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Long-term Health Outcomes of Youth Sports Injuries
  1. Nicola Maffulli1,*,
  2. Umile Giuseppe Longo2,
  3. Nikolaos Gougoulias3,
  4. Mattia Loppini4,
  5. Vincenzo Denaro4
  1. 1 Barts and The London School of Medicine and Dentistry, United Kingdom;
  2. 2 University Campus Bio-Medico of Rome, Italy;
  3. 3 Frimley Park Hospital, Portsmouth Road, Frimley, Surrey, GU15 8UJ, United Kingdom;
  4. 4 Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Italy
  1. Correspondence to: Nicola Maffulli, Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Centre Lead and Professor of Sports and Exercise Medicine, Consultant Trauma and Orthopaedic Surgeon, Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, 275 Bancroft Road, London, E1 4DG, United Kingdom; n.maffulli{at}


Injuries can counter the beneficial effects of sports participation at a young age if a child or adolescent is unable to continue to participate because of residual effects of injury. We review the current knowledge in the field of long-term health outcomes of youth sports injuries to evaluate the evidence regarding children dropping out of their sport due to injury, physeal injuries and growth disturbance, studies of injuries affecting the spine and knee of young and former athletes, and surgical outcome of anterior cruciate ligament reconstruction in children.

Studies of dropping out of sport due to injury are limited primarily to gymnasts and implicate such injuries as anterior cruciate ligament rupture and osteochondritis dissecans of the elbow joint in young athletes early retirement. Although most physeal injuries resolve with treatment and rest, there is also evidence of disturbed physeal growth as a result of injury. Radiological findings implicate the effects of intense physical loading and injury in the development of spinal pathology and back pain during growth of youth athletes; however, the long-term effects are unclear. Follow-up studies of young athletes and adults indicate a high risk of osteoarthritis after meniscus or anterior cruciate ligament injury.

Future prospective cohort studies with a follow-up into adulthood are needed to clarify the long term health outcomes of youth sports injuries. Important to this research is the meticulous documentation of injuries on injury report forms that include age-appropriate designations of the type of injury and the accurate determination of exposure-based injury rates.

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