How often do ACL tears happen to athletes?

How’s your fantasy football team doing? Lost any star players to an anterior cruciate ligament or ACL tear? St. Louis Rams quarterback Sam Bradford is out for a tear in his left knee for the second season in a row. Stephen Tulloch, a linebacker for the Detroit Lions, went down in week three with an ACL tear in his left knee.

ACL tears are common in football players and in professional, amateur and youth athletes in other contact sports with more than 250,000 occurring each year. An ACL tear is a season-ending injury, but does it signal the end of an athlete’s career? Not necessarily.

ACL tears affect 250,000 athletes each year Click To Tweet

So how often do athletes with ACL tears return to the sport they love? Dr. Joshua Harris, a Houston Methodist orthopedic surgeon, sought out to find just that. He matched athletes with ACL tears in the National Football League, National Basketball Association, National Hockey League, Major League Soccer and the X Games to athletes without tears based on age, experience and pre-tear performance.

“In addition to determining how often these athletes are able to return to sport after an ACL tear, our studies also revealed interesting patterns in ACL tears,” Dr. Harris said. “For example, we were able to determine which NBA playing positions had a harder time recovering and which knee was more susceptible to ACL tears in MLS players.”

National Hockey League

Athletes in the NHL had a return to sport rate of 97 percent – the highest rate of all major sports leagues. Left-handed shooters are more likely to tear their ACL, but all performed better after returning to the ice.

National Football League

Because the rates of ACL tears in the NFL are so high and specific offensive and defensive positions are unique in their cutting and pivoting demands on the knee, Dr. Harris and his team decided to narrow their research for this study to quarterbacks. The researchers found quarterbacks have a return to sport rate of 92 percent and, on average, played for five years after returning from an ACL tear, which proved ACL tears are not career-ending injuries for quarterbacks.


National Basketball Association

Dr. Harris found that 62 percent of ACL tears in the NBA occur in the second half, mostly in the fourth quarter of the game, possibly due to fatigue. Overall, NBA athletes have a high return to sport rate of 86 percent. Guards have the most difficult time returning to sport, while centers have the most predictable outcomes.

Major League Soccer

While most injuries in Major League Soccer athletes are non-contact injuries, these players tend to have more ACL tears in their left knee and have a 77 percent chance of returning to the field after an ACL tear.

“Because of the cutting and pivoting nature of soccer, MLS players may have more ACL tears in the leg they plant with,” Dr. Harris said. “The majority of soccer players kick with their right and plant with their left, which may explain why they tend to have more ACL tears in their left knee.”

X Games

Dr. Harris and his team looked specifically at skiers and snowboarders. Skiers tend to have more tears in their left knee and had an 87 percent chance of returning to their sport. Snowboarders had a 70 percent return to sport rate and won more medals after recovering from an ACL tear.

“This injury can happen to anyone,” Dr. Harris explained. “Researching ACL tears in athletes helps all of our patients because we are able to evaluate treatments and bring the best solutions back to our practice.”

5 signs you may need a knee replacement

More than 600,000 knee replacements are performed each year in the United States, and an aging population will continue to drive that number up. If knee pain is affecting your daily life, it might be time to ask your physician about a knee replacement.

Before you take another pain reliever, consider these five signs from Dr. Stephen Incavo, an orthopedic surgeon at Houston Methodist, that suggest it’s time for a knee replacement.

Sign #1: Decrease in activity level or quality of life

Knee pain should not affect your daily routine or prevent you from enjoying your favorite activities. If you experience in a decrease in activity level or quality of life, talk to your doctor.

Sign #2: Pain and/or stiffness at night

If you dread the evening because your knees begin to stiffen up or become painful, you might be a good candidate for a knee replacement.

“Some patients will only have knee pain or stiffness at night, so they think they don’t need a knee replacement. It isn’t normal to be unable to sleep at night due to knee pain.”

More than 600,000 knee replacements are performed each year in the United States Click To Tweet

Sign #3: Non-surgical options no longer help

In some cases, your physician may recommend trying non-surgical options, such as physical therapy or anti-inflammatory medicine, to provide pain relief. If the non-surgical treatment doesn’t help or stops helping, don’t hesitate to go back for a visit.

“Don’t wait too long after non-surgical options stop helping to come back in. The goal is to get you back to a happy, pain-free life, but you have to tell your doctor when something isn’t working for you.”

Sign #4: Future prognosis is not good

For many, your knee pain slowly erodes activity level or quality of life. But if the condition of your knee will continue to worsen, why wait? 

“So many patients with arthritis know they will eventually need a knee replacement, but think they aren’t ready for it yet. But think about your current situation. Ask yourself if you want to enjoy your present years or wait until you’re older and potentially lose all mobility.”

Sign #5: The first replacement has not helped

Unfortunately, not all knee replacements function properly and may require a revision surgery to correct the problem. 

Reviewed by Dr. Stephen Incavo