Reply to “Impairment in quality of life with different sport orthopaedic musculoskeletal injuries: A comprehensive analysis of the German arthroscopy register”

We sincerely thank the authors for their thoughtful and supportive letter and for their interest in our work [6]. We strongly agree that the presented findings underscore the substantial and often underestimated burden of musculoskeletal injuries on quality of life and on public health. In particular, we appreciate the authors' emphasis on the comparability of quality-of-life impairment between musculoskeletal pathologies and traditionally prioritized disease entities such as cardiology and oncology. This aspect is, in our view, of major political and societal relevance. Musculoskeletal disorders affect a large proportion of the population, frequently at a young age, and may result in decades of pain, functional limitation, recurrent surgical interventions, and progressive joint degeneration. A severe sports injury sustained in early adulthood can therefore lead to lifelong consequences, including chronic instability, repeated operations, early-onset osteoarthritis, and ultimately joint replacement and revision procedures, as well as reduced work ability [2, 5]. In this context, the cumulative burden over time may exceed that of many diseases occurring later in life and could have a severe impact on the quality of life of patients. Prevention of musculoskeletal diseases including sports injuries and osteoarthritis is of uppermost importance and can be cost-effective on a national level [3, 4]. The complementary epidemiological data presented by the authors further strengthen the notion that musculoskeletal conditions represent a global public health challenge, extending well beyond the acute injury phase and the immediate surgical indication [1]. Their findings highlight that structural joint damage and its sequelae can lead to long-term disability and societal impact, particularly in young and otherwise healthy populations. This convergence of registry-based clinical data and large-scale epidemiological evidence reinforces the urgent need to elevate musculoskeletal health within healthcare policy and resource allocation. We also acknowledge the authors' discussion regarding psychological aspects and biopsychosocial models of care. While we fully agree that mental and psychosocial factors are relevant components of patient outcomes, our primary intention with the present analysis was to draw attention to the magnitude of quality-of-life impairment attributable to musculoskeletal injury itself. Especially from a health-political perspective, demonstrating that disorders of the musculoskeletal system lead to quality-of-life losses comparable to cancer or cardiovascular disease may represent the most powerful argument to increase awareness and prioritization of orthopaedic and trauma care. Future studies may further refine these insights by integrating more detailed psychological instruments in selected subgroups. In summary, we are grateful for the authors' constructive contribution, which supports the core message of our study. Musculoskeletal injuries are not merely biomechanical problems but conditions with profound and long-lasting consequences for individual quality of life and society. We hope that with this growing evidence and interest in quality of life it will help to strengthen the visibility and relevance of orthopaedic trauma in health policy discussions. The authors declare no conflicts of interest.