College Athletes’ Perception of Anterior Cruciate Ligament Injuries and Subsequent Reconstruction

Abstract

Objectives:Anterior cruciate ligament (ACL) tears are one of the most common ligamentous injuries of the knee. While many advances have been made in both surgical technique and rehabilitation protocols, it still remains a very serious athletic injury. In recent years, a few high-profile athletes have returned to an elite sport performance level relatively quickly after ACL reconstruction, but previously published literature suggests otherwise. The purpose of this study is to evaluate a college athlete's perception and understanding of ACL injury and subsequent reconstruction.Methods:During pre-participation physicals, a total of 157 surveys were prospectively administered to athletes at a single NCAA Division II university, all of which were returned. Consent was obtained prior to survey administration. The surveys, consisting of sixteen questions, were designed to evaluate the athletes’ knowledge of ACL injury, anatomy, and recovery from surgery. In addition, basic demographic information was obtained including the participants’ source of ACL knowledge. Statistical analysis is pending.Results:The average age of participants was 20.1 years (Range: 18-23). Football, soccer and baseball were the most represented sports among participants, but a wide variety were present. Of the 157 surveys administered, 106 of participants (68%) knew that the ACL was a ligament. The majority of participants (63%) thought it would take 8-12 months to return to sport after an injury, but 31% said an athlete could return in less than 6 months (Range: 2 to 15 months). On average, the participants thought 64% of athletes could return to play in their sport after an ACL injury and reconstruction, but only 45% could return to their previous level of play. However, several participants (8%) believed greater than 80% of athletes could return to their previous level of play after an ACL reconstruction. Only 11% of respondents knew that a knee brace cannot prevent ACL injury. Most participants (82%) said that if they had an ACL injury they would undergo reconstructive surgery. Only 26% of participants knew that an athlete with an ACL injury was at an increased risk for an injury to their contralateral ACL. Furthermore, about half of the participants (54%) thought that on-field performance would not improve following an ACL injury and reconstruction. The most common source of participants’ knowledge of ACL injury was from a friend or family member (71%). Far fewer participants gained at least some of their knowledge from the internet (32%), television (27%) or their physician/surgeon (29%).Conclusion:This is the first study, to our knowledge, to assess the perceptions of high-level athletes with regards to ACL injury, reconstruction and return to play. This study demonstrates that there is a large amount of variability in college athletes’ perception of ACL injuries. The range of recovery time from surgery was quite large, signifying a knowledge gap among high-level athletes with regard to this very common injury. Orthopaedic surgeons may want to assess and tailor their pre-surgical discussions with a college athlete to the individual's knowledge of ACL injury and reconstructions, so that realistic pre-surgical expectations are set. However, the benefits of this approach warrant further investigation.