With the college football season beginning, it is a good time to discuss a surgery that can end the players’ seasons – ACL reconstruction.

A new study by Jimmy H. Daruwalla and others looked at college football players from three major conferences – the Southeastern Football on fieldConference (SEC), the Atlantic Coast Conference (ACC), and Pacific 12 (PAC-12). They analyzed the data of 184 players from those three conferences who underwent ACL reconstructions during their college careers.

Those team physicians and researchers wanted to determine if factors like scholarship status, status on the depth chart, years of play and graft choice affect return to play after ACL surgery.

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Return to play for college football players after ACL reconstruction

• 151 of 184 players (82%) returned to full, unrestricted practice or competition after surgery. The average time for the players to return to football was 251 days.
94.2% of starters returned to play after ACL surgery. 87.7% of frequently utilized players returned, while players who only occasionally played returned 72.9% of the time after ACL reconstruction.
• 87.5% of starting players were able to return as starters after ACL surgery.
• 87.6% of college football players on scholarships returned to play. Only 68.8% of the players who were not on scholarships returned to play after ACL reconstruction.
84.5% of players who underwent ACL reconstruction using an autograft (either patella tendon or hamstring) returned to play, compared to 68.9% of players who received an allograft.

Overall return to play

When looking at college football players at Division I schools, specifically from three of the power conferences (SEC, ACC, and PAC-12), ACL reconstruction largely appears to be a successful surgery. 82% of players return to play college football. This rate of return exceeds that seen in other recent studies, including two studies that showed return to play rates of 79% and 63% among different groups of NFL players.

Scholarship players and starters

Factors related to the individual players were a more fascinating aspect of this study. Players on scholarship returned to play more often than did walk ons. Starters were more likely to return to play than those who were only occasionally or rarely used. These findings are Wide receiver on grass football fieldsimilar to those looking at return to play rates of NFL players who were drafted in the early rounds compared to players drafted in later rounds or who went undrafted.

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It is hard to know exactly why certain athletes are more likely to return to sports than others. Motivation and physical ability probably play some role. Maybe football players at Division I schools on scholarships are better athletes and regain strength and function more quickly. Maybe starters are inherently more motivated to return fully and reclaim their starting rolls. Maybe scholarship athletes fear losing them. Or maybe the schools invest more time and resources into the rehab of the top players.

Why do you think scholarship athletes and starting players are more likely to return to play after ACL surgery? Please leave your opinions here!

Jimmy H. Daruwalla, Patrick E. Greis, Robert Hancock, ASP Collaborative Group and John W. Xerogeanes. Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in NCAA Division 1 College Football Athletes: A Study of the ACC, SEC, and PAC-12 Conferences. Orthopaedic Journal of Sports Medicine. 2014;2