title: Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in National Collegiate Athletic Association Division I Soccer Athletes: A Study of the Southeastern Conference.
abstract: BACKGROUND
  Factors and details regarding return to play in elite, collegiate female soccer athletes after an anterior cruciate ligament (ACL) injury and reconstruction have not been well studied.
  
  
  OBJECTIVE
  To evaluate return to play among collegiate female soccer players, specifically examining the effect of surgical and individual athlete characteristics on the return-to-play rate.
  
  
  METHODS
  Descriptive epidemiology study.
  
  
  METHODS
  Sports medicine and athletic training staff at institutions from the National Collegiate Athletic Association Southeastern Conference (SEC) were contacted to request participation in the study. All institutions were sent a standardized spreadsheet with response choices and instructions regarding athlete inclusion criteria. Athlete, injury, surgical technique, and return-to-play data were requested for ACL reconstructions performed on female soccer athletes at the participating institutions over the previous 8 years. χ(2) analyses were used to compare the return-to-play rate by year in school, scholarship status, position, depth chart status, procedure, graft type, graft fixation, concomitant procedures, and previous ACL injuries.
  
  
  RESULTS
  All 14 of the SEC institutions chose to participate and provided data. A total of 80 ACL injuries were reported, with 79 surgical reconstructions and return-to-play data for 78 collegiate soccer athletes. The overall return-to-play rate was 85%. There was a statistical significance in return-to-play rates favoring athletes in earlier years of eligibility versus later years (P < .001). Athletes in eligibility years 4 and 5 combined had a return-to-play rate of only 40%. Scholarship status likewise showed significance (P < .001), demonstrating a higher return-to-play rate for scholarship athletes (91%) versus nonscholarship athletes (46%). No significant differences in return-to-play rates were observed based on surgical factors, including concomitant knee procedures, graft type, and graft fixation method.
  
  
  CONCLUSIONS
  Collegiate female soccer athletes have a high initial return-to-play rate. Undergoing ACL reconstruction earlier in the college career as well as the presence of a scholarship had a positive effect on return to play. Surgical factors including graft type, fixation method, tunnel placement technique, concomitant knee surgeries, and revision status demonstrated no significant effect on the return-to-play rate.
authors.affiliation: Appalachian State University, Boone, North Carolina, USA University of Kentucky, Lexington, Kentucky, USA howardjs@appstate.edu.
authors.forename: Jennifer S
authors.initials: JS
authors.lastname: Howard
authors.affiliation: OrthoWest Ltd, Middleburg Heights, Ohio, USA.
authors.forename: Mark L
authors.initials: ML
authors.lastname: Lembach
authors.affiliation: Commonwealth Orthopaedic Centers, Edgewood, Kentucky, USA.
authors.forename: Adam V
authors.initials: AV
authors.lastname: Metzler
authors.affiliation: University of Kentucky, Lexington, Kentucky, USA.
authors.forename: Darren L
authors.initials: DL
authors.lastname: Johnson
mesh_terms: D000293:Adolescent; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007718:Knee Injuries / Q000601:surgery; D012189:Retrospective Studies; D000068958:Return to Sport / Q000502:physiology* / Q000706:statistics & numerical data; D012916:Soccer / Q000293:injuries* / Q000706:statistics & numerical data; D013334:Students / Q000706:statistics & numerical data; D014495:Universities / Q000706:statistics & numerical data; D055815:Young Adult
keywords: anterior cruciate ligament; female athlete; return to play