2023 ISAKOS Biennial Congress ePoster
Contralateral ACL Rupture is More Common than ACL Graft Rupture in Australian Netballers After ACL Reconstruction
Conor Honeywill, MD, B. Phty, Sydney, NSW AUSTRALIA
Lucy J. Salmon, PhD, Sydney, NSW AUSTRALIA
Leo A. Pinczewski, MBBS, FRACS, FAOA, Sydney, NSW AUSTRALIA
Keran Sundaraj, MBBS MCs (Trauma) FRACS FAOA, Wollstonecraft, NSW AUSTRALIA
Justin P. Roe, FRACS, A/Prof., Sydney, NSW AUSTRALIA
North Sydney Orthopaedic and Sports Medicine Centre, Sydney, New South Wales, AUSTRALIA
FDA Status Not Applicable
Summary
From a prospectively collected database, a consecutive series of 326 female netballers who underwent primary ACLRs were surveyed at a minimum of five years following reconstruction to determine rates of injury, return to sport and psychological readiness to return to sport.
ePosters will be available shortly before Congress
Abstract
Introduction
The aim of this study was to determine Anterior Cruciate Ligament (ACL) graft and contralateral ACL (CACL) survival in patients who have undergone ACL reconstruction (ACLR) with hamstring autograft following netball injuries, and determine factors associated with repeat ACL injury and return to netball.
Methods
From a prospectively collected database, a consecutive series of 332 female netballers who underwent primary ACLRs using hamstring autografts were identified. Subjects were surveyed at a minimum of five years following reconstruction, including details of further ACL injuries to either knee, return to netball or other sports and psychological readiness with the ACL-RSI score.
Results
267 participants (80%) were reviewed at the mean follow up of 9 years (60-180 months). There were 11 ACL graft ruptures and 27 contralateral ACL ruptures. ACL graft survival was 99%, 97%, 97 and 96% at 1, 2, 5 and 7 years after surgery respectively. CACL survival was 100%, 99%, 94% and 90% at 1, 2, 5 and 7 years respectively. The 7-year ACL graft survival was 97% in those aged >20 and 91% in those 20 years or less (HR 3.3, 95%CI 1-10.9, p=0.047). The 7-year CACL survival was 93% in those aged >20 and 78% in 20 years or less (HR 3.1 (95% CI 1.4-6.6, p=0.012). A return to netball was reported by 62% of participants, was associated with lower survival (HR 10 95% CI 1.3-74.2, p=0.025). The mean ACL-RSI score was 65 in those who returned to netball and 39 in those who did not (p=0.001).
Discussion
ACLR with hamstring autografts is a reliable procedure for netballers with a survival rate of 96% at 7 years, allowing 62% of participants to return to netball. A successful return to netball was associated with greater psychological readiness, and a poorer contralateral ACL survival. CACL injury occurred with double the frequency of ACL graft rupture, and was increased by 3x in those 20 years or less.