Key determinants of return to sport after anterior cruciate ligament reconstruction in snowboarders and skiers.

Altay, Nasuhi; Özdemir, Ekrem; Topsakal, Fatih Emre; Şahbat, Yavuz; Demirel, Esra · Knee · 2026

retrospective_cohort · Level III

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Abstract

Anterior cruciate ligament (ACL) injuries are common in winter sports. While ACL reconstruction (ACLR) restores stability, return to sport (RTS) is influenced by factors beyond surgery, including age, work-related loss, and psychological readiness. This retrospective single-center cohort study included 34 skiers/snowboarders undergoing primary ACLR (2019-2024). Demographic, occupational, and psychosocial data were compared between those who returned to pre-injury sport and those who did not. Multivariable logistic regression identified independent RTS predictors. Mean age was 31.3 ± 7.1 years; 47.1% returned to sport. Younger age (27.6 ± 6.4 vs. 34.6 ± 6.0 years, P = 0.003) and shorter return-to-work time (median 3.0 vs. 4.0 months, P < 0.001) were associated with RTS. Multivariable analysis showed age (odds ratio (OR) = 0.74, P = 0.040) and workforce loss (OR = 0.02, P = 0.005) were independent predictors, with workforce loss being the strongest. Kinesiophobia was not significant (P = 0.745). RTS after ACLR in winter athletes is multifactorial. Workforce loss and older age are major barriers, highlighting the need for early socioeconomic and occupational assessment in rehabilitation. A multidisciplinary approach addressing psychological and work-related constraints may optimize RTS.