Young athletes who return to sport before 9 months after anterior cruciate ligament reconstruction have a rate of new injury 7 times that of those who delay return

Review written by Dr Christina Le info

Key Points

  • Returning to sport earlier than 9 months after anterior cruciate ligament (ACL) reconstruction may lead to greater risk of sustaining an ACL graft injury or contralateral ACL injury.
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BACKGROUND & OBJECTIVE

It is no surprise that individuals who have undergone a primary anterior cruciate ligament (ACL) reconstruction run a greater risk of sustaining a secondary ACL injury than those who have never had an ACL injury. The incidence of secondary ACL injury may be as high as 23% in young patients (< 25 years old) who return to high-risk sports like soccer (1). Time to return to sport (RTS) and functional tests have been examined as possible factors that could influence re-injury risk, but the existing evidence is inconsistent (2,3).

The primary objective of this study was to assess the association between sustaining a secondary ACL injury (i.e. ACL graft injury or contralateral ACL injury) and time to RTS, symmetrical muscle function, and symmetrical quadriceps strength at the time of RTS in young athletes after primary ACL reconstruction. The authors also examined the association between participants’ demographics and sustaining a secondary ACL injury.

The incidence of secondary ACL injury may be as high as 23% in young patients who return to high-risk sports like soccer.
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Clinicians should explain to patients the potentially higher risk of re-injury associated with returning to sport prior to 9 months post-surgery.

METHODS

Participants aged 15-30 years old who participated in activities rated 6 or greater (e.g. volleyball, basketball, soccer) on the Tegner Activity Scale (TAS) and underwent primary ACL reconstruction were recruited from the Project ACL database. Functional tests were completed at

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