Type of Sport and Outcomes After ACL Reconstruction

Researchers from Hospital for Special Surgery (HSS) in New York have published a new study entitled, “Comparative Influence of Sport Type on Outcome After Anterior Cruciate Ligament Reconstruction at Minimum 2-Year Follow-up.” The work, which appears in the February 2017 edition of Arthroscopy, involved 294 patients with a mean age of 25.5 years; mean follow-up was 3.7 years.

The authors wrote, “Included patients were enrolled as part of a prospective institutional ACL [anterior cruciate ligament] registry. Inclusion criteria were preoperative self-identification as a competitive athlete, maximum score on the preoperative Marx Activity Scale, and minimum 2-year follow-up. Demographic, intraoperative, and outcome data were extracted from the registry. Outcome tools administered as part of the registry included International Knee Documentation Committee (IKDC), Lysholm-Tegner Scales, Marx Activity Scale (MAS), and 12-Item Short Form Health Survey (SF-12).”

“Included sports categories were soccer, skiing, basketball, lacrosse, football, and tennis. At baseline, compared with other sports, lacrosse players have higher outcome scores while skiers had lower scores. At 2-year follow-up, however, across all outcome tools, football players demonstrated significantly higher outcome scores than all other athletes. Conversely, at 2-year follow-up, soccer players demonstrated a significantly lower Lysholm and a trend toward lower IKDC scores.”

“…Football players demonstrate quantitatively higher outcome scores whereas soccer players have lower scores. However, these outcome score differences may not be clinically significant and may be subject to confounding variables. Continued attention should be paid to understanding sport-specific outcome after ACLR.”

David Altchek, M.D. is Co-Chief Emeritus in the Sports Medicine & Shoulder Service at HSS. He told OTW, “These are the most common high velocity pivoting sports. The most important result was that there seems to be a sport specific variance in patient reported outcome after ACL reconstruction. Future research is to investigate why there is this variance and how we can improve the patient reported outcomes. One possible factor is that current ACL rehabilitation is not sport-specific and may play a role.”