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EARLY RETURN TO PLAY AFTER ACL RECONSTRUCTION IN PROFESSIONAL SOCCER PLAYERS

P. P. MARIANI (1,2) 1 -«FORO ITALICO» ROME UNIVERSITY, ROME, ITALY 2 -«VILLA STUART» HOSPITAL, ROME, ITALY
Background: the right time to return to play after anterior cruciate ligament reconstruction (ACLr) is still debated and six or more months may elapse before RTP is permitted. The yet unsolved problem is how quickly and safely rehabilitation should proceed before an athlete can be allowed to play. Study design: cohort study. Hypothesis: Our Hypothesis was that early RTP (3–4 months) is not harmful to knee stability and does not increase the risk of subsequent knee problems. Material and Methods: A specially designed questionnaire was sent to 83 professional soccer players (National First or Second Division championships) who underwent ACLr with an autologous patellar tendon graft 2005 to 2009 and still playing at same level. The players were invited to report all subsequent articular and muscular problems after the ACLr. The responses from the 41 (51.8%) players who completed the questionnaire were used to create two groups of players: group A (n=24) comprised players who reported returning to training within 3 months and appearing in an official game within 4 months after surgery, and group B (n=17) comprised players who reported returning to training 3 months or more and appearing in an official game 6 months or more after surgery. The athlete’s clinical charts were reviewed and the data compared for knee joint stability as measured on a KT-2000 at a 6-month follow-up evaluation and for muscular strength as measured with a MuscleLab system 2, 3 and 6 months postoperatively.
Results: The KT-2000 measurements and the deficits in quadriceps strength in the injured vs. healthy limb did not show significant difference. Incidence of subsequent injuries, surgery, and muscular injuries following ACLr were similar in both groups. Clinical relevance: Following aggressive rehabilitation, early RTP is possible without the risk of new injuries or impaired knee stability.
Keywords: 
return to play; Anterior Cruciate Ligament; rehabilitation; knee; soccer.