Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared With Their Athletic Peers?

Allen, Melissa M.; Pareek, Ayoosh; Krych, Aaron J.; Hewett, Timothy E.; Levy, Bruce A.; Stuart, Michael J.; Dahm, Diane L.

doi:10.1177/0363546516648439

Cited by 102 publications

(97 citation statements)

References 35 publications

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“…The high re-injury rate after ACL reconstruction among adolescent patients, as described in the literature [1, 2, 13, 23, 27, 34, 36], can be partly explained by the fact that the adolescent patients return to knee-strenuous sport too early, without achieving adequate muscle function.…”

Section: Discussionmentioning

confidence: 99%

Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction

Beischer

Senorski

Thomeé³

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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PurposeThe purpose of this study was to evaluate the return to knee-strenuous sport rate, muscle function and subjective knee function among adolescent patients (15–20 years of age) and adult patients (21–30 years of age) 8 and 12 months, respectively, after anterior cruciate ligament (ACL) reconstruction. It was hypothesised that no differences in outcome would be found between age groups at 8 or 12 months after ACL reconstruction.MethodsCross-sectional data from five tests of muscle function, from the Knee injury and Osteoarthritis Outcome Score (KOOS) and the Tegner Activity Scale (Tegner), performed at 8 and 12 months after a primary ACL reconstruction, were extracted from a rehabilitation outcome register. A total of 270 (51% women) athletes, aged 15–30 years, who were all involved in knee-strenuous sport prior the injury, were included at 8 months after ACL reconstruction. At 12 months 203 (51% women) were included. The return to knee-strenuous-sport rates and the rate of achieving a limb symmetry index of ≥ 90% in all five tests of muscle function, defined as recovery of muscle function, and subjective knee function scores, as measured with the KOOS, were compared between age groups.ResultsThe adolescent patients had a higher (50%) return to knee-strenuous sport rate compared with the adult patients (38%) 8 months after ACL reconstruction (p = 0.04). At the 12-month follow-up, no difference was found between the age groups; 74 and 63%, respectively. At the 8-month follow-up, 29% of the patients, in both age groups, who had returned to sport had recovered their muscle function in all five tests of muscle function. At the 12-month follow-up, the corresponding results were 20% for the adolescents and 28% for the adult patients. No difference in mean KOOS scores was found between the age groups at 8 or at 12 months after ACL reconstruction.ConclusionThe majority of young athletes make an early return to knee-strenuous sport after a primary ACL reconstruction, without recovering their muscle function. To set realistic expectations, clinicians are recommended to ensure that young athletes receive information about not to return before muscle function is recovered and that this may take longer time than 12 months.Level of evidenceII.

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Section: Discussionmentioning

confidence: 99%

Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction

Beischer

Senorski

Thomeé³

et al. 2017

Knee Surg Sports Traumatol Arthrosc

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“…[17, 19] These injuries are also most frequent in the first 2 years after ACLR. [22, 26] Several risk factors are implicated in this increased risk of second ACL injury, including surgical factors (graft placement and type),[6, 7] demographics (sex and age),[121] activity level,[17] sport,[16] and neuromuscular and biomechanical factors. [24] Also, there are anatomical and intrinsic risk factors that have not been discussed in this article because these factors are not subject to change by delaying a RTS.…”

Section: Discussionmentioning

confidence: 99%

“…[2] Long-term follow-ups of 10 years or more have reported second injury rates between 23% and 27%. [3–5] Several factors have been implicated in second ACL injury risk, including graft placement,[6–8] graft type,[9–13] sex,[14–16] age,[5, 14, 17–19] time from surgery,[10, 20, 21] activity level,[22, 23] and aberrant neuromuscular and biomechanical adaptations. [24]…”

Section: Introductionmentioning

confidence: 99%

Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations

2016

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Anterior cruciate ligament (ACL) tears are common knee injuries sustained by athletes during sports participation. A devastating complication of returning to sport following ACL reconstruction (ACLR) is a second ACL injury. Strong evidence now indicates that younger, more active athletes are at particularly high risk for a second ACL injury and this risk is greatest within the first two years following ACLR. Nearly one-third of the younger cohort that resumes sports participation will sustain a second ACL injury within the first two years after ACLR. The evidence indicates that the risk of second injury may abate over this time period. The incidence rate of second injuries in the first year after ACLR is significantly greater than the rate in the second year. The lower relative risk in the second year may be related to athletes achieving baseline joint health and function well after the current expected timeline (6 to 12 months) to be released to unrestricted activity. This highlights a considerable debate in the return to sport decision process as to whether an athlete should wait until two years after ACLR to return to unrestricted, sports activity. In this review, we present evidence in the literature that athletes achieve baseline joint health and function approximately two years after ACLR. We postulate that delay in returning to sports for nearly two years will significantly reduce the incidence of second ACL injuries.

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“…31 in a cohort of 90 female players found that returning to play after ACLR was associated with a higher risk of sustaining graft tears compared with those who did not return to soccer (15 versus 0%, p=0.04). However, there was no significant difference regarding contralateral ACL tears (19% for returning players versus 9% for those who did not return, p=0.34).…”

Section: Shoe-surface Interactionmentioning

confidence: 96%

Risk factors of anterior cruciate ligament injury in football players: a systematic review of the literature

Volpi

Bisciotti

Chamari

et al. 2016

MLTJ

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SummaryBackground: The ACL lesion represents one of the most dramatic injuries in a sportsman's career. There are many injury risk factors related to intrinsic, or non-modifiable, and extrinsic, or modifiable, factors. In literature at today current evidence suggests that ACL injury risk is multifactorial and involves biomechanical, anatomical, hormonal and neuromuscular factors. Purpose: To perform a systematic review of the literature concerning the ACL injury risk factors in soccer. Conclusion:The injury risk factors show a low level of evidence, further studies in the field are needed. Study design: Systematic review.

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Are Female Soccer Players at an Increased Risk of Second Anterior Cruciate Ligament Injury Compared With Their Athletic Peers?

Cited by 102 publications

References 35 publications

Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction

Young athletes return too early to knee-strenuous sport, without acceptable knee function after anterior cruciate ligament reconstruction

Should Return to Sport be Delayed Until 2 Years After Anterior Cruciate Ligament Reconstruction? Biological and Functional Considerations

Risk factors of anterior cruciate ligament injury in football players: a systematic review of the literature

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