High return to sports and favorable long-term clinical outcomes in professional elite skiers following anterior cruciate ligament reconstruction utilizing hamstring tendon autografts

Anterior cruciate ligament (ACL) injury are commonly observed in athletes; however, there is a scarcity of research examining the long-term outcome of the use of hamstring tendon autografts for anterior cruciate ligament reconstruction (ACLR) in professional elite skiers. To report the clinical outcome and associated factors of ACLR in a professional elite skiing population in China. The research encompassed a cohort of elite skiers in China who underwent ACLR utilizing hamstring tendon autografts. The selection criteria were limited to professional elite skiers, specifically those affiliated with the national ski team who had attained top three rankings in international or domestic competitions prior to their injury occurrence. The data on the levels of return to sports, graft rupture occurrences, long-term functional outcomes, and the influencing factors were comprehensively examined. A cohort of 29 elite skiers (33 knees) were included for follow-up at an average of 8.6 ± 4.1 years (range, 5.0–18.0 years). Following ACLR, only one elite skier was unable to resume participation in training, while 84.8% (28/33) of elite skiers successfully returned to compete in official competitions. Furthermore, 66.7% (22/33) of elite skiers achieved top three placements in international or domestic competitions, indicating a successful return to elite-level competition. Athletes who return to formal competition exhibited a significantly shorter delay between injury and surgery compared to those who did not (3.1 months and 13.7 months, respectively, P = 0.039). Graft rupture after ACLR was observed in six knees (18.1%). Several associated factors for graft rupture were identified, including a high Beighton score, a longer delay between injury and ACLR, a graft diameter less than 8 mm, and partial meniscectomy. The majority of professional elite skiers were capable of returning to sport after ACL injuries with ACLR utilizing hamstring tendon autografts. Moreover, elite skiers who resumed participation in formal competitions exhibited a shorter delay between injury and surgery, in contrast to those who did not. Level IV.