Anterior cruciate ligament injuries in elite and high school rugby players: a 11-year review

Abstract

Objectives: Over a 11-year period, we investigated the incidence of anterior cruciate ligament (ACL) injuries and the clinical outcomes after ACL reconstruction with hamstring autografts in two homogenous cohorts of rugby players. Methods: Two teams, including those in elite (94 players) and high school (290 players) clubs, were followed. Results: Isolated ACL injuries occurred in 28 players (12 elite, 16 high school). The incidence during match play was 1.26 per 1000 player-hours (95% confidence interval [95% CI]: 0.48–2.05) among elite players and 0.97 per 1000 player-hours (95% CI: 0.30–1.64) among high school players. After ACL reconstruction, 26 players (12 elite, 14 high school) were successfully contacted for follow-up at a mean of 71.9 months. None (0%) of the elite and 4 (29%) of the high school players experienced graft ruptures. Seven (58%) elite and 10 (91%) high school players were fearful of reinjury; the mean time to overcome this fear was 6.1 ± 4.9 months among elite players and 17.5 ± 26.0 months among high school players. Conclusion: In conclusion, young rugby players experienced inferior outcomes after ACL reconstruction with hamstring autografts compared with their older counterparts.

Keywords:

• Anterior cruciate ligament reconstruction
• Rugby
• Return to play
• Fear of reinjury
• Reinjury

Acknowledgments

The authors are grateful to the clubs, players, coaching staff and medical staff participating in this study. The authors also thank Ichiro Yoshida and Satoshi Tashiro, who work as athletic trainers, for assisting in the collection of the study data; Yusuke Maki’s work as a physiotherapist is also acknowledged.