Sport for all seasons, a new philosophy.

We surely need to apply the same stringent rules about informed consent to the postsurgery situation as we do for the preoperative scenario. A ‘return to sport’ consent form should be mandated for every patient who undergoes sport-related surgery, and the form should clearly identify all the short and long-term risks involved in this course of action. There is ample evidence from the past 5 years alone to highlight the long-term risks associated with meniscal damage and ACL injury.1–7 I have not recommended a return to sport for any elite athlete who has had an ACL injury in the past 10 years and this is clearly documented in the patient’s notes. The fact that I have a low success rate, and that none of these patients has taken the slightest notice of my dire predictions (all of them returned to elite level sport), is hopefully a testament to the universally accepted ‘play now—pay later’ philosophy and not a refl ection on my poor counselling skills. However, in the same way that a packet of cigarettes should always carry a health warning, I should perhaps add a small caveat—‘Any team physician who has a high success rate in this area is likely to lose their job.’