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Five to ten years ago it was common for orthopaedic surgeons to assure their ACL injured patients that 90–95% of the time they would have a good to excellent result with surgical reconstruction. We suspect that such advice can still be heard in orthopaedic offices. However, recent studies evaluating return to play, recurrent or contralateral ACL injuries, and specific graft choices, have raised concern that the picture we were painting may have been too rosy.
Walden et al1 present their outcomes of a prospective study on football (soccer) players regarding actual return to play rates. The authors followed 78 elite soccer clubs for 4 years and reported 140 complete ACL injuries (98% that underwent reconstruction). Surprisingly, prior to completing rehabilitation, five patients had reruptures and four required contralateral ACL surgery. At 3 years, 86% of patients were still playing football but only 65% were playing at …