The Socioeconomic Impact of Anterior Cruciate Ligament Injury: The Patients Perspective

Author(s): Charles Gamble, Mazyad Atassi, Lee Hoggett, Bilal Barkatali

Introduction: Anterior cruciate ligament (ACL) injuries have significant impact on patients. Knee function and return to sport post injury is well evidenced however personal financial impact and duration of time off work is less well known. This study evaluates the perceived socioeconomic impact to the patient following ACL injury treated with ACL reconstruction (ACLR).

Method: A retrospective case report of 92 patients who had ACLR between September 2014 and December 2022. Operative techniques included bone-patella tendon-bone graft, hamstring graft and quadriceps graft. Patients were contacted retrospectively via telephone and answered a standardised questionnaire. The primary outcome was socioeconomic impact of ACL injury. Secondary outcomes included: mean time off work, sick leave taken and return to sport.

Results: Patients took an average of 9 weeks off work (0-52 weeks), with 48% taking sick leave from work. Financial losses from work averaged £3581 (£300-£10,000). Furthermore, there was an average additional personal cost of £796 (£100-£3500) secondary to their injury. This was common for alternative travel arrangements. 90% of patients were able to return to playing some form of sport, taking an average of 56 weeks (8-208 weeks). 40% of participants returned at a reduced level and 25% returned at their preinjury level.

Discussion: Patient reported data on time away from work and personal financial loss following an ACL injury is scarce. This study provides key information that can inform surgeons when consulting patients on ACLR. Further studies are required to compare non operative and operative treatment modalities and their socioeconomic impact.