Background Serious sport and active recreation injuries are common with the potential for grave long-term consequences. Despite this few studies have examined the long-term outcomes of these injuries.

Objective To establish if patients hospitalised with orthopaedic sport and active recreation injuries have returned to their pre-injury levels of health and function 12-months post-injury and to identify predictors of poor outcomes.

Design Prospective cohort study with 12-month follow-up.

Setting Two Level 1 trauma centres and one regional hospital in Victoria, Australia.

Participants Adults with orthopaedic sport and active recreation injuries who were admitted to either Level 1 trauma centre between March 2008 and March 2009 or the regional hospital between June 2008 and June 2009 and captured by the Victorian Orthopaedic Trauma Outcomes Registry. There were 324 participants recruited to the study of which 98% were successfully followed up at 12-months post-injury.

Assessment of risk factors Independent variables assessed for predictors of outcome were sporting group, age, sex, education level, major trauma classification (injury severity score>15) and injury patterns.

Main outcome measurements The 36-item Short Form Health Survey (SF-36) and the Glasgow Outcome Scale Extended.

Results At 12-months post-injury 58.1% of participants reported reduced function and a significant reduction in physical health (p<0.001) and mental health (p<0.001). Multivariate analysis identified injury due to motor sports (p=0.001) or equestrian sports (p=0.015) and being classified as a major trauma (p=0.043), as predictors of a poor physical health outcome. Low education level (p=0.040) and having a major trauma injury (p=0.047) were predictors of a poor mental health outcome.

Conclusion The findings of our study highlight that at 12-month post-injury, most patients injured during sport and active recreation had not returned to their pre-injury status. This information is useful for setting priorities for treatment and for the progression of sports injury prevention.