Clinical Outcomes of Anterior Cruciate Ligament Reconstruction in Gaelic Games Players

The Gaelic games, specifically Gaelic football, hurling, and camogie, are high-intensity, level 1 field sports. However, there is a lack of data regarding the outcomes of anterior cruciate ligament reconstruction (ACLR) in Gaelic games players.

To evaluate the rates of return to play (RTP), ACL graft reinjury, contralateral ACL injury, and patient-reported outcome measures (PROMS) in a cohort of Gaelic footballers and hurling/camogie players at 2 years after ACLR.

Cohort study; Level of evidence, 2.

A consecutive cohort of 1891 Gaelic games players who underwent primary ACLR between 2014 and 2018 was included. Patients were contacted at 2 years postoperatively with an overall follow-up rate of 93.4%. The rate of RTP, subsequent ACL injury, and PROMS were recorded. The PROMS evaluated were the Marx score, the ACL-Return to Sport after Injury (ACL-RSI), and the International Knee Documentation Committee (IKDC) score.

The mean age was 23 ± 6 years, and 73.3% of athletes were male. RTP rates were 87.8% for Gaelic football and 89.5% for hurling/camogie, with 72.7% and 76.3% of athletes returning to an equivalent or higher level of performance, respectively. Female Gaelic footballers had a slightly lower RTP rate than males (83.8% vs 89.1%; P < .016). The mean time to RTP was 10.8 ± 4 months. The rate of bone-patellar tendon-bone (BPTB) autograft reinjury was 3.3% (51/1547) versus 15.3% (33/216) for hamstring (HT) autografts (P < .001). Senior intercounty (elite) players had the lowest rate of contralateral ACL injury (8.1%, 14/173). Gaelic footballers and hurling/camogie players reported good outcomes with mean IKDC scores of 86.9 ± 9.8 versus 87.9 ± 8.9, (P = .064), mean Marx scores of 11 ± 4.7 versus 11.3 ± 4.6 (P = .309), and mean ACL-RSI scores of 74.1 ± 23.5 versus 75.8 ± 24.2 (P = .321), respectively.

RTP rates among Gaelic games players were high, with the majority returning to an equivalent/higher level of performance. The rate of BPTB graft reinjury was low, considering the injury risk associated with returning to level 1 sport. Younger patients and those who underwent HT autograft reconstruction were at the highest risk of ACL graft reinjury. Overall, Gaelic games players reported good knee function and outcomes after ACLR.