Self-reported knee function and activity level are reduced after primary or additional anterior cruciate ligament injury in female football players: a five-year follow-up study

Anne Fältström; Martin Hägglund; Henrik Hedevik; Joanna Kvist

doi:10.1016/j.bjpt.2023.100573

Self-reported knee function and activity level are reduced after primary or additional anterior cruciate ligament injury in female football players: a five-year follow-up study

Braz J Phys Ther. 2023 Nov-Dec;27(6):100573. doi: 10.1016/j.bjpt.2023.100573. Epub 2023 Nov 22.

Authors

Anne Fältström¹, Martin Hägglund², Henrik Hedevik², Joanna Kvist³

Affiliations

¹ Rehabilitation Centre, Ryhov County Hospital, Jönköping, Region Jönköping County, Sweden; Unit of Physical Therapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden. Electronic address: anne.faltstrom@rjl.se.
² Unit of Physical Therapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden.
³ Unit of Physical Therapy, Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden; Stockholm Sports Trauma Research Center, FIFA Medical Centre of Excellence, Karolinska Institute, Stockholm, Sweden.

Abstract

Background: Playing football involves a high risk of anterior cruciate ligament (ACL) injuries and these may affect knee function and activity level.

Objectives: To measure changes in self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players with or without an ACL-reconstructed knee.

Methods: Female football players, age 19.9 (SD 2.6) years, with either a primary ACL-reconstruction 1.6 (SD 0.7) years after ACL-reconstruction (n = 186) or no ACL injury (n = 113) were followed prospectively for five years. Self-reported data collected at baseline and follow-up included knee function (International Knee Documentation Committee Subjective Knee Form [IKDC-SKF]), activity level (Tegner Activity Scale), and satisfaction with knee function (Likert scale 1=happy; 7=unhappy) and activity level (1-10 scale). Information on any new ACL injury during the follow-up period was collected.

Results: Players with ACL-reconstruction at baseline who either did (n = 56) or did not (n = 130) sustain an additional ACL injury, and players with no injury at baseline who remained injury free (n = 101) had a lower Tegner score at follow-up. Players with additional ACL injury had lower IKDC-SKF score (mean difference: -11.4, 95% CI: -16.0, -6.7), and satisfaction with activity level (mean difference: -1.5, 95% CI: -2.3, -0.7) at follow-up. Players with no additional ACL injury had higher satisfaction with knee function (mean difference: 0.6, 95% CI: 0.3, 0.9) at follow-up. Players with no ACL injury had lower satisfaction with activity level (mean difference: -0.7, 95% CI: -1.1, -0.3) at follow-up. Players with additional ACL injury had larger decreases in all variables measured compared to the two other groups.

Conclusion: Primary, and even more so additional, ACL injuries decreased self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players.

Keywords: Knee; Reinjuries; Return to sports; Satisfaction; Soccer.

MeSH terms

Adult
Anterior Cruciate Ligament Injuries* / physiopathology
Athletic Injuries* / physiopathology
Female
Follow-Up Studies
Humans
Knee Joint* / physiopathology
Self Report
Soccer* / injuries
Young Adult