ArticleKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2025
More knee reinjuries after ACL reconstruction compared to nonsurgical treatment of the ACL. A 2-year follow-up of the NACOX prospective cohort study.
Article in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- No Difference in Return-to-Sport Rate or Activity Level in People with Anterior Cruciate Ligament (ACL) Injury Managed with ACL Reconstruction or Rehabilitation Alone: A Systematic Review and Meta-Analysis.Sports medicine (Auckland, N.Z.) · 2025Pooled it
- Patient-Reported Knee Function and Return-to-Sport Rates After Nonsurgical and Surgical Treatment of an Acute Anterior Cruciate Ligament Injury: Results From the NACOX Prospective Cohort Study.The American journal of sports medicine · 2026Article
- The impact of mental fatigue on the risk of non-contact anterior cruciate ligament injury during sharp stop-jump maneuver in male college students.BMC sports science, medicine & rehabilitation · 2025Article
- Running and Jumping After Muscle Fatigue in Subjects with a History of Knee Injury: What Are the Acute Effects of Wearing a Knee Brace on Biomechanics?Bioengineering (Basel, Switzerland) · 2025Article
- More knee reinjuries after ACL reconstruction compared to nonsurgical treatment of the ACL. A 2-year follow-up of the NACOX prospective cohort study.Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA · 2025Article
- Effects of mental fatigue on biomechanical characteristics and risk associated with non-contact anterior cruciate ligament injuries during landing.Frontiers in bioengineering and biotechnology · 2025Article
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Authors and funding
5 authors.
Funding
Abstract
purposeTo describe knee reinjuries and surgeries within 2 years after an acute anterior cruciate ligament (ACL) injury, in patients treated with or without ACL reconstruction (ACLR).
methodsTwo years follow-up of 275 patients (52% females, mean age 25.2 [SD 7.0] years) about knee reinjuries and surgeries were analysed from the prospective NACOX cohort study, aiming to describe recovery after an acute ACL injury treated according to clinical routine. Knee reinjury was defined as increase or new symptoms due to new trauma. At 2 years after injury, 169 (61%) had undergone an ACLR. Results are presented with descriptive statistics and risk ratios (RR).
resultsThirty-two patients sustained reinjuries within 2 years; 6 in the non-ACLR group, and 26 in the ACLR group (7 before and 19 after ACLR). Twelve patients in the ACLR group sustained a graft rupture and three did an ACL revision. Patients with non-ACLR, aged 21-25 years, had a 5.9-fold higher risk for reinjury than those aged 15-20 years (RR 5.9 [1.3-26.9]; p = 0.012). Twenty-four patients had surgery in the non-ACLR group and 36 patients in the ACLR group (excluding primary ACLR), where six were before ACLR and 30 were after ACLR.
conclusionTwelve percent sustained a knee reinjury and 21% underwent knee surgery within 2 years after the index ACL injury. There was a higher reinjury incidence in the ACLR group, but no difference in incidence of surgeries. Thus, ACLR did not reduce the risk of traumatic reinjuries or surgeries, which is important for treatment decision considerations. LEVEL OF EVIDENCE: Level I.
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