2018 Arthroscopy Journal
Anterior cruciate ligament (ACL) tears have been reported to have an annual incidence of 0.17 per 1,000 players in college football and 0.7 per 1,000 players in the National Football League (NFL). Previous data have shown that up to 8% of all participants at the NFL Combine had a history of an ACL injury. Football players have a high risk of ACL injury because of the contact and pivoting nature of the sport, and the ACL injury rate has been found to be up to 10 times higher during competitive games than during practice.
Persistent rotational knee instability has been reported in up to 25% of patients after anterior cruciate ligament reconstruction (ACLR), which can potentially affect athletic performance. ACL tears often result in an extended period away from sport, extensive rehabilitation, and anxiety about future performance and ultimately may lead to decreased performance. Previous studies in NFL players have reported that the return-to-play rate after an ACLR ranges from 63% to 92%. However, return to sports has been shown to depend on player position, with quarterbacks having the highest return-to-play rates.
The findings of studies on performance after return to play are inconsistent, with some reporting that most players return to their previous level of participation but others reporting that, despite a high rate of return to play, the rate of return to the same competitive level was lower. Literature on the effect of ACLR on draft status and the initial performance of NFL players participating in the NFL Combine is lacking. Therefore, the purpose of this study was to evaluate whether players with a history of an ACLR before the NFL Combine played or started fewer games and/or participated in fewer eligible snaps compared with NFL Combine participants without a history of knee injury or surgery. We hypothesized that players with a previous ACLR would start and play fewer games and participate in fewer eligible plays (lower percentage of snaps) in the first 2 seasons in the NFL than those without a previous knee injury.