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Published VersionCC BY-NC V4.0, Open Access
Journal article
Sports Participation 25 Years After Anterior Cruciate Ligament Reconstruction: A Prospective Longitudinal Study Comparing Patients With Patellar Tendon and Hamstring Tendon Grafting to Uninjured Controls
The American Journal of Sports Medicine, Vol.53(13), pp.3089-3097
2025
PMCID: PMC12578954
PMID: 41124651
Appears in UniSC Supported Open Access Outputs
Abstract
Background:
Approximately 55% of individuals return to previous sports levels after anterior cruciate ligament (ACL) reconstruction (ACLR), but the duration of their sporting life post-ACLR and how this differs from uninjured sports participants is unknown.
Purpose:
To trace the 25-year trajectory of sports participation in individuals who have undergone ACLR and compare sporting activity between graft types and between ACLR individuals and uninjured controls.
Study Design:
Cohort study; Level of evidence, 3.
Methods:
A total of 62 individuals (44 males; mean age, 27 years) underwent ACLR (31 bone–patellar tendon–bone grafting, 31 semitendinosus/gracilis grafting). Sporting activity was assessed preinjury, at 6 and 25 years after surgery on a 6-point scale based on pivoting demands. A total of 30 uninjured individuals matched for age, sex, and sporting activity were assessed at equivalent time points. Pearson chi-square and Student t tests were used to compare outcomes between graft types and between ACLR individuals and controls.
Results:
In total, 50 (81%) individuals (35 males) with ACLR and 20 (67%) uninjured controls were followed up after 25 years. Overall, 88% of the ACLR group were active in sports, 22% in vigorous pivoting sports. Three ACLR individuals had total knee replacements, 9 ruptured their contralateral ACL, and 8 ruptured their graft. There was no significant difference between graft types in sports level played presurgery (P = .442), 6 years after surgery (P = .511), or 25 years after surgery (P = .100). At 25 years after surgery, ACLR individuals participated in sports at higher levels (P = .005) and over longer periods (P = .032) than controls.
Conclusion:
Interestingly, after ACLR, patients were more engaged in sports than uninjured controls. Although the level of sports activity typically decreased over 25 years, findings highlight the potential for longevity in sports after an ACLR, irrespective of graft type.
Details
- Title
- Sports Participation 25 Years After Anterior Cruciate Ligament Reconstruction: A Prospective Longitudinal Study Comparing Patients With Patellar Tendon and Hamstring Tendon Grafting to Uninjured Controls
- Authors
- Susan Keays (Corresponding Author) - University of the Sunshine Coast, Queensland, School of HealthPeter A Newcombe (Author) - The University of QueenslandAnthony C Keays (Author)Daniel Mellifont (Author) - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceNatalie J Collins (Author) - The University of Queensland
- Publication details
- The American Journal of Sports Medicine, Vol.53(13), pp.3089-3097
- Publisher
- Sage Publications, Inc.
- Date published
- 2025
- DOI
- 10.1177/03635465251380293
- ISSN
- 1552-3365; 0363-5465
- PMID
- 41124651; PMC12578954
- Copyright note
- This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
- Organisation Unit
- Healthy Ageing Research Cluster; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 991178745902621
- Output Type
- Journal article
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