Dr. James Gladstone, an orthopedic surgeon at Mt. Sinai Medical Center, says, "They're only playing at approximately 2/3rds of the level they were playing at before the injury." Dr. James Carey, the study author out of Vanderbilt University, says, "It's the first time anyone has used player performance and their statistics to look at the outcomes of a surgical procedure."
Perhaps the most concerning stat is that one fifth--21 percent--of the injured players never played another NFL game. "The predominant thinking when 31 head NFL team physicians were interviewed, is that 90 to 100 percent of players, presuming not borderline talent, return to the NFL," states Dr. Carey. Of those who did return, it took 9 to to 12 months to get back on the field.
"This study gives us pause and says even in the best case scenarios these are players who are going to work their butts off doing rehab 8 hours a day to get back to playing and even then a fifth of them, 20 percent aren't getting back to playing," Dr. Gladstone adds. Interestingly, those who get ACL injuries are more likely to be high-performance players. "They have frequent accelerations, decelerations, twisting, cutting maneuvers, that puts them at the highest risk," according to Dr. Carey.
They're more likely to be injured because they compete in more plays per game, carry the ball longer on each play, and attract more defensive attention. "The biggest problem with an ACL injury is that once it's torn there is no way that it's going to heal or be repaired, except with surgery," says Dr. Gladstone. But those great players end up less great after that surgery. It's believed players don't get back to where they were because of one or more factors, including knee pain, stiffness, loss of strength, deconditioning and reduced proprioception, which is the sense of knowing where your leg is.
Also, ACL reconstruction does not perfectly recreate the complex anatomy and composition of a player's ACL before injury. "They should have reasonable expectations for what they can expect their knee to do and how they can contribute to the team in the future and I think it's important to the fans and the team owners to similarly have those expectations that are realistic," Dr. Carey points out.