Please login to view this media
- Talk
- 14/07/2021
- UK
Outcomes According to Surgical Technique in Pro-Footballers' ACL Reconstructions
Description
In this presentation, Dr. Andy Williams discusses the outcomes of primary ACL reconstruction surgeries performed on professional football players. He shares insights gained from his experience, noting that a significant portion of his practice involves dealing with athletes, which presents unique challenges and opportunities for learning. Dr. Williams highlights the importance of effective follow-up with this population, noting that they are easier to track due to their visibility in professional sports and the availability of medical staff details. He addresses the difficulty in gathering patient-reported outcome measures (PROMs) from these players but emphasizes the value of studying athletes to refine treatment strategies.
Williams presents data on return-to-play rates, which range from 77% to 95%, along with re-rupture rates of 6% to 10%. He points out that some studies suggest that up to 25% of graft failures may occur among these athletes. He also reflects on unresolved questions regarding graft types and surgical techniques, particularly concerning femoral tunnel placement and the use of tenodesis. The study borrows from a retrospective analysis of consecutive cases of isolated ACL ruptures managed over a specified time frame, primarily using four-strand hamstring or patellar tendon grafts.
The results indicate a high return-to-play rate of 96%, with younger patients (<25 years) showing the most success. Factors such as prior surgeries, including meniscectomy, negatively affect return rates. Additionally, the average return-to-play time was found to be 10.5 months, longer than the six months commonly expected in public discourse.
Critically, Williams reports a 9.5% re-rupture rate and identifies surgical technique as a contributing factor to graft failure, emphasizing the need for continuous evaluation and adjustment of operative standards. In conclusion, he advocates for further studies and refinement of surgical approaches to enhance patient outcomes and clarify the relationship between techniques, graft types, and postoperative success.