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High return to play rate following treatment of multiple-ligament knee injuries in 136 elite athletes

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of the study is to assess return to play rate and timing of elite athletes treated for multi-ligament knee injuries with modern surgical techniques.

Methods

A retrospective review was performed of all professional or national/international level athletes treated for a multi-ligament knee injury by the senior author in the period from February 2001 to October 2019, with a minimum of 2-year follow-up. The study cohort consisted of 136 elite athletes who underwent surgery of two or more knee ligaments. Outcomes measures were return to play (RTP), defined as return to elite level sport, return to play time, and further surgical procedures.

Results

One hundred and twenty (88.2%) athletes returned to elite level sport at an average of 12.8 months from operation. In unicruciate injuries, ACL and PCL-based injuries had similar return to play rates (89.1% vs. 87.5% respectfully, n.s.) although mean RTP time was longer in those with PCL-based injuries (15.2 vs. 11.9 months, p < 0.01). Bicruciate injuries had longer RTP times compared to unicruciate injuries (mean RTP 16.0vs. 12.4 months, p < 0.05) but were able to return at a similar rate (83.3% vs. 88.9%, n.s.). Medial and lateral sided injuries had similar RTP rates (89.3% vs. 87.9%, n.s.) though lateral sided injuries took longer before returning to play (13.4 vs. 11.6 months, p < 0.05). Further surgery was required in 54 (39.9%) patients including 25 (18.4%) manipulations under anaesthesia. Four (2.9%) of the athletes underwent revision ligament surgery.

Conclusion

Modern surgical techniques used in the treatment of multi-ligament knee injuries can lead to high return to play rates in elite athletes.

Level of evidence

IV.

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Funding

No funding was obtained for this study.

Author information

Authors and Affiliations

  1. Houston Methodist Orthopedics and Sports Medicine, Houston, USA

    Kyle A. Borque

  2. Fortius Clinic, 17 Fitzhardinge Street, London, W1H 6EQ, UK

    Mary Jones, Ganesh Balendra, Vitor Hugo Pinheiro, Bobby Singh Anand & Andy Williams

  3. FIFA Medical Centre of Excellence, London, UK

    Mary Jones, Ganesh Balendra, Vitor Hugo Pinheiro, Bobby Singh Anand & Andy Williams

  4. Department of Trauma Surgery, Klinikum Rechts der Isar, Technical University Munich, Munich, Germany

    Lukas Willinger

Authors
  1. Kyle A. Borque
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  2. Mary Jones
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  3. Ganesh Balendra
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  4. Lukas Willinger
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  5. Vitor Hugo Pinheiro
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  6. Bobby Singh Anand
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  7. Andy Williams
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Contributions

MJ and KB participated in the design of the study, data collection and analysis, and drafting the manuscript, VP, GB, and BA participated in the data collection and review of the manuscript, LW performed the statistical analysis and review of the manuscript, AW conceived of the study and participated in drafting and reviewing the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Andy Williams.

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Conflict of interest

AW is an editorial board member of the AJSM and a shareholder in Innovate Orthopaedics. No other authors have any conflicts of interest.

Ethical approval

Approval to undertake the study was given by the institution involved in line with UK Health Research Authority guidance.

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Borque, K.A., Jones, M., Balendra, G. et al. High return to play rate following treatment of multiple-ligament knee injuries in 136 elite athletes. Knee Surg Sports Traumatol Arthrosc 30, 3393–3401 (2022). https://doi.org/10.1007/s00167-022-06926-3

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