Return to sport and work after multiligament knee injury

Multiligament knee injuries (MLKIs) are complex and often associated with significant functional impairments. Data on return to sport (RTS) and return to work (RTW) remain limited, particularly for recreational athletes and the general population. The purpose of the study was to evaluate RTS, RTW and physical activity levels after surgical treatment of MLKIs.

Patients surgically treated for MLKI at a single Level 1 Trauma centre from 2013 to 2020 were included. Patient-reported outcomes included the Tegner score and work status before and after injury. Physical activity was assessed using the activity questionnaire from the Nord-Trøndelag Health Study (HUNT 1). Health-related quality of life was measured with the EuroQol 5-Dimension Questionnaire (EQ-5D).

Out of 191 eligible patients, 124 (65%) participated (mean age 37 ± 13.7 years, range 17-70). RTS: 77% (n = 84) returned to some level of sport, 37% (n = 31) returned to their pre-injury sport at any level, and only seven of 28 (25%) resumed high-level pivoting sports. The mean Tegner score declined from 5.2 to 3 (p < 0.001). RTW: 90% (n = 112) returned to work, but 15% required task modifications or became disabled. Work participation significantly declined (2.1-1.9, p < 0.04). Patients with single cruciate injuries had better outcomes, including higher Tegner (3.6 vs. 3, p = 0.043) and EQ-5D scores (0.931 vs. 0.893, p = 0.012) than those with bicruciate injuries.

A significant number of patients with an MLKI were unable to return to their former sports activities, with only 37% returning to the same level as before the injury. Although most patients were able to return to their pre-injury work levels, 15% had to adapt to less demanding tasks or became disabled due to the injury. Despite significant reductions in activity levels, most patients reported good health-related quality of life.

Level IV, cross-sectional cohort study.