruction, these surgeries appear to lead to a significantly shorter career with fewer games played in the long term,” said lead author Robert H. Brophy, MD, assistant team physician for the St. Louis Rams.

The study used a database containing the injury history and career statistics of National Football League (NFL) athletes from 1987-2000. Athletes who had a history of meniscectomy and/or ACL surgery and no other surgery or major injury were matched to a control group of athletes without previous surgeries. Athletes were also matched by position, year drafted, round drafted, and additional history. Researchers identified 54 athletes with a history of meniscectomies, 29 with a history of ACL reconstruction, and 11 with a history of both surgeries.

The results illustrated that those individuals with a history of isolated meniscectomy had a career that was approximately 1.5 years shorter on average than their matched controls. They also played 23 fewer games over their careers.

Isolated ACL surgery, on the other hand, did not significantly reduce the length of years or games played in this cohort.

Although the sample of athletes with both surgeries was relatively small, these players did have shorter careers and played fewer games than their matched controls. The difference, however, was not statistically significant. When compared to players who had either meniscectomy or ACL reconstruction, players who had both surgeries had shorter careers in terms of games started, games played, and years in the league.

“A combination of ACL reconstruction and meniscectomy may be more detrimental to an athlete’s durability than either surgery alone. With further research, we will be able to better understand how these injuries and surgeries impact an athlete’s career and what can be done to improve long-term outcomes,” said Dr. Brophy.

Dr. Brophy’s coauthors for “Effect of ACL Reconstruction and Meniscectomy on Career Length in NFL Athletes: A Case Control Study” are Corey S. Gill, MD; Stephen Lyman, PhD; Ronnie P. Barnes, MS, ATC; Scott A. Rodeo, MD; and Russell F. Warren, MD. The authors report the following disclosures: Dr. Brophy—Breg; Dr. Rodeo—Wyeth amd Cayenne Medical; Dr. Gill—no conflicts; Dr. Warren—Biomet, Smith & Nephew, KFX, SERICA, and Ortec; Dr. Lyman and Mr. Barnes—not available.