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NEW YORK | Sat Aug 7, 2010 2:51am IST

NEW YORK (Reuters Health) - Despite surgery, less than two-thirds of National Football League players are able to return to play after knee ligament tears, new research hints.

That number runs counter to the optimism of most team physicians, who said they believed 90 to 100 percent of players would be back on the field, according to an earlier survey.

However, the doctor who led the new study, based on 49 NFL players who had all had surgery to replace the knee's anterior cruciate ligament, or ACL, said he wasn't surprised.

"At this level and with this much competition I think the lower rates of return were expected," Dr. Vishal Michael Shah of the Richmond Bone and Joint Clinic in Sugarland, Texas, told Reuters Health in an e-mail.

The average career of an NFL athlete is only 3.5 years, according to the researchers, whose findings were published in the American Journal of Sports Medicine.

Whether or not players returned to compete, Shah said, probably had little to do with the success of surgery and more with "how much money the team has invested in them already and who else is waiting on the sideline to replace them."

Shah said there wasn't really much the highly trained NFL players could do to prevent injuries.

"The type of injuries they are sustaining are likely unpreventable," he said.

Of the 49 players followed by the researchers, 31 went back to play NFL games, on average slightly less than a year after surgery. Age and type of surgery weren't related to who returned, but those who'd played more games were more likely to go back.

And how many rounds of drafts the athlete had gone through turned out to make a big difference: those who'd been drafted in the first four rounds had 12 times the odds of competing again.

"Higher draft picks have generally been paid more money and the teams have more 'investment' in them," Shah said.

"They are incentivized to give these players more of a chance to return and fight for their job while they may rather 'cut their losses' for late draft picks," he added. "Basically it comes down to the fact that NFL contracts are not guaranteed."

SOURCE: link.reuters.com/dak73n The American Journal of Sports Medicine, online July 7, 2010.

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