Second ACL Injury Odds Much Greater In Athletes with Prior ACL Injury History

obesity and living kidney Interview with: Mark V. Paterno PT, PhD, MBA, SCS, ATC

Coordinator of Orthopaedic and Sports Physical Therapy
Associate Professor, Sports Medicine Biodynamics Center
Acting Scientific Director, Division of Occupational Therapy and Physical Therapy
Cincinnati Children’s Hospital Medical Center
3333 Burnet Ave. MLC 10001
Cincinnati, OH 45229-3039 What are the main findings of the study?

Dr. Paterno: Our study suggests that young patients (average age 16 y/o) who return to pivoting and cutting sports after Anterior cruciate ligament (ACL) reconstruction are 6 times more likely to suffer a second ACL injury than an individual with no prior history of ACL injury.  In addition, females after ACL reconstruction may be more likely to injury their opposite limb than actually re-injure the same limb they initially hurt.  Finally, when you look at the results of this 2 year outcome study in conjunction with the 1 year outcomes we published last year, it would appear that the greatest risk of suffering a second ACL injury is within the first several months after returning to sports. Were any of the findings unexpected?

Dr. Paterno: These results were not particularly unexpected.  Typically, the reported incidence of second injury reported in the literature is much lower than what our study suggests. However, these studies typically include a population that is very diverse in terms of age and activity level. Both age and activity level can serve as a confounding variable in this type of study, therefore, we were most interested in knowing what the 2nd injury incidence was for a very high risk population, that being young and activity teenagers.  These findings supported our results that a young and active individual may suffer a higher rate of repeat ACL injury. What should clinicians and patients take away from your report?

Dr. Paterno: Clinicians and patients should be aware that suffering a second ACL injury is definitely a possibility after having an ACL reconstruction and returning to pivoting and cutting sports.  Clinicians should think critically about the criteria we currently use for making a decision about readiness to return to sport and how we could potentially better manage this population during medical and rehabilitative treatment. What recommendations do you have for future research as a result of this study?

Dr. Paterno: Future research should focus on developing more appropriate, evidence based criteria for making decisions about readiness to return to sports.  When we are better able to predict who will do well after ACL reconstruction and who is at higher risk for a future injury, we will be better able to develop more valid return to sport criteria and develop better intervention to hopefully mitigate this risk.


Second ACL injuries 6 times more likely after reconstruction
Presented at 2013 American Orthopaedic Society for Sports Medicine
Update 7/12/2013


Last Updated on July 16, 2013 by Marie Benz MD FAAD