Results published in The American Journal of Sports Medicine showed a significant risk of multiple ACL injuries among younger patients, with a high rate of third ACL injuries identified.
Kate E. Webster
At a mean follow-up of 4.5 years, Kate E. Webster, PhD, and colleagues determined the number of subsequent ACL injuries experienced among 128 patients aged 25 years or younger at the time of their first revision ACL reconstruction. Researchers recorded surgical details and range of sport participation outcomes. They assessed the associations between subsequent ACL injury and return to sport, knee pathology and the drilling of new femoral or tibial tunnels at revision surgery using contingency tables.
Results showed 16% of patients experienced graft re-rupture at a mean time of 2 years after revision surgery, and 12% of patients experienced contralateral ACL injuries at a mean time of 3.9 years. Overall, 27% of patients experienced a third ACL injury. Having medial meniscal pathology was significantly associated with sustaining a graft re-rupture. However, researchers found graft re-rupture was not associated with using the same tunnels from the primary procedure at revision surgery.
Results showed return to preinjury level of sport was achieved by 83% of patients after primary reconstruction vs. 68% of patients after revision reconstruction. After revision procedure, researchers noted a significantly greater rate of return to preinjury sport among patients who had a third ACL injury compared with patients who did not have further ACL injuries (83% vs. 62%).
“The most important finding of our study was that we confirmed that younger athletes are at a significant risk of having multiple ACL injuries,” Webster told Healio.com/Orthopedics. “Of the young athletes with revision ACL reconstruction in our study, 27% had a third ACL injury. This is concerning for future knee health in such young athletes. Young athletes who have had multiple ACL injuries by their early 20s will be at significantly increased risk for developing knee osteoarthritis, which will have a lifetime impact on their ability to remain active.” – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.