Citation

Hamrin Senorski E, Svantesson E, Beischer S, Thomeé C, Thomeé R, Karlsson J, Samuelsson K. Am. J. Sports Med. 2018; 46(7): 1551-1558.

Affiliation

Department of Orthopedics, Sahlgrenska University Hospital, Mölndal, Sweden.

Copyright

(Copyright © 2018, American Orthopaedic Society for Sports Medicine, Publisher SAGE Publishing)

DOI

10.1177/0363546518765120

PMID

29659299

Abstract

BACKGROUND: There is insufficient knowledge about the way that concomitant injuries affect the short-term likelihood of a return to a knee-strenuous sport after anterior cruciate ligament (ACL) reconstruction. Hypotheses/Purpose: The purpose was to study whether patient characteristics, concomitant injuries, and graft choice at primary ACL reconstruction can predict return to sport (RTS) 1 year after surgery. The hypotheses were that younger age at the time of ACL reconstruction would positively affect RTS, while the presence of concomitant injuries would negatively affect RTS 1 year after surgery. STUDY DESIGN: Case-control study; Level of evidence, 3.

METHODS: Data were extracted from a rehabilitation-specific register and the Swedish National Knee Ligament Register. Twelve months after surgery, all patients were evaluated for RTS via the Tegner Activity Scale. The primary outcome was a return to knee-strenuous sport, defined as a Tegner Activity Scale ≥6. Univariable and multivariable logistic regression analyses were performed with patient characteristics, concomitant knee injuries, and graft choice as independent variables.

RESULTS: A total of 272 patients (51% female) with a mean ± SD age of 25.0 ± 9.2 years were included. In the multivariable analysis, a favorable odds ratio (OR) for returning to sport was found for patients of male sex (OR, 2.58; 95% CI, 1.43-4.65; P =.0016), younger age at the time of ACL reconstruction (OR, 2.32; 95% CI, 1.59-3.33; P <.0001), a higher preinjury score on the Tegner Activity Scale (OR, 1.45; 95% CI, 1.13-1.87; P =.0038), and an absence of injury to the meniscus (OR, 1.92; 95% CI, 1.10-3.36; P =.023) and medial collateral ligament (OR, 7.61; 95% CI, 1.42-40.87; P =.018). In addition, the absence of cartilage injury was favorable in terms of RTS in the univariable analysis (OR, 2.48; 95% CI, 1.40-4.39; P =.0018).

CONCLUSION: Positive predictors of a return to knee-strenuous sport 1 year after ACL reconstruction were male sex, younger age, a high preinjury level of physical activity, and the absence of concomitant injuries to the medial collateral ligament and meniscus.

Language: en

Keywords

ACL; anterior cruciate ligament; register; return to sport; sport