Performance and Return to Sport After Anterior Cruciate Ligament Reconstruction in National Hockey League Players

Background: Anterior cruciate ligament (ACL) rupture is a significant injury in male National Hockey League (NHL) players. Purpose: To determine (1) the return to sport (RTS) rate in the NHL following ACL reconstruction, (2) performance on RTS, and (3) the difference in RTS and performance between players who underwent ACL reconstruction and controls. Study Design: Cohort study; Level of evidence, 3. Methods: NHL players undergoing ACL reconstruction were evaluated. All demographic data were analyzed. Matched controls were selected from the NHL during the same years as those undergoing ACL reconstruction. The index year (relative to the number of years of experience in the NHL) in controls was the same as the year that cases underwent ACL reconstruction. RTS and performance in the NHL were analyzed and compared between cases and controls. Student t tests were performed for analysis of within- and between-group variables. Bonferroni correction was used in the setting of multiple comparisons. Results: A total of 36 players (37 knees) meeting the inclusion criteria underwent ACL reconstruction while in the NHL. Thirty-five players were able to RTS in the NHL (97%), and 1 player returned to the international Kontinental Hockey League. Of the players who RTS in the NHL, 100% were able to RTS the season after ACL reconstruction (mean, 7.8 +/- 2.4 months). Length of career in the NHL after ACL reconstruction was 4.47 +/- 3.3 years. The revision rate was 2.5%. There were significantly more cases playing in the NHL at 3 (P = .027) and 4 (P = .029) years following surgery compared with controls (index year). After ACL reconstruction, player performance was not significantly different from preinjury performance. Following ACL reconstruction (or index year in controls), cases played significantly more minutes, took more shots, had better shooting percentages, and scored more goals and points than did controls (P < .01 for all). Control players did not significantly outperform cases after ACL reconstruction in any performance measure. Conclusion: There is a high RTS rate in the NHL following ACL reconstruction. All players who RTS did so the season following surgery. Performance following ACL reconstruction was not significantly different from preinjury. Cases performed better than did controls in several performance measures. Controls did not outperform cases in any measured performance variable