Summary
Although second ACL injuries are common after ACLR, significant improvements in KOOS subscales and return to high level sports can be expected.
Abstract
Background
An increasing number of sports-related anterior cruciate ligament (ACL) injuries and subsequent ACL reconstructions (ACLR) can be observed in the young and athletic population. However, little is known about sport specific outcomes, concomitant injuries, and return to sport (RTS) rates after adolescent ACLR. The purpose of this study was to evaluate differences in sport-specific concomitant injuries, RTS rates, second ACL injuries, and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales after adolescent ACLR across a variety of popular sports.
Methods
This prospective cohort study included patients aged 10-18 years at the time of ACLR. Demographic and injury-related data and KOOS subscales before ACLR and at the one- and two-year follow-ups were obtained from the Swedish National Knee Ligament Registry (SNKLR). A survey to assess sport-specific outcomes and RTS was sent to eligible patients. Group comparisons were performed between the most popular sports and between females and males.
Results
Overall, 1,392 patients with a mean age of 16.4 ± 1.4 years at the time of ACLR were included. The mean time between ACLR and survey completion was 9.7 ± 4.2 years. The most prevalent type of sport was soccer (n=712), followed by handball (n=187), floor hockey/field hockey (n=132), basketball (n=60), and other sports (n=301). Concomitant injuries (71%) and second ACL injuries (30%) were common across all sports. No significant differences were found in ipsilateral second ACL injuries across sexes and sports. 24% of patients competed at an elite level sport (highest national level of junior sport or higher) for some period after ACLR. 8% of patients did not RTS at all, with females significantly more often not RTS than males (9% vs. 4%, p=0.041). Significant improvements were observed in KOOS subscales from baseline to the one- and two-year follow-ups for all sports.
Conclusion
Concomitant injuries (71%) are frequently observed after ACL injury in adolescents. Although second ACL injuries (30%) are common after ACLR, significant improvements in KOOS subscales and return to high level sports can be expected.