Return to Play After Patellar Tendon Autograft for Primary Anterior Cruciate Ligament Reconstruction in Rugby Players

BACKGROUND: There is scant literature on outcomes after anterior cruciate ligament (ACL) reconstruction in rugby players, and no prior study has evaluated the outcomes of bone–patellar tendon–bone (BTB) autograft ACL reconstruction. PURPOSE: To assess the rate of return to play, the timing of that return, and the subsequent graft reinjury rate among rugby players after ACL reconstruction with BTB autograft. METHODS: The ACL registry at a single hospital was screened for professional and amateur rugby players who had undergone a primary ACL reconstruction with BTB autograft. Professional rugby players were those playing for one of the professional provincial teams in Ireland. Outcomes were analyzed for the rate and timing of return to play, functional outcomes, and subsequent graft ruptures. Additionally, outcomes were compared between professional and amateur athletes. STUDY DESIGN: Case series; Level of evidence, 4. RESULTS: A total of 126 patients with 24 months of follow-up were enrolled. The overall rate of return to play was 84.9%, with 75.4% returning to the same level of play; 8.7% of patients did not return to play secondary to non–knee-related issues. The mean time to return was 10.9 ± 4.9 months. Among professional rugby players, 93.3% were able to return at a mean time of 9.7 ± 4.4 months; 80% returned to the same level. The mean Anterior Cruciate Ligament–Return to Sport after Injury score was 78.4 ± 20.2, the Cincinnati knee score was 92.5 ± 8.0, the International Knee Documentation Committee score was 88.2 ± 8.1, and the Marx score was 9.7 ± 5.3. Two patients sustained a subsequent rerupture of the reconstructed ACL, and 4 players sustained a contralateral ACL injury within the follow-up interval of 2 years. CONCLUSION: Rugby players receiving BTB ACL reconstruction demonstrated good clinical outcomes with a high rate of return to sport, with the majority returning before 12 months. The rate of a subsequent ACL injury was low among the authors’ cohort at short-term follow-up.