Return to pivoting sport after ACL reconstruction: association with osteoarthritis and knee function at the 15-year follow-up

Abstract

Objectives: To examine the associations between return to pivoting sport following anterior cruciate ligament reconstruction (ACLR) and knee osteoarthritis (OA), self-reported knee symptoms, function, and quality of life after 15 years. Methods: Study sample included 258 participants with ACLR 15 years previously. Return to pivoting sport (handball, soccer, and basketball) data were collected by interviews, and symptomatic OA was defined as Kellgren-Lawrence grade ≥2 plus almost daily knee pain in the last month. Self-reported symptoms, function and quality-of-life were assessed with the Knee Injury and Osteoarthritis Outcome Score (KOOS). Adjusted regression models were used to analyze the associations between return to pivoting sport and OA (present or not), and self-reported outcomes. P-values ≤ 0.05 were considered statistically significant. Results: Two hundred and ten (81%) participants (57% men) with mean age 39.1 (±8.7) years completed the 15-year follow-up, and 109 (52%) had returned to pivoting sport. Returning to pivoting sport was associated with less symptomatic OA (OR 0.28, 95% CI 0.09, 0.89) and radiographic OA (OR 0.40, 95% CI 0.17, 0.98), adjusted for age, sex, combined injury, self-reported knee function, and time between injury and surgery. Those who returned to pivoting sport had better function in activities of daily living (ADL). Conclusion: The participants with ACLR who returned to pivoting sport had lower odds of knee OA, and better self-reported ADL function. Further investigation is required to understand the clinical significance of these findings.