Sleep and psychological factors are associated with meeting discharge criteria to return to sport following ACL reconstruction in athletes.

This study aimed to determine if sleep quality and psychological factors were associated with time to meet the discharge criteria to return to sport (RTS) following anterior cruciate ligament reconstruction (ACL-R) among athletes. A cohort-study design included 89 athletes following ACL-R. Each participant completed a battery of questionnaires at 6 different time points: within 3 days of injury occurrence and at post-surgery (1.5 m, 3 m, 4.5 m, 6 m and when discharge criteria were met). Assessment included sleep quality and quantity, symptoms of depression, anxiety, stress, psychological readiness to RTS and fear of re-injury. The primary outcome was the time needed to meet all discharge criteria to RTS. Sleep parameters and psychological factors were not associated with time to meet the discharge criteria to RTS. However, athletes that had lower scores of anxiety (OR 1.2 (95% CI 1.0, 1.3) and insomnia (OR 1.2 (95% CI 1.0, 1.3) at baseline were more likely to meet the RTS discharge criteria. Athletes with better sleep quality at 3m, 4.5m and 6m were more likely to meet the RTS discharge criteria OR 1.3 (95% CI 1.1, 1.7), 2.0 (95% CI 1.1-3.4) and 1.4 (95% CI 1.0, 1.9) respectively. Sleep quality and psychological factors were not associated with time to meet the discharge criteria to RTS but impacted whether athletes adhered and completed their rehabilitation program or not. Monitoring sleep quality and psychological factors of athletes before and following ACL-R surgery is important to identify athletes who could have difficulties in adhering to and completing their rehabilitation program to RTS.

ACL injury incidence, severity and patterns in professional male soccer players in a Middle Eastern league.

AIM: To ascertain ACL injury incidence, severity (injury burden) and patterns (contact/non-contact and reinjuries) in a professional male football league in the Middle East over five consecutive seasons. METHODS: Prospective epidemiological study reporting ACL injuries in professional male soccer players in the Qatar Stars League, with complete matches/training exposure over five seasons (2013-2014 to 2017-2018), corresponding to 2243 player seasons and 729 team months. RESULTS: 37 complete ACL ruptures occurred in 37 players during 486 951 hours of player exposure. The overall ACL injury rate was 0.076 injuries/1000 hours of exposure (season range 0.045-0.098). Injury incidence during matches and training was 0.41 and 0.04 injuries/1000 hours of exposure, respectively. Match injury incidence was greater than that of training (OR 11.8, 95% CI 6.21 to 23.23, p<0.001). Average injury-related time-loss following ACL injury was 225 days±65 (range 116-360). Overall injury burden was 16.3 days lost/1000 hours of exposure. CONCLUSION: The overall ACL injury rate in professional male soccer players competing in the Middle East was 0.076 injuries/1000 hours of exposure, match injury incidence was greater than training, while the average ACL time-loss was 225 days.