Sandon A, et al. - Via a total of 1,661 soccer players from the Swedish National Knee Ligament Registry, researchers followed up on soccer players 10 years following a primary anterior cruciate ligament (ACL) reconstruction to find out how many players returned to play soccer, what impacted their decision, and if there were any variations in additional ACL injuries (graft failure and/or contralateral ACL injury) between those who returned to play and those who did not. About 51% returned to play soccer. The primary reason was knee-related for those who did not return to play. Pain and/or instability, followed by fear of reinjury were the most prevalent knee-related reasons for not returning. A significantly greater risk of additional ACL injury was noted in players who return to soccer. Of the players who returned to play soccer, 28.7%, 9.7%, and 20.6% had an additional ACL injury, a graft failure, and a contralateral ACL injury, respectively. In conclusion, a significantly greater risk of sustaining a further ACL injury was noted in players that return to soccer. Only half of the soccer players return to play following ACL reconstruction, and in two-thirds of those who did not return, the reason was knee-related. The great risk of maintaining additional knee injury is of serious concern to the player's future knee health and should be acknowledged when deciding on a return to play.