Table 1

 Follow up studies on the rate of return to sport, risk of re-rupture, and the prevalence of radiological osteoarthritis after an initial anterior cruciate ligament (ACL) injury

StudyMaterialOperative/Non-operativeReturn to sportFollow up (years)Re-ruptureOsteoarthrosisRemarks
A total of 540 papers were identified through a Medline search using the following key words: “Anterior Cruciate Ligament/*injuries” AND “Follow-Up Studies”. Abstracts were reviewed to identify studies reporting on the return rate to sport, the reinjury rate, and/or the prevalence of osteoarthritis with a mean follow up period of at least four years. In addition, reference lists of selected papers were reviewed to identify additional studies. Follow up studies describing partial ACL ruptures or reconstructive surgery with sutures only were excluded. A single or double asterisk is used to indicate which piece of information the remark in the Remarks column is referring.
Op, Operative; Non-op, non-operative; BPTB, bone-patella-tendon-bone graft; STG, single strain gracilis; Hamstrings, includes semitendinosus, gracilis and iliotibial grafts; LAD, Kennedy ligament augmentation device.
Von Porat et al14N = 205; age, 38 (30–56)89/65*7.8% (9 op & 3 non-op)1478%** in both groups*154 answered questionnaire
Soccer male**122 players with radiological exam
McDaniel & Dameron32N = 50 (53 knees)Non-operative74%*1486%*Returned to strenuous sport
Fink et al13N = 71 (84%) in sports activity Skiing: 63%, Soccer: 24%46/2544% reduction in op/70% reduction in non-op*10–13078%/83%*Reduction in high risk sports participation
Myklebust et al9N = 79 (♂: 29, ♀: 50)57/2258%/82%6–1113% *42%/46%***BPTB reconstructed
Team handball**Radiological exam of 50 players
Drogset & Grøntvedt21N = 100 (♂: 45, ♀: 55)Reconstruction with LAD (n = 49)812%*50%*All occurred in pivoting activities
Different sports activitiesWithout LAD (n = 51)
Roos et al10N = 310 (♂: 213, ♀: 97)157/15322%/19%*7Not examinedNone of the players played at the same level as before injury
Ruiz et al33N = 30 (♂: 21/♀: 9)Reconstruction12 patients changed first choice sport*7 (5–9)3.3%50%*Change not attributed to knee pathology alone
Football: 11 Rugby: 12 Other: 7STG: 4
BPTB: 26
Johma et al34N = 59BPTB710%57%
Scavenius et al35N = 33 (♂: 20/♀: 13)Non-operative9%7Not examined
Mostly soccer, handball, alpine skiing
Jennings et al36N = 50 (♂: 32/♀: 18)BPTB32% same level, 94% lower level5.2Not examined
Brandsson et al28N = 102* (♂: 74/♀: 38)BPTB4–72.9%Not examined*The 3 players with re-rupture were excluded
Howe et al37N = 83BPTB537%**Reported medial joint space narrowing
Pinczewski et al38N = 180 (♂: 95/♀: 85)*BPTB: N = 905BPTB: 3%12%***No information on sports participation. **BPTB: 18%
Hamstrings: N = 90Hamstrings: 8%Hamstrings: 4%
Otto et al19N = 68 (♂: 49/♀: 19)BPTB38% preinjury level, 15% higher level54.4%24%
Pivoting/side stepping sports
Sandberg & Balkfors18N = 112 (♂: 75/♀: 37)BPTB35% returned to same level (soccer)59.8%Not examined
Different sports, soccer:72%25% quit, rest only fitness training(2–11)
Ferretti et al39N = 114Hamstrings67% same level525.4%*No description of type of sports
32% reduced participation
1 increased level *
Cooley et al40N = 33Hamstrings45% maintained activity level53%**5%*Not due to knee limitations
55% reduced activity level***Was excluded from follow up together with patient with meniscectomy
Patel et al41N = 32 (♂: 8/♀: 24)BPTB41%59%28%
88% from “sporting activities”
Wang et al42N = 44 (♂: 32/♀: 12)BPTB4.861%
2/3 sports related
Bak et al43N = 132(♂: 117/♀: 15)Hamstrings68% same level43%*Not examined*20% among females
Soccer29% lower level