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We aimed to report the trajectory of self‐reported outcomes up to 11 years post‐ACLR. We also explored the relationship between hop performance at 1 year and: (i) future self‐reported knee outcomes; and (ii) risk of subsequent knee events. 124 participants (43 women, mean age 31 ± 8 years) were recruited at 1 year following hamstring‐autograft ACLR. Hop performance was assessed with single‐forward and side‐hop tests. Follow‐up was completed at 3 (n = 114), 5 (n = 89) and 11 years (n = 72) post‐ACLR. Self‐reported outcomes were assessed at each follow‐up with the Knee injury Osteoarthritis Outcome Score (KOOS) pain and quality of life (QOL) subscales. Generalized linear mixed models estimated the relationship between hop performance and self‐reported outcomes. Subsequent knee events (new injury/surgery) to either knee were recorded, with the relationship between hop performance and risk of subsequent knee events analyzed with Cox proportional hazards. Self‐reported knee outcomes were stable (mean change < 10 points) across all timepoints but with major within‐sample variability. There was a modest relationship between greater hop performance at 1 year and better future KOOS‐pain (average marginal effect [AME] % improvement with + 1 cm single forward hop = 0.06% [95% CI 0.02–0.10]). A nonlinear spline relationship showed better single‐forward hop performance was associated with better KOOS‐QOL for scores < 108 cm, not present for higher hop scores > 108 cm. There were 21 index and 11 contralateral subsequent knee events. Hop performance was not related to risk of a subsequent knee event (hazard ratio index knee 0.99 [95% CI 0.98–1.02]). In conclusion, self‐reported knee pain and quality of life were generally stable across the 11‐year follow‐up period. Greater hop performance at 1‐year post‐ACLR was related to better self‐reported knee outcomes up to 11‐year follow‐up (of questionable clinical importance), but not associated with the risk of subsequent knee injury/surgery. [ABSTRACT FROM AUTHOR]

Altered biomechanics are frequently observed following anterior cruciate ligament reconstruction (ACLR). Yet, little is known about knee‐joint loading, particularly in the patellofemoral‐joint, despite patellofemoral‐joint osteoarthritis commonly occurring post‐ACLR. This study compared knee‐joint reaction forces and impulses during the landing phase of a single‐leg forward hop in the reconstructed knee of people 12‐24 months post‐ACLR and uninjured controls. Experimental marker data and ground forces for 66 participants with ACLR (28 ± 6 years, 78 ± 15 kg) and 33 uninjured controls (26 ± 5 years, 70 ± 12 kg) were input into scaled‐generic musculoskeletal models to calculate joint angles, joint moments, muscle forces, and the knee‐joint reaction forces and impulses. The ACLR group exhibited a lower peak knee flexion angle (mean difference: −6°; 95% confidence interval: [−10°, −2°]), internal knee extension moment (−3.63 [−5.29, −1.97] percentage of body weight × participant height (body weight [BW] × HT), external knee adduction moment (‐1.36 [−2.16, −0.56]% BW × HT) and quadriceps force (−2.02 [−2.95, −1.09] BW). The ACLR group also exhibited a lower peak patellofemoral‐joint compressive force (−2.24 [−3.31, −1.18] BW), net tibiofemoral‐joint compressive force (−0.74 [−1.20, 0.28] BW), and medial compartment force (−0.76 [−1.08, −0.44] BW). Finally, only the impulse of the patellofemoral‐joint compressive force was lower in the ACLR group (−0.13 [−0.23, −0.03] body weight‐seconds). Lower compressive forces are evident in the patellofemoral‐ and tibiofemoral‐joints of ACLR knees compared to uninjured controls during a single‐leg forward hop‐landing task. Our findings may have implications for understanding the contributing factors for incidence and progression of knee osteoarthritis after ACLR surgery. [ABSTRACT FROM AUTHOR]

Background: Patients with bilateral anterior cruciate ligament (ACL) injuries tend to report worse results in terms of knee function and quality of life as compared with those with unilateral injury. There are limited data regarding return to preinjury sport in this group. Purpose: To report return-to-sport rates for patients who had bilateral ACL reconstruction and to compare outcomes according to age and sex. Study Design: Case series; Level of evidence, 4. Methods: A total of 107 patients (62 male, 45 female) who underwent primary ACL reconstruction surgery to both knees completed a detailed sports activity survey at a mean 5-year follow-up (range, 2.5-10 years). Follow-up also included the International Knee Documentation Committee subjective form, Marx Activity Scale, and Knee injury and Osteoarthritis Outcome Score–Quality of Life subscale. Rates of return to preinjury levels of sport were calculated for the whole cohort, and for further analysis, the group was divided according to age (<25 vs ≥25 years), sex, and time between the reconstruction procedures (<3 vs ≥3 years). Results: The rate of return to preinjury sport after bilateral ACL reconstruction was 40% (95% CI, 31%-50%), as compared with an 83% (95% CI, 74%-88%) return rate after the first reconstruction procedure. Although not statistically significant, return rates were higher for male versus female patients (47% vs 31%) and older versus younger patients (45% vs 31%). Of those who returned to their preinjury levels of sport after the second reconstruction, 72% thought that they could perform as well as before their ACL injuries. In contrast, only 20% thought that they could perform as well if they returned to a lower level. Fear of reinjury was the most common reason cited for failure to return to sport after the second reconstruction. Patient-reported outcome scores were higher for those who returned to their preinjury levels of sport but did not differ for sex and age. Conclusion: Return-to-sport rates drop markedly after a second (contralateral) ACL reconstruction, with less than half of the investigated cohort returning to its preinjury level of sport. Return-to-sport outcomes are less than ideal for patients who have ACL reconstruction surgery to both knees. [ABSTRACT FROM AUTHOR]