Factors influencing return to play and second anterior cruciate ligament injury rates in level 1 athletes after primary anterior cruciate ligament reconstruction: 2-year follow-up on 1432 reconstructions at a single center

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dc.contributor.authorKing, Endaen
dc.contributor.authorRichter, Chrisen
dc.contributor.authorJackson, Marken
dc.contributor.authorFranklyn-Miller, Andyen
dc.contributor.authorFalvey, Eannaen
dc.contributor.authorMyer, Gregory D.en
dc.contributor.authorStrike, Siobhanen
dc.contributor.authorWithers, Danen
dc.contributor.authorMoran, Rayen
dc.date.accessioned2023-05-25T13:49:22Z
dc.date.available2023-05-25T13:49:22Z
dc.date.issued2020-02-07en
dc.description.abstractBackground: Despite the importance of return-to-play (RTP) rates, second anterior cruciate ligament (ACL) injury rates, and patient-reported outcomes of athletes returning to sports after ACL reconstruction (ACLR), these outcomes have not been evaluated together across a single cohort nor the pre- and intraoperative factors influencing outcomes explored. Purpose: To prospectively report outcomes after ACLR relating to RTP, second ACL injury, and International Knee Document Committee (IKDC) scores in a large cohort of athletes at a single center to examine the influence of pre- and intraoperative variables on these outcomes. Design: Cohort study; Level of evidence, 3. Methods: A consecutive cohort of 1432 athletes undergoing primary ACLR by 2 orthopaedic surgeons was followed up prospectively more than 2 years after surgery. Pre- and intraoperative findings were reported with outcomes at follow-up relating to RTP, second ACL injury, and IKDC. Between-group differences for each outcome were reported and the predictive ability of pre- and intraoperative variables relating to each outcome assessed with logistic regression. Results: There was >95% follow-up 2 years after surgery. The RTP rate was 81%, and of those who returned, 1.3% of those with patellar tendon grafts and 8.3% of those with hamstring grafts experienced ipsilateral rerupture (hazard ratio, 0.17). The contralateral ACL injury rate was 6.6%, and the IKDC score at follow-up was 86.8, with a greater proportion of patients with patellar tendon grafts scoring <80 on the IKDC (odds ratio, 1.56; 95% CI, 1.15-3.12). There was no relationship between time to RTP and second ACL injury, and there was a moderate correlation between ACL–Return to Sport After Injury score and RTP at follow-up (P < .001, rho = 0.46). There were a number of differences in pre- and intraoperative variables between groups for each outcome, but they demonstrated a poor ability to predict outcomes in level 1 athletes at 2-year follow-up. Conclusion: Findings demonstrated high overall RTP rates, lower reinjury rates with patellar tendon graft after 2-year follow-up in level 1 athletes, and no influence of time to RTP on second ACL injury. Despite differences between groups, there was poor predictive ability of pre- and intraoperative variables. Results suggest pre- and intraoperative variables for consideration to optimize outcomes in level 1 athletes after ACLR, but future research exploring other factors, such as physical and psychological recovery, may be needed to improve outcome prediction after ACLR.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationKing, E., Richter, C., Jackson, M., Franklyn-Miller, A., Falvey, E., Myer, G.D., Strike, S., Withers, D. and Moran, R. (2020) 'Factors influencing return to play and second anterior cruciate ligament injury rates in level 1 athletes after primary anterior cruciate ligament reconstruction: 2-year follow-up on 1432 reconstructions at a single center', American Journal of Sports Medicine, 48(4), pp.812-824. doi: 10.1177/0363546519900170en
dc.identifier.doi10.1177/0363546519900170en
dc.identifier.eissn1552-3365en
dc.identifier.endpage824en
dc.identifier.issn0363-5465en
dc.identifier.issued4en
dc.identifier.journaltitleAmerican Journal of Sports Medicineen
dc.identifier.startpage812en
dc.identifier.urihttp://hdl.handle.net/10468/14515
dc.identifier.volume48en
dc.internal.IRISemailaddresseannafalvey@ucc.ieen
dc.internal.authorcontactotherÉanna Falvey, Medicine, University College Cork, Cork, Ireland T: +353-21- 490-3000 E: eannafalvey@ucc.ieen
dc.internal.availabilityFull text availableen
dc.internal.emailaddresse.noonan@ucc.ieen
dc.language.isoenen
dc.publisherSAGE Publishingen
dc.rights© 2020, the Authors. Reprinted by permission of SAGE Publications. This is a post-peer-review, pre-copyedit version of the following article: King, E., Richter, C., Jackson, M., Franklyn-Miller, A., Falvey, E., Myer, G.D., Strike, S., Withers, D. and Moran, R. (2020) 'Factors influencing return to play and second anterior cruciate ligament injury rates in level 1 athletes after primary anterior cruciate ligament reconstruction: 2-year follow-up on 1432 reconstructions at a single center', American Journal of Sports Medicine, 48(4), pp.812-824, doi: 10.1177/0363546519900170. The final authenticated version is available online at: https://doi.org/10.1177/0363546519900170en
dc.rights.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
dc.subjectAnterior cruciate ligament reconstructionen
dc.subjectReturn to playen
dc.subjectReinjuryen
dc.subjectAthletesen
dc.titleFactors influencing return to play and second anterior cruciate ligament injury rates in level 1 athletes after primary anterior cruciate ligament reconstruction: 2-year follow-up on 1432 reconstructions at a single centeren
dc.typeArticle (peer-reviewed)en
oaire.citation.issue4en
oaire.citation.volume48en
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