ACL reconstruction in female athletes

Higher rate of knee injuries found in female athletes after ACL reconstruction

We’ve already discussed data emanating from the USA about the higher rate of ACL injuries amongst female athletes when compared to their male counterparts – and a new study from over the Atlantic not only confirms that, but also reveals even more alarming information.

According to the study, which was recently published in the American Journal of Sports Medicine, a higher rate of new ACL injuries and other new knee injuries occurred among female soccer players who underwent ACL reconstruction when compared with data culled from their female knee-healthy counterparts.

In their study, the research team matched 117 active female football players who had undergone ACL reconstruction with 119 knee-healthy female soccer players from the same teams and tracked their progress over two years, encouraging the participants to answer a web-based questionnaire that addressed their participation in soccer, and logged new acute-onset or non-traumatic injuries to either knee, or injury to other body locations. They also graded the participants’ current activity level according to the Tegner Activity Scale – both at baseline and at the end of the two-year follow-up.

A traumatic result for ACL victims

The results showed an almost fivefold higher incidence of new ACL injuries, and a seven-times higher incidence of knee injury treated with surgery among players who underwent ACL reconstruction, compared to their healthier counterparts. During the two-year follow-up, the research team discovered that 62% of players who underwent ACL reconstruction gave up the sport, compared with 36% of patients in the control group.

Furthermore, a greater satisfaction with knee function was found among the control group at baseline and follow-up, while the research team noted no differences in the rate of other injuries between the two groups.

“Our results point to an unacceptably high rate of new traumatic and non-traumatic knee injuries among female soccer players with [ACL reconstruction] ACLR,” the authors commented: “High-quality research is required to identify which factors increase or decrease the risk for sustaining additional knee injuries. This information may subsequently help to inform the development and implementation of injury prevention strategies.”

Are the results alarming for female athletes with ACL injuries?

My concern is when patients get self-selected by presentation. A significant proportion of ACL injured patients are those who were at high risk from the beginning, because of unfavourable constitutional mechanics. Having selected themselves, by definition, they are unfortunately at higher risk of it happening again despite potentially ‘successful’ and well-performed surgery. Throw into that the poor guidance on achieving the requisite return to sport, in a field which is still in its infancy, and you have quite a potent cocktail.

If you’re concerned you’re suffering from an ACL tear and want to arrange a consultation with Mr Jonathan Webb at either his London or Bristol clinic, call 0203 195 2443.