title: Anterior cruciate ligament injuries in elite and high school rugby players: a 11-year review.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  In conclusion, young rugby players experienced inferior outcomes after ACL reconstruction with hamstring autografts compared with their older counterparts.
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Takazawa
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Nagayama
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ikeda
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawasaki
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Muneaki
authors.initials: M
authors.lastname: Ishijima
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Yoshitomo
authors.initials: Y
authors.lastname: Saita
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Haruka
authors.initials: H
authors.lastname: Kaneko
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Shinnosuke
authors.initials: S
authors.lastname: Hada
authors.affiliation: a Department of Orthopaedics , Juntendo University School of Medicine , Tokyo , Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kaneko
mesh_terms: D000328:Adult; D016118:Anterior Cruciate Ligament / Q000601:surgery; D000070598:Anterior Cruciate Ligament Injuries; D059549:Anterior Cruciate Ligament Reconstruction / Q000379:methods*; D001265:Athletic Injuries / Q000453:epidemiology*; D064592:Autografts; D015331:Cohort Studies; D005500:Follow-Up Studies; D005538:Football / Q000293:injuries*; D006801:Humans; D015994:Incidence; D007718:Knee Injuries / Q000453:epidemiology / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D012421:Rupture / Q000601:surgery; D012574:Schools; D017695:Soft Tissue Injuries; D014182:Transplantation, Autologous / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anterior cruciate ligament reconstruction; Fear of reinjury; Reinjury; Return to play; Rugby