822 MEP013 – Only 50% return to sport after ACL reconstruction: a 1–3-year follow-up of 631 athletes from the Norwegian knee ligament registry

AbstractBackground Given the popularity of high-risk pivoting sports at all levels in the general population, it is imperative to better understand aspects of RTS within non-elite athletes.Objective To determine RTS rates and describe rehabilitation and choices in the RTS process 1–3 years after ACL reconstruction in pivoting sports athletes undergoing usual care. Design Cross-sectional study. Setting Data from athletes registered in the Norwegian Knee Ligament Register (NKLR), combined with a study-specific questionnaire. Participants Athletes (16–40 years), injured while playing soccer, handball or basketball, were identified through the NKLR and invited to complete a questionnaire 1–3 years after primary ACLR. Of 1901 athletes invited to participate, 631 (33%) responded. Main Outcome Measurements RTS rates were calculated in concordance with the Bern Consensus Statement (2016). Results Of 631 non-elite athletes, 391 (62%) returned to participation, 312 (50%) returned to sport, and 71 (15%) returned to performance 1–3 years after primary ACLR. The main reasons for not returning were fear of re-injury (n=85, 35%) and knee-issues like pain, swelling and instability (n=84, 35%). All athletes underwent rehabilitation with a physiotherapist for a mean duration of 9 months (SD=5). Physiotherapists were most frequently (n=462, 78%) involved in the RTS decision. Of all athletes, 278 (45%) had not been tested to assess physically readiness prior to return, primarily due to lack of recommendation from the responsible clinician. Conclusion Fifty percent of mainly non-elite athletes returned to sport 1–3 years after ACLR, with fear of re-injury and knee-issues being the main reasons for non-return. All athletes underwent physio-guided rehabilitation for a mean 9 months, while testing prior to return was performed in only 55% of the athletes. The RTS rates should be conveyed to patients to adjust expectations, and the use of testing should be encouraged to enhance a safer return to sport.