2015 ISAKOS Biennial Congress ePoster #1377

A Comparison of Clinical Outcomes and Return to Play Between Elite and High School Rugby Players after Anterior Cruciate Ligament Reconstruction

Yuji Takazawa, MD, PhD, Tokyo JAPAN
Masataka Nagayama, MD, Tokyo JAPAN
Hiroshi Ikeda, MD, PhD, Tokyo JAPAN
Takayuki Kawasaki, Tokyo JAPAN
Muneaki Ishijima, MD, PhD, Tokyo JAPAN
Yoshitomo Saita, MD, PhD, Tokyo JAPAN
Haruka Kaneko, Tokyo JAPAN
Shinnosuke Hada, MD, Tokyo JAPAN
Yohei Kobayashi, MD, PhD, Tokyo JAPAN
Kazuo Kaneko, MD, PhD, Prof., Tokyo JAPAN

Dept. of Orthopaedics, Juntendo University, Bunkyo-ku, Tokyo, JAPAN

FDA Status Not Applicable

Summary: Younger patients had inferior outcomes both in subjectively and objectively after ACL reconstruction with hamstring autograft in rugby players.

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Abstract:

Background—Recently, increasing evidence has shown that younger patients could have an inferior outcome after anterior cruciate ligament (ACL) reconstruction. A comparison of the clinical results after same procedure of ACL reconstruction between different ages of players in the same sport is necessary. Among the various sports, rugby has an elevated risk for high energy and speed injuries to the knee, ACL injuries are particularly common.

Purpose—We compared clinical outcomes, differences in return to match play, and fear of re-injury between two different homogenous cohorts, elite and high school rugby players who had undergone ACL reconstruction with hamstring autograft.

Design—A retrospective review.

Setting—Two teams of rugby players (elite and high school).

Participants— Between April 2001 and March 2012, a total of 2 teams with 384 players (elite players, 94; high school players, 290) were followed.

Main outcome measures—Subjective and objective outcomes, the ratio of return to play and fear of re-injury.

Results—Twenty-six players (12 elite; 14 high school) had undergone ACL reconstruction and were successfully followed for a mean of 71.9 months postoperatively (elite, 85.0 ± 40.7 months; high school, 50.1± 32.0 months). The anterior stability and negative ratios in the pivot-shift test were not significantly different between the groups. No (0%) elite players but 4 (29%) high school players experienced ACL graft ruptures (P < 0.05); similarly, no elite players (0%) but 3 (21%) high school players experienced contralateral ACL injuries (P = 0.09). Overall, 23/26 (88%) players returned to the same level of match play. The mean single assessment numeric evaluation score at the time of return to match play was higher in elite (93.3 ± 9.6 points) than that in high school players (70.7 ± 23.3 points; P < 0.01); 7/12 (58%) elite and 10/11 (91%) high school players had fear of re-injury, and the time taken to overcome fear was shorter in elite (6.1 ± 4.9 months) than in high school (17.5 ± 26.0 months) players. “Being Tackled” was the most frequently reported reason for fear of re-injury when returning to match play among all players.

Conclusion—High school players had inferior subjective outcomes after ACL reconstruction and had a higher ratio of second knee injury compared with elite rugby players.