Self-reported knee function and activity level are reduced after primary or additional anterior cruciate ligament injury in female football players: a five-year follow-up study.
Anne Fältström, Martin Hägglund, Henrik Hedevik and 1 others
PMID 38043159WHAT IT FOUND
Female football players who had another ACL injury after reconstruction reported a decrease of 11.4 points on a 100-point knee function scale over five years; those without another injury did not change.
Activity and satisfaction also fell.
Key findings
01After primary ACL reconstruction, players who sustained a new ACL injury reported a decrease of 11.4 points on the IKDC-SKF knee function scale, while players who did not sustain a new injury showed no change.
02Players with an additional ACL injury had larger decreases than players with no additional injury: 12.5 points on knee function, 1.5 points on activity level, 0.9 points on satisfaction with knee function, and 1.3 points on satisfaction with activity level.
03Players with an additional ACL injury also had larger decreases than players with no ACL injury: 1.6 points on activity level, 1.5 points on satisfaction with knee function, and 1.0 points on satisfaction with activity level.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This was an exploratory analysis of a prospective cohort, not a randomised trial, so it shows associations rather than treatment effects. Only female football players were studied, so the results may not apply to male athletes or other sports. Of 242 eligible players with primary ACL reconstruction, 186 responded to follow-up and 56 did not respond; nonresponders did not differ on available variables, but attrition may still affect results. Players with no ACL injury did not complete the IKDC-SKF, so knee function could not be compared with controls. Time from additional injury to follow-up varied from 2 to 81 months; a sensitivity analysis removed eight players with injury or reconstruction within one year of follow-up. Outcomes were self-reported, activity level was graded by one author with the Tegner scale, and the satisfaction scales were not examined for psychometric parameters. Few players were still playing football at follow-up, so football-specific changes were not analysed.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read these findings as evidence that a specific rehabilitation or prevention programme caused or prevented the declines. The study followed self-reported outcomes after ACL injury in female football players and did not test a treatment.