Many people who undergo repair of the anterior cruciate ligament (ACL) of the knee are at high risk for recurrent injury to the same ligament. Now Norwegian researchers say that simple postoperative screening tests before permitting the athlete to go back to sports may lower the risk.

It estimates that nearly 30% of young active individuals who undergo anterior cruciate ligament surgery will have the same injury again within a few years after the procedure. The two risk factors for reinjury to the anterior cruciate ligament include participating in sports and being young.

The Norwegian researchers observed that two factors that lead to recurrent ACL injury were returning to sports with poor muscle strength and returning to the sporting activity too early. The researchers collected data on 100 participants with an average age of 24 who had undergone prior anterior cruciate ligament surgery.

Over the course of 24 months, surveys are initiated where participants report if they suffer another knee injury.

The researchers’ surgeons also assess the strength of the quadriceps muscle in both legs to ensure a “return to sport” criteria. Overall, 24 patients experienced another knee injury; individuals who performed jumping and pivoting sports activities were more than four times likely to experience knee injuries than those who did not. Twenty-five percent of the participants met the criteria of return to sports.

Of those who failed the “return to sports” (75%) criteria, 38% suffered another knee injury compared to 5.6 % of those who passed the test. Those who had symmetrical strength in both quadriceps before they started sports had markedly reduced the risk of another knee injury. The longer the individual waited before the return to sport the lesser the risk became and eventually this risk plateaued at around 9 months.

This study reveals that young people need to know that rushing back to surgery after anterior cruciate ligament reconstruction carries a high risk. Athletes should wait at least 9 months after surgery or after regaining sufficient thigh muscle strength which is comparable to the unhurt leg before they enter the sporting world.

Recurrent injury to the ACL is also associated with a longer recovery period and return to sports is not always ensured.

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