Comparison of Return-to-Sports Rates Between Male and Female Australian Athletes After ACL Reconstruction.

Abstract

Return to sports (RTS) is a goal for most patients who undergo anterior cruciate ligament reconstruction (ACLR). Although it has been reported that women RTS at a significantly lower rate compared with men, demographic and contextual factors that may be associated with this have not been investigated. To compare RTS rates between men and women and investigate factors that may be associated with different rates of RTS in an Australian context. Cohort study; Level of evidence, 3. A total of 1338 patients who underwent primary ACLR between January 2014 and December 2017 were invited to complete a detailed sports participation questionnaire 2 to 7 years after surgery. RTS rates were calculated and compared between men and women overall and after stratifying by age at surgery (<20, 20-29, 30-39, or ≥40 years) and geographical location (metropolitan or rural). Contingency analysis was performed to compare factors associated with rates of RTS. The survey completion rate was 81% (1080/1338). Overall, women had a significantly lower RTS rate compared with men (65.4% vs 74.9%; P = .001). However, when patients were grouped by age, the lower rate of RTS for women was significant only in the 20- to 29-year age group (P = .01). For athletes who returned to sports, there was no sex-based difference when comparing the levels of RTS. When grouping patients based on geographical location, there was a significantly lower rate of RTS in metropolitan-based women compared with metropolitan-based men (P < .001) and rural-based women (P = .042). Although women returned to sports at a lower rate than men overall, this difference was predominantly seen in the 20- to 29-year age bracket and in those who lived in metropolitan areas. There was no difference between men and women regarding the RTS level.