BMJ Open Sport & Exercise Medicine (May 2023)

Musculoskeletal pain is not clearly associated with the risk of anterior cruciate ligament reconstruction in adolescents

  • John-Anker Zwart,
  • Kjersti Storheim,
  • Anne Marie Fenstad,
  • Maren Hjelle Guddal,
  • Marianne Bakke Johnsen,
  • Håvard Visnes,
  • Sofie Hammernes Strømme

DOI
https://doi.org/10.1136/bmjsem-2022-001453
Journal volume & issue
Vol. 9, no. 2

Abstract

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Objectives The purpose of this study was to investigate whether self-reported musculoskeletal pain (MSP) was associated with a future anterior cruciate ligament reconstruction (ACLR).Methods In this population-based prospective cohort study, we included 8087 participants from the adolescent part of the Trøndelag Health Study (Young-HUNT) in Norway. The exposure was self-reported MSP from the Young-HUNT3 study (2006–2008), which was categorised into two MSP load groups (high MSP and low MSP) based on frequency and number of pain sites. The outcome was ACLRs recorded in the Norwegian Knee Ligament Register between 2006 and 2019. Logistic regression was used to investigate association between MSP load and ACLR, given as ORs with 95% CIs. All tests were two-sided and p values of ≤0.05 were considered statistically significant.Results 8087 adolescents were included. We identified a total of 99 ACLRs, with 6 ACLRs (0.9%) in adolescents who reported high MSP load and 93 ACLRs (1.3%) among those who reported low MSP load. Adolescents reporting high MSP load had 23% lower odds of an ACLR (OR 0.77, 95% CI 0.31 to 1.91) compared with adolescents with low MSP load. However, the CIs were very wide.Conclusion Self-reported high MSP load in adolescents was not associated with increased risk of future ACLR. Although the number of participants was high, the relatively few cases of ACLR mean that we cannot be conclusive about the presence or absence of an association.