This study aimed to investigate the factors associated with reinjury in female athletes who returned to their previously played sports after ACL reconstruction.
This study included 380 female athletes who underwent primary ACL reconstruction at our hospital and returned to playing their previous sports (mean age at surgery: 23.1 ± 9.9 years). The patients were classified into two groups: those who sustained ipsilateral ACL reinjury within one year after surgery (reinjured group) and those who did not sustain any reinjury (non-injured group). Age at the time of surgery, preoperative period, timing of return to sports, and isokinetic knee strength (60 deg/s) were determined six months after initial surgery to compare each group. The two groups were compared using Mann-Whitney’s U test. Statistical analysis was performed using SPSS for Windows software (SPSS Inc, Chicago, IL). The level of significance was determined at P .05.
Reinjury within the first year after surgery occurred in 19 cases (5%), with a mean age of 17.6 ± 2.4 years. The age and preoperative period values showed no differences between the two groups. The time when they returned to sports was significantly earlier in the reinjured group (7.1 ± 1.7 months) than in the non-injured group (8.8 ± 2.6 months) (P 0.05). Mean limb symmetry index for quadriceps and hamstring strength showed no significant differences between the reinjured and non-injured groups after six months; the limb symmetry index for knee extension strength was 85.6 ± 14.3% and 77.7 ± 19.5%, respectively. For hamstring strength it was, 88.8 ± 20.8% and 87.4 ± 17.5%, respectively. The hamstring/quadriceps ratio was significantly lower in the reinjured group (45.7 ± 8.7%) than in the non-injured group. (55.4 ± 16.5%) (P 0.05)
Female athletes who sustained reinjuries within a year of ACL reconstruction returned to sports significantly earlier than those who did not experience a reinjury. An earlier return may have interrupted the graft remodeling process, causing its failure. The hamstring/quadriceps ratio was lower in the reinjured group, indicating that muscle imbalances, particularly weaker hamstrings, could have contributed to the higher reinjury rate. These findings suggest that both the timing of sports return and addressing muscle imbalances should be key considerations in post-operative rehabilitation.
The results of this study will contribute to implementing effective physical therapy to prevent reinjury after ACL reconstruction in female athletes.
second ACL injury
female Athletes
